ACCC Final Exam Questions With
Complete Solutions
Common myths about older adults
Ill, disabled, unattractive, forgetful, confused, rigid, boring and unfriendly, unable to learn and understand new information
Truths about older adults
They are optimistic, good memories, broad social contacts and interests, tolerance for others, lifelong learners
Developmental tasks for older adults
• Adjusting to decreasing health and physical strength
• Adjusting to retirement and reduced or fixed income
• Adjusting to death of a spouse, children, siblings, friends
• Accepting self as aging person
• Maintaining satisfactory living arrangements
• Redefining relationships with adult children and siblings
• Finding ways to maintain quality of life
Changes of integumentary system of older adults
Loss of skin elasticity, fat loss in extremities, pigmentation changes, glandular atrophy, thinning hair, gray/white hair, increased facial fair in women, decreased in men, slower nail growth, atrophy of epidermal arterioles Changes of respiratory system in older adults
Decreased cough reflex, decreased ciliary activity, increased anterior-posterior chest diameter, increased chest wall rigidity, fewer alveoli, increased airway resistance
Cardiovascular changes of older adults
thickening of blood vessel walls , narrowing of vessel lumens , loss of vessel elasticity, lower cardiac output, decreased peripheral circulation, decreased number of heart muscle fibers, decreased elasticity of heart valves, decreased baroreceptor sensitivity, decreased efficiency of venous valves, increased systolic blood pressure,
GI changes of older adults
Periodontal disease, decreased saliva, decrease in saliva, gastric secretions and pancreatic enzymes; decreased peristalsis and small bowel motility; gastric atrophy, decreased intrinsic factor, increased stomach pH, hemorrhoids, rectal prolapse, impaired rectal sensation
Musculoskeletal
Decreased muscle mass and strength, decalcification of bones, degenerative joint changes, dehydration of intervertebral disks, fast tissue increases
Neurological changes in older adults Degeneration of nerve cells, decrease in neurotransmitters, decreased rate of conduction impulses
Eye changes in older adults
Decreased accommodation to near/far vision (presbyopia), difficulty adjusting to changes from light to dark, yellowing of the lens, altered color perception, increased sensitivity to glare, smaller pupils
ear changes in older adults
Loss of acuity for high-frequency tones (presbycusis), thickening of tympanic membrane, sclerosis of inner ear, buildup of earwax (cerumen)
Taste, smell, touch changes in older adults
Diminished taste; fewer taste buds
Diminished smell
Decreased skin receptors
Decreased proprioception
GU changes in older adults
Fewer nephrons, 50% decrease in renal blood flow by age 80, decreased bladder tone capacity, males have enlargement of their prostate, females have reduced sphincter tone
Reproductive changes in older adults
Males: sperm counts diminished, smaller testes, erections less firm and slow to develop Females: decreased estrogen, degeneration of ovaries, atrophy of
vagina, uterus and breasts, dryness of vaginal mucosa
Endocrine changes in older adults
General—alterations in hormone production with decreased ability to respond to stress
Thyroid—diminished secretions
Cortisol, glucocorticoids—increased anti-inflammatory hormone
Pancreas—increased fibrosis, decreased secretion of enzymes and hormones, decreased sensitivity to insulin
Immunity changes in older adults
Thymus decreases in size and volume, T cell function decreases,
core temperature elevation is lowered
What change in the neurological system suggests pathology ?
Changed cognition or dementia
Three main points during older adult assessments
Interrelation between physical disease and psychosocial aspects of aging
Effects of disease and disability on a patients current functional status
Tailoring the nursing assessment to an older adult
Tailoring assessment to older adults
Assessment takes more time because of longer history, allow for
rest periods and conduct physical exam in multiple sessions.
Complete Solutions
Common myths about older adults
Ill, disabled, unattractive, forgetful, confused, rigid, boring and unfriendly, unable to learn and understand new information
Truths about older adults
They are optimistic, good memories, broad social contacts and interests, tolerance for others, lifelong learners
Developmental tasks for older adults
• Adjusting to decreasing health and physical strength
• Adjusting to retirement and reduced or fixed income
• Adjusting to death of a spouse, children, siblings, friends
• Accepting self as aging person
• Maintaining satisfactory living arrangements
• Redefining relationships with adult children and siblings
• Finding ways to maintain quality of life
Changes of integumentary system of older adults
Loss of skin elasticity, fat loss in extremities, pigmentation changes, glandular atrophy, thinning hair, gray/white hair, increased facial fair in women, decreased in men, slower nail growth, atrophy of epidermal arterioles Changes of respiratory system in older adults
Decreased cough reflex, decreased ciliary activity, increased anterior-posterior chest diameter, increased chest wall rigidity, fewer alveoli, increased airway resistance
Cardiovascular changes of older adults
thickening of blood vessel walls , narrowing of vessel lumens , loss of vessel elasticity, lower cardiac output, decreased peripheral circulation, decreased number of heart muscle fibers, decreased elasticity of heart valves, decreased baroreceptor sensitivity, decreased efficiency of venous valves, increased systolic blood pressure,
GI changes of older adults
Periodontal disease, decreased saliva, decrease in saliva, gastric secretions and pancreatic enzymes; decreased peristalsis and small bowel motility; gastric atrophy, decreased intrinsic factor, increased stomach pH, hemorrhoids, rectal prolapse, impaired rectal sensation
Musculoskeletal
Decreased muscle mass and strength, decalcification of bones, degenerative joint changes, dehydration of intervertebral disks, fast tissue increases
Neurological changes in older adults Degeneration of nerve cells, decrease in neurotransmitters, decreased rate of conduction impulses
Eye changes in older adults
Decreased accommodation to near/far vision (presbyopia), difficulty adjusting to changes from light to dark, yellowing of the lens, altered color perception, increased sensitivity to glare, smaller pupils
ear changes in older adults
Loss of acuity for high-frequency tones (presbycusis), thickening of tympanic membrane, sclerosis of inner ear, buildup of earwax (cerumen)
Taste, smell, touch changes in older adults
Diminished taste; fewer taste buds
Diminished smell
Decreased skin receptors
Decreased proprioception
GU changes in older adults
Fewer nephrons, 50% decrease in renal blood flow by age 80, decreased bladder tone capacity, males have enlargement of their prostate, females have reduced sphincter tone
Reproductive changes in older adults
Males: sperm counts diminished, smaller testes, erections less firm and slow to develop Females: decreased estrogen, degeneration of ovaries, atrophy of
vagina, uterus and breasts, dryness of vaginal mucosa
Endocrine changes in older adults
General—alterations in hormone production with decreased ability to respond to stress
Thyroid—diminished secretions
Cortisol, glucocorticoids—increased anti-inflammatory hormone
Pancreas—increased fibrosis, decreased secretion of enzymes and hormones, decreased sensitivity to insulin
Immunity changes in older adults
Thymus decreases in size and volume, T cell function decreases,
core temperature elevation is lowered
What change in the neurological system suggests pathology ?
Changed cognition or dementia
Three main points during older adult assessments
Interrelation between physical disease and psychosocial aspects of aging
Effects of disease and disability on a patients current functional status
Tailoring the nursing assessment to an older adult
Tailoring assessment to older adults
Assessment takes more time because of longer history, allow for
rest periods and conduct physical exam in multiple sessions.
