NURS 212 FINAL REVIEW QUESTIONS

We talked about two primary modifiable risk factors that contribute to hearing loss in older adults. List one of them.

Smoking and exposure to noise

What is the leading cause of hearing loss in older adults?

impacted cerumen

Shortening and fattening of intestinal villi in older adults leads to reduced absorption of which nutrients? Name one.

Calcium, Vit B12 and Folate

What is it called when a person has a persistent sensation of ringing, roaring, blowing, buzzing or other type of noise  in his ear that does not originate in the external environment?

Tinnitus

Hearing aids can be of great use in a hearing impaired adult. What is one scenario where they would NOT be helpful?

she didnt put answer lol but:

• In a situation where the socioeconomic factors of a client do not favour the acquisition of a hearing aid.

• In a situation where the older adult lives alone and does not have the dexterity or knowledge to operate, maintain, and position hearing aids properly.

• It is said to encourage older adults to use hearing aids in one-to-one conversations and to remove hearing aids in a larger setting

What is one age-related change in the digestive system of older adults that contributes to constipation?

Slower gastric and intestinal motility

Macular Degeneration results in loss of central vision or peripheral vision?

central

What is the Universal Falls Risk mneumonic and what do each of the letters stand for?

 

SAFE: Safe environment; Assist with Mobility; Falls and injury risk reduction; Engage patient and family

Progression of macular degeneration can be self-monitored with daily use of what?

an Amsler Grid

What is the leading cause of reversible blindness?

cataracts

There is one pathologic eye condition we discussed in class that was and is characterized by sudden onset severe eye pain, clouded or blurred vision, dilation of the pupil and nausea/ vomiting. What is it?

Acute closed-angle glaucoma, where the flow of aqueous humour is blocked suddenly

What is the name of the chart that is used to measure vision?

Snellen chart

What are two age-related changes to the digestive system of older adults?

a. Less efficient chewing

b.     Reduced senses of smell and taste

c.     Slower gastric motility

d.     Degenerative changes affecting digestion

e.     Less daily intake; fewer but higher quality calories

Give an example of a simple action an older adult can take to prevent or manage constipation.

a.     Increase fibre intake, increase fluid intake, avoid unnecessary opioid use

C-Diff is a bacterial infection of the intestines causing diarrhea. A significant risk factor for developing C-diff includes a history of frequent use of what type of medication?

antibiotics

What is dysphagia?

difficulty swallowing

If someone is in hospital with dysphagia, who is the professional (after the nurse screens) who does the in-depth swallowing assessment to determine diet?

A) Nutritionist B) Doctor  C) Speech Language Pathologist

C: Speech Language Pathologist

Older adults often experience dehydration because of limiting __________ to reduce incidence of incontinence.

fluid/liquid

According to Hirst, Lane, & Miller (2015), older adults living in residential care experience UTI’s 44-58% of the time. True or False.

TRUE

What is the single most common cause of preventable nosocomial infections in hospitals?

CAUTI: Catheter-Acquired Urinary Tract Infections

What are some health promotion interventions to reduce incidence of incontinence?

Continence products. Regular toileting

What does the Braden Scale assess?

Predict or risk for skin breakdown

What does the letter E stand for in the FHA Falls Prevention acronym SAFE?

Engage with family

Baroreceptors are less sensitive to changes in blood pressure, particularly with position changes, as individuals age. True or false:

TRUE

How is Tuberculosis spread?

droplet

List some non-pharmacologic comfort measures a nurse can provide to relieve pain in elderly patients?

she didnt put answer but i found this on ppt:

• Music therapy

• Pet therapy

• Biofeedback

• TENS (transcutaneous nerve stimulation, usually by PT)

• Body movement therapy

• Reposition

• Games and visits

• Gardening

• Favorite foods

• Therapeutic touch

• Counseling

• Art therapy

• Prayer and meditation

• Swimming or hydrotherapy

• Movement & stretches

• Heat and/or icing

• Herbal formulations

• Acupuncture/acupressure

What is the 5^th vital sign?

pain

What is the mneumonic nurses use to remember what items to assess in a comprehensive pain assessment?

LOTTAARRPP

True or false. Most cardiovascular disease is due to genetics.

False. Most CV disease is related to lifestyle choices, and as such, is modifiable, though it IS true that some CV disease is genetic

What are two differences between nociceptive and neuropathic pain?

• Generally reversible vs irreversible

• Usually well localized, constant, and often with an aching or throbbing quality vs burning, sharp and shooting

• Generally responds well to opioids vs generally doesn’t

What are two tools a nurse can use to assess and document pain?

a.     PAINAD

b.     Faces

c.     0-10

d.     Body mapping

When using the PAIN-AD for assessing pain in patients with Advanced Dementia, what are two of the five items being assessed?

a.     Breathing

b.     Negative vocalization

c.     Consolability

d.     Facial expression

e.     Body language

NSAIDs should be used cautiously in patients with a known history of what?

GI Bleed

When giving narcotics to the elderly, what is the motto that we follow?

Start low and go slow

What are two common side effects of most narcotic analgesics?

Constipation, sedation, respiratory suppression

What assessments are critical to perform when evaluating the effect of a narcotic analgesic?

Vital signs and a Pasero Sedation Scale

True or false: Opioid tolerance and physical dependence are expected with long-term opioid treatment and should not be confused with psychological dependence (addiction) which is a mental health concern.

True

When providing end-of-life care, what are two of the four items we talked about in class that you NEED to know?

a.     Advance directives?

b.     Diagnosis/ prognosis?

c.     Managing physical symptoms given diagnosis/ prognosis

d.     End of life plan?

True or false. Palliative care is specialized psychiatric care provided to individuals living with life-limiting illnesses.

False. Specialized medical care

Cancer is a class of diseases characterized by what?  

Out of control cell growth

What are the two different types of tumours an individual can have?

Benign or malignant

Most cancers are named after ________?

the body part in which they started

What is one type of cancer that has been linked to heredity?

Colon and Breast; retinoblastoma in kids

What are two screening tests for cancer that women are recommended to have?

a.     Mammogram Q2yrs 50-69 yrs

b.     Pelvic exam Q1yr x 3 negs then Q3yrs

What is a screening test recommended annually for men?

Digital Rectal Exam

What are the three different broad categories of treatment for cancer?

a.     Surgery

b.     Chemotherapy

c.     Radiation

What are the two possible goals of therapy to treat cancer:

Cure vs Palliation

What is a significant medical emergency when receiving chemotherapy?

Febrile Neutropenia

In Febrile Neutropenia, what is the hallmark presenting complaint?

fever

General principle of medication administration in the elderly?

Start low and go slow

What are some risk factors affecting cardiovascular function in older adults? 

a.     Atherosclerosis

b.     Physical inactivity

c.     Obesity

d.     Smoking

e.     Poor dietary habits

f.      HTN

g.     Lipid disorders

h.     Metabolic syndrome

1Orthostatic hypotension is a reduction in ____ mmHg systolic or _____ mmHg diastolic within three minutes of standing after being recumbent for at least five minutes.

20, 10

True of false. According to Miller, et al (2015), >50% of hospitalized older adults experience orthostatic hypotension.

she didnt put answer lol

What might an older adult experiencing symptomatic orthostatic hypotension complain of when standing?

lightheadedness, dizziness, fatigue, blurred vision

What is postprandial hypotension?

systolic BP reduction of 20mmHg or more within 2h of eating a meal

Describe how to conduct an assessment for orthostatic hypotension:

a.     Maintain the person’s arm in the same position.

b.     Obtain initial BP reading after the person has been sitting or lying for 5 mins.

c.     Obtain second BP reading after the person has been standing for 1-2 mins

Describe how to conduct an assessment for postprandial hypotension:

a.     Obtain initial BP reading before a meal

b. Obtain second and third readings at 15 minute intervals after the meal is completed

Older adults as well as women experience a high incidence of atypical chest pain. What are two atypical symptoms?

Nausea, fatigue, anxiety, headache, cough, visual disturbance, SOB and pain in the jaw/neck, throat

Due to a combination of age-related changes to the respiratory and immune systems, older adults are more prone to lower respiratory tract infections like pneumonia and influenza. True or false.

true

What is one piece of education that nurse’s can give to older adults to reduce their risk of developing either influenza or pneumonia?

Stop smoking. Immunize.

Fragility fractures occur primarily when older adults have what chronic condition?

Osteoporosis

What are some health promotion strategies nurses can suggest to older adults to reduce their risk of falling/ developing fractures with falls? 

hip protectors, non-slip socks/ shoes, walking with a walking aid, as needed, brakes on wheel chairs, etc

True or false. Older adults have less ability to thermoregulate than young adults?

true