Final Exam: NUR163/ NUR 163 (Latest
2023/ 2024 Update) Concepts of Practical
Nursing in the Care of Elderly Patients
Exam Review| Questions and Verified
Answers| Graded A – Hondros
Fatigue – ANSWER Subjective Measurement
If someone is having trouble sleeping, what intervention could we use? – ANSWER
Encourage pt to go outside, because sunlight helps with melatonin levels
What is a intervention for a older adult who is having trouble sleeping because of
a constant need to go to the bathroom – ANSWER Wear
depends (adult diapers)
A newley admitted patient is having multiple problems. What symptom do you
report first? – ANSWER Breathing
What is a primary sexual right? – ANSWER 2 consenting adults
To be effective communicators, nurses must… – ANSWER
Develop awareness of their own values and beliefs and the way they influence
their perception of patients’ experiences
Cultural Competence – ANSWER A set of behaviors that
includes understanding the impact of cultural values and beliefs on human
experiences, while maintaining awareness of own cultural values and their effect
on the perception of self and others.
Circadian – ANSWER From Latin word “about a day”
What is the average amount of sleep needed for people ages 20 to 60 years? –
ANSWER 7.5 hours
What body system controls sleep? – ANSWER Central Nervous
System
What causes older adults to feel sleepy earlier in the evening and to wake earlier
in the morning? Know as “phase advance” – ANSWER
Decreases in melatonin (which regulates the sleep-wake cycle) and growth
hormone (which promotes sleep) lead to a shift in circadian rhythm
Final Exam: NUR163/ NUR 163 (Latest
Update) Concepts of Practical Nursing in
the Care of Elderly Patients Exam
Review| Questions and Verified Answers|
Graded A – Hondros
What should a woman who already been through menopause report to their PCP
- ANSWER Vaginal Bleeding
What is common for a women who has given multiple vaginal births to
experience? – ANSWER Vaginal Prolapse
What should a patient do if they are experiencing urinary frequency, decreased
urine flow and nocturia? – ANSWER Schedule a prostate
examine for BPH
What happens with fragile capillaries? – ANSWER Senile
Purpura
What can commonly cause erectile dysfunction? – ANSWER
Diabetes
What is import we do as nurses for a residents’ sexual wellbeing? – ANSWER
Protect it
Due to a decreased immune response, who is at a higher risk for STI’s? –
ANSWER adults over 50
What should be used for vaginal dryness? – ANSWER water
based lubricant
Common reasons older adults refuse their annual physical exam? – ANSWER
a) Cost
b) Fear of what they may find
c) feel they do not need
d) lack of transportation
What you might find in a patient who is non adherent to medications? –
ANSWER a) getting worse not better
b) not progressing to wellness
c) thinks medication is not working
d) repeat complications
What kind of direct questions to use when you need to know something quickly? –
ANSWER Closed questions
What medication would a male possibly have taken if experiencing chest pains? –
ANSWER Viagra
How do you effective speak with older adults? – ANSWER
Simple terminology and effective communication
NUR 163 Final Concepts of Practical
Nursing in the Care of Elderly Patients
Exam Review| Questions and Verified
Answers| Graded A – Hondros
Nursing Interventions for skin integrity – ANSWER
turn q2h, use draw sheet, heels on pillows, bladder training
discharge instructions for cardiac patients – ANSWER
pace yourself
rest periods
conserve energy
UAP and fall prevention – ANSWER toilet q2h
no loose socks
physiological changes in older adults – ANSWER
decreased peristalsis
decreased cardiac output
Relocation Stress Syndrome – ANSWER pt
frequently irritable
pt stays in room
S/S of stress – ANSWER muscle tension
hyperventilation
decreased HR
dizziness
Patients at greatest risk of stress related problems – ANSWER
Also have chronic illness
loss of spouse
relocated
decreased income
screenings for older adults to assess stress – ANSWER
BMI
BP
cognitive
functional
potential nutritional complications for older adults – ANSWER
limited income
limited transportation
neighborhood only has convenience stores
external stressors – ANSWER heat, cold, noise,
light, physical trauma
intrinsic motivation – ANSWER internal
motivation
what do older adults fear the least – ANSWER
death
Ostomies – ANSWER change when 1/3 full
chronic fatigue syndrome – ANSWER lasts more
than 6 months and is accompanied by muscle and joint pain, headaches, and
sleep and memory problems
Exam 2: NUR163/ NUR 163 (Latest
Update) Concepts of Practical Nursing in
the Care of Elderly Patients Exam
Review| Questions and Verified Answers|
Graded A – Hondros
The nurse is caring for four patents today. Which finding should the nurse
immediately report to the RN? – ANSWER – Patient with positive
Chvostek’s signs
Which patient finding should cause the nurse to encourage oral (PO) fluid intake?
- – ANSWER Diarrhea
The home health nurse is visiting a patient and notices the unpaid caregiver is
having caregiver strain. The nurse knows, when communicating with the patient
unpaid caregiver praise is the best way to improve caregiver strain. Which of the
following would be the best response to the caregiver? – ANSWER
I’ve noticed all your time and effort with the patient. You are very important to
the healthcare team”
Which patient will the nurse determine to have potential for hypernatremia? –
ANSWER The patient who consumes excessive amount of table salt
The LPN is preparing to discuss a plan of care with a 72-year-old patient who is
hard of hearing. When communicating with the patient. What is the best
approach? – ANSWER Speak in a low pitch tone and face level with
the patient
patient arrives in the emergency department (ED) and is diagnosed with
hyperkalemia. The nurse will monitor the patient for which possible consequence
of hyperkalemia. – ANSWER Cardiac arrhythmias
Which of the following patients would least likely experience a fluid and
electrolyte imbalance? – ANSWER A 23-year-old with an upper
extremity bone fracture
The older adult is waiting for test results from their doctor develops nausea and
excessive gas. Which is the probable cause of these symptoms? – ANSWER
Slowing of peristalsis
Which nursing intervention would not be appropriate for a patient with fluid
volume excess? – ANSWER Increase in sodium intake
The nurse is obtaining a health history from a new resident at the assisted living
facility. The nurse knows it is important to ask which question regarding fluids and
electrolytes? – ANSWER What medications, including dietary
supplements, do you take?”
Which is true of an older adult who used coping skills effectively during his
younger years? – ANSWER They will continue to use similar coping
behaviors throughout
The LPN is providing teaching on the use of complimentary and alternative
therapies. Which statement by the geriatric patient shows an understanding of
Final Exam: NUR163/ NUR 163 (Latest
2023/ 2024 Update) Concepts of Practical
Nursing in the Care of Elderly Patients
Exam Review| Questions and Verified
Answers| Graded A – Hondros
What type of pain meds are ibuprofen and tylenol? – ANSWER
Analgesics
-anti-inflammatories
- muscle relaxers
What are the 3 types of prevention? – ANSWER Primary: prevents
illness before it begins
Secondary: catches illness and treats it before it worsens; screenings
Tertiary: Rehabilitation; After disease or injury is established
Elderly patients should have a well balanced diet with an intake around __
calories.
A) 1500
B) 2000
C) 1200
D) 1300 – ANSWER C) 1200
How much exercise should an elderly person get? – ANSWER 30
minutes a day
Ex – walking, gardening, swimming
How many times a day should the elderly brush their teeth?
A) 4
B) 3
C) 2
D) 1 – ANSWER C) 2
How close is intimate space?
A) 18-48 inches
B) 0-18 inches
C) 48 inches to 12 feet
D) greater than 12 feet – ANSWER B) 0-18 inches
How close is personal space?
A) 18-48 inches
B) 0-18 inches
C) 48 inches to 12 feet
D) greater than 12 feet – ANSWER A) 18-48 inches
How close is social space?
A) 18-48 inches
B) 0-18 inches
C) 48 inches to 12 feet
D) greater than 12 feet – ANSWER C) 48 inches to 12 feet
the partial or total loss of the ability to communicate
Affects the ability to understand/ express through words, gestures, and writing
use visual aids
Most common in older adults – ANSWER aphasia
How close is public space?
A) 18-48 inches
B) 0-18 inches
C) 48 inches to 12 feet
D) greater than 12 feet – ANSWER D) greater than 12 feet
Speaking to elderly like children
- uses terms like honey, dearie, and sweetie
patronizing/ demeaning way to speak to older adults
slow speech with simple vocabulary. – ANSWER elder speak
a slowly progressive decline in mental abilities, including memory, thinking, and
judgment, that is often accompanied by personality changes - causes both cognitive and language defects
- slow onset; uncurbable
- use gestures and Y/N questions
Caused by damage to cerebral cortex
Characteristics include: limited attention span, inability to focus on more than one
thing at a time, confusion of reality and fantasy, inability to follow complete
directions – ANSWER Dementia
Which type of diabetes is insulin dependent?
A) Type 1
B) Type 2 – ANSWER A) Type 1
NUR 163 Final Concepts of Practical
Nursing in the Care of Elderly Patients
Exam Review| Questions and Verified
Answers| Graded A – Hondros
If someone is in menopause for awhile and they have vaginal bleeding, should
it be reported? – ANSWER Yes
What is a uterine prolapse and when does it happen? – ANSWER
Usually happens after multiple vaginal births,
A hysterectomy is a treatment for – ANSWER
Multiple Vaginal Births
Signs and symptoms of an enlarged prostate: – ANSWER
Decreased urine output
Weak stream of urine
Nocturia
Frequent UTI’S
What happens if you see scattered bruising areas on patients fore arms –
ANSWER Normal Age related change for bruising,
this is due to capillaries becoming fragile
FVD – ANSWER causes- not enough in, too much out
(Lasix), alcohol, hypernatremia, D/V, sweating/hemorrhaging
S/S- Decrease in BP, increase ing HR, headache, dry mucous membranes,
confusion/altered mental status, concentrated urine, decreased UO, weak
thready pulse
Interventions- IV fluids (cautious of elderly, can cause pulmonary edema if
done too quickly), oral fluids, hold diuretic, treat underlying cause, monitor
i/o, monitor vitals, decrease sodium intake
stress – ANSWER s/s- decreased in immune resonse,
lose/gain weight, decrease output, increased frequency,
constipation/diarrhea, teeth grinding, mood swings
vitals- increased HR, BP, RR
fatiguues/insomnia, gastic ulcer, blood glucose increased
elderly and stress – ANSWER #1 cause – loss of
loved one- child unexpected
financial loss, loss of independence, lack of support. Elderly do not tend to
fear/stress about death themselves
at risk ineffective coping – ANSWER substance
abuse, tobacco, alcohol, prescriptions, cognitive impairment, poor coping in
younger years, poor support systems, chronic illness
Can normal age changes contribute to sexual dysfunction? – ANSWER
Yes
what is the most effective form to prevent STI’s besides abstinence? –
ANSWER Condoms
If an older female is experiencing vaginal dryness, what can we recommend? –
ANSWER Water Based lube and pain medication 30
minutes before
Exam 1: NUR163/ NUR 163 (Latest
Update) Concepts of Practical Nursing in
the Care of Elderly Patients Exam
Review| Questions and Verified Answers|
Graded A – Hondros
What is the biggest factor with patient education? – ANSWER
Motivation
How often should older adults get visual screenings? – ANSWER
Annually
What should toothpaste contain? – ANSWER floride
When re-positioning a patient what should be done to prevent pressure ulcers? –
ANSWER float the heels
If a patient scores a 60 on the morris fall scale what fall risk are they? –
ANSWER High fall risk
If a patient is a high fall risk, what kind of care should they get to prevent falls? –
ANSWER standards for moderate risk plus bed alarms
Who came up with the national patient safety goals? – ANSWER
Joint commission
What is a big factor in the ability of an older adult to do health maintenance? –
ANSWER losing a spouse
Home health aides cannot do anything with what? – ANSWER
medication
What is the minimum amount of exercise recommended of daily activity/exercise?
- ANSWER 30 mins a day
What type of prevention are immunizations? – ANSWER
primary prevention
What is a major communication barrier for the elderly? – ANSWER
medical terminology
What is one way to give a patient a sense of being a person? – ANSWER
engage patients in social conversations
What are some ways to communicate with the elderly? – ANSWER
bend down close to the patient
Exam 2: NUR163/ NUR 163 (Latest
Update) Concepts of Practical Nursing in
the Care of Elderly Patients Exam
Review| Questions and Verified Answers|
Graded A – Hondros
The nurse is caring for four patents today. Which finding should the nurse
immediately report to the RN? – ANSWER – Patient
with positive Chvostek’s signs
Which patient finding should cause the nurse to encourage oral (PO) fluid intake?
- – ANSWER Diarrhea
The home health nurse is visiting a patient and notices the unpaid caregiver is
having caregiver strain. The nurse knows, when communicating with the patient
unpaid caregiver praise is the best way to improve caregiver strain. Which of the
following would be the best response to the caregiver? – ANSWER
I’ve noticed all your time and effort with the patient. You are very important to the
healthcare team”
Which patient will the nurse determine to have potential for hypernatremia? –
ANSWER The patient who consumes excessive amount
of table salt
The LPN is preparing to discuss a plan of care with a 72-year-old patient who is
hard of hearing. When communicating with the patient. What is the best approach?
- ANSWER Speak in a low pitch tone and face level
with the patient
patient arrives in the emergency department (ED) and is diagnosed with
hyperkalemia. The nurse will monitor the patient for which possible consequence
of hyperkalemia. – ANSWER Cardiac arrhythmias
Which of the following patients would least likely experience a fluid and
electrolyte imbalance? – ANSWER A 23-year-old
with an upper extremity bone fracture
The older adult is waiting for test results from their doctor develops nausea and
excessive gas. Which is the probable cause of these symptoms? – ANSWER
Slowing of peristalsis
Which nursing intervention would not be appropriate for a patient with fluid
volume excess? – ANSWER Increase in sodium
intake
The nurse is obtaining a health history from a new resident at the assisted living
facility. The nurse knows it is important to ask which question regarding fluids and
electrolytes? – ANSWER What medications,
including dietary supplements, do you take?”
Exam 2: NUR163/ NUR 163 (Latest
Update) Concepts of Practical Nursing in
the Care of Elderly Patients Exam
Review| Questions and Verified Answers|
Graded A – Hondros
- Know the difference between ongoing partial, comprehensive, focused ad
emergency assessments
A nurse performs an assessment on a client who has been admitted to a long-term
care facility for physical rehabilitation. What is the term for this type of
assessment?
A home health care nurse takes the vital signs of a patient who is receiving
supplemental oxygen at home for chronic obstructive pulmonary disease (COPD).
This is the nurse’s fourth visit to the patient’s home. The nurse records the data
collected on the patient’s chart. What type of assessment has this nurse performed?
A home health nurse is visiting a patient who recently was hospitalized for repair
of a fractured hip. The patient tells the nurse, I have had a lot of pain in my
abdomen. What type of assessment would the nurse conduct? – ANSWER
Comprehensive assessment
An ongoing partial assessment, or follow-up assessment, is conducted at regular
intervals
focused - Position patient should be in for abdominal assessment
Which of the following positions should not be used to assess the abdomen? –
ANSWER supine,dorsal recumbent, sims
kneechest - how do you assess pupillary accommodation
To assess a client’s visual accommodation, the nurse has the client: – ANSWER
look at a close object, then look at a distant object - framework for focused assessment – ANSWER for
physicians and advanced nurse practitioners, used during focused assessment of
acutely/critically ill or determine function of a particular body area - purpose of documentation – ANSWER to expand nursing
knowledge and skills - steps of abdominal assessments- inspection, palpation, percussion, and
auscultation
During a physical assessment, a nurse inspects a patient’s abdomen. What
assessment technique would the nurse perform next? – ANSWER
c. When assessing the abdomen, the sequence is inspection, auscultation,
Hondros NUR 163 Final Concepts of
Practical Nursing in the Care of Elderly
Patients Exam Review| Questions and
Verified Answers| Graded A – Hondros
what are the stages of the grieving process – ANSWER
denial
anger
bargaining
depression acceptance
Why do older people reminisce? – ANSWER They
need to feel that their existence has made a difference. That their lives have had
purpose and meaning.
What does the older adult fear the most? – ANSWER
losing control and power over themselves
What food does the middle east like? – ANSWER
meat
rice
vegetables
chronic fatigue syndrome (CFS) – ANSWER A
medical condition characterized by long-term fatigue and other symptoms that
limit a person’s ability to carry out ordinary activities.
How to improve sleep in the elderly – ANSWER –
give a light snack
-turn off lights and TV
-mild exercise
bladder capacity cant change but the bladder tone may change – ANSWER
stress incontinence
what is the 18th months of the grieving stage? – ANSWER
the stages of denial
erectile dysfunction (ED) – ANSWER inability to
achieve erection of penis
primary assessment before beginning exercise – ANSWER
cardio
Nur 163- Final Exam Concepts of
Practical Nursing in the Care of
Elderly Patients Exam Review|
Questions and Verified Answers|
Graded A – Hondros
If a female is in menopause has sudden onset vaginal bleeding what do you do? –
ANSWER report it
when would a uterine prolapse be most likely to occur? – ANSWER
after multiple vaginal births
or when anything weakens the muscular tissues of the uterus
TX: hysterectomy
or can sling it back up
What are the signs and symptoms of an enlarged prostate? – ANSWER
decreased urine (stream)
painful urination
Nocturia
frequent urination
(you should also schedule an exam if any of these things should occur)
What does it mean if you see scattered bruises on the forearms of an older adult? –
ANSWER It is a normal sign of aging, as we age our capillaries become
more fragile.
(we bruise easier forearms especially, called Senile purpura)
What common circulation decreasing disease process in the older male population
can cause erectile dysfunction? – ANSWER Diabetes
If you are working in a LTCF and an older married couple are roomed together and
you walk in on them having sex, what should you do? – ANSWER
Provide Privacy
Put a Do Not Disturb sign on door
Do older adults get sexually transmitted diseases easier than younger
adults/teenagers? – ANSWER Yes, older adults are at a higher risk
because of their weakened immune systems.
Can normal age related changes contribute to sexual dysfunction? – ANSWER
yes, due to weakened circulation.
Besides abstinence what is the best way to avoid getting an STI? – ANSWER
Condoms (safe sex practices)
When an older adult female (menopausal) has painful(dryness) during sexual
intercourse, what could possibly alleviate this issue? – ANSWER water
soluble lubricant
Pain medications 30 minutes prior to sexual experience
Why do older adults procrastinate going to the doctor? – ANSWER Fear
No motivation
Transportation
Financially unstable
What would you question if an older adult is not adhering to a medication or TX
regimen? – ANSWER Ask them why?
Are they in denial?
Can you afford your tx?
Do you need transportation?
Do you understand why you need these TX?
Hondros NUR 163 exam 2 Concepts of
Practical Nursing in the Care of
Elderly Patients Exam Review|
Questions and Verified Answers|
Graded A – Hondros
Which type of exercises should the elderly/cardiac patients not take part in? –
ANSWER Isometric/isotonic exercises due to vagal response
When giving diuretics, which electrolyte do you supplement due to the smallest
margin of error? – ANSWER potassium
Which system controls stress on the body, or the Fight or Flight instinct? –
ANSWER parasympathetic system
stress on the body/mind – ANSWER negative emotions, insomnia,
alertness
stress causes: pupils – ANSWER dilate
stress causes: GI – ANSWER mouth is dry, dec. peristalsis, dec.
appetite, N/V, ulcers, heart burn
stress causes: heart – ANSWER inc. HR, inc. BP
stress causes: lungs – ANSWER inc. respirations, dilate
bronchioles, hyperventilation -> resp. alk.
stress causes: blood glucose – ANSWER increased
stress causes: insulin production – ANSWER decreased
stress causes: sex drive – ANSWER dec. libido
stress causes: urinary – ANSWER dec. output
stress causes: musculoskeletal – ANSWER tension, headache,
backache, sore muscles
stress causes: immune system – ANSWER dec. WBC count ->
cancer
stress causes: skin/hair – ANSWER acne, eczema, psoriasis, hair
loss
Relaxation Techniques for Stress Management – ANSWER
exercise, art therapy, music, prayer, meditation, reiki, breathing exercises,
massage
Nur 163 Exam 2 Concepts of Practical
Nursing in the Care of Elderly Patients
Exam Review| Questions and Verified
Answers| Graded A – Hondros
What is a sign of hypocalcemia that you want to report to the RN? – ANSWER
Chvostek and Trousseaus
What should you do if patient has diarrhea? – ANSWER Give
fluids
Encourage fluid intake
What findings would you encourage fluid intake? – ANSWER
Dehydration
Diarrhea
Hypernatremia
What should you do to unpaid caregivers? – ANSWER Give
them praise
Correct them if needed
Tell them they are part of the health care team
What causes hypernatremia? – ANSWER Over use of table
salt
Dehydration
Cardiac Arrhythmia
How to communicate to someone who is hard of hearing – ANSWER
Low pitch tone
Eye level / face level
See your lips
Stand on good side
What same sign and symptom dose hypokalemia and hyperkalemia have? –
ANSWER Cardiac Arrhythmia
Who has more of a chance to have a fluid imbalance? – ANSWER
Older adults – increase thirst
If patient have fluid volume excess what don’t you do? – ANSWER
Don’t increase fluids
Don’t increase sodium
Do older adults use the same coping skills as they did when they were younger
and are they still affective? – ANSWER Yes
Complementary and Alternative Therapies – ANSWER
Mediation
Imaginary
Drinking green tea
Massages
Acupuncture
When you have a older patient what age related complications would be related
to pain? – ANSWER Back pain
Bone demineralization