NUR 255 Final Exam Review (2026) | Units 9–12 | Aging & Mental Health Nursing

NUR 255
FINAL EXAM REVIEW
(Covers Units 9, 10 & 11/12)
Concepts of Aging, Chronic Illness & Mental Health
Nursing - Galen College of Nursing

, UNIT 9
Chapter 41: assessment of the nervous system, age related changes in the older adult, pg.
845
Changes in the nervous system related to aging:
 Slower processing time
o Provide sufficient time for the affected older adult to respond to questions and/or
direction
 Recent memory loss
o Reinforce teaching by repetition, using written teaching and memory aids such as
electronic alarms or applications for electronic devices that provide recurrent
alarms
 Decreased sensory perception of touch
o Remind the patient to look where his or her feet are placed when walking
o Instruct the patient to wear shoes that provide good support when walking
o If the patient is unable, change his or her position frequently (every hour) while
he or she is in the bed or chair
 Change in perception of pain
o Ask the patient to describe the nature and specific characteristics of pain
o Monitor additional assessment variable to detect possible health problems
 Change in sleep patterns
o Ascertain sleep patterns and preferences, ask if sleep pattern interferes with ADLs
o Adjust the patient’s daily schedule to his or her sleep pattern and preference as
much as possible (i.e. evening vs. morning bath)
 Altered balance and/or decreased coordination
o Instruct the patient to move slowly when changing positions
o If needed, advise the patient to hold onto handrails when ambulating
o Assess the need for an ambulatory aid, such as a cane
 Increased risk for infection
o Monitor carefully for infection
 Changes in sleep patterns
o Assess sleep habits
o Provide usual bedtime routines
o Decrease noise and light at night
Chapter 42: care of patients with problems of the central nervous system: the brain,
epilepsy, pg. 876-880; Parkinson’s, pg. 868-873
A seizure is an abnormal, sudden, excessive, uncontrolled electrical discharge of neurons within
the brain that may result in a change in LOC, motor or sensory ability, and/or behavior.

,Epilepsy is two or more seizures experienced by a person, it is a chronic disorder, can be caused
by an abnormality in electrical neuronal activity; an imbalance of neurotransmitters, especially
gamma aminobutyric acid (GABA); or a combination of both.
Five types of general seizures may occur in adults and involve both cerebral hemispheres.
 Generalized seizures
o Tonic-clonic seizures
 lasts 2-5 minutes
 tonic phase that causes stiffening or rigidity of the muscles, particularly of
the arms and legs
 immediate loss of consciousness
 clonic or rhythmic jerking of all extremities follows
 the pt. may bite his or her tongue and become incontinent of urine or feces
 fatigue, acute confusion, and lethargy may last up to an hour after the
seizure
o Tonic seizure
 autonomic changes lasting 30 seconds to several minutes
 an abrupt increase in muscle tone
 loss of consciousness
o Clonic seizure
 lasts several minutes
 causes muscle contraction and relaxation
o Myoclonic seizures
 lasting for just a few seconds
 cause a brief jerking or stiffening of the extremities that may occur singly
or in groups
 the contractions by be symmetric or asymmetric.
o Atonic seizures (akinetic seizures)
 lasting for seconds, followed by postictal confusion
 the patient has a sudden loss of muscle tone
 these cause the pt. to fall, which can result in injury
 tends to be the most resistant to drug therapy
 Partial seizures (focal or local seizures)
 begin in a part of one cerebral hemisphere
 some partial seizures can become generalized tonic-clonic, tonic, or clonic
seizures
o Complex partial seizures (psychomotor or temporal lobe seizures)
 may cause loss of consciousness or a blackout for 1-3 minutes
 characteristic automatism may occur as in absence seizures
 the patient is unaware of the environment and may wander at the start of
the seizure
 he or she may have amnesia because the area of the brain most often
involved is the temporal lobe

, o Simple partial seizures
 remain conscious throughout the episode
 he or she often reports an aura (unusual sensation) before the seizure takes
place
 auras may consist of “déjà vu” (already seen) phenomenon,
perception of an offensive smell, or sudden onset of pain
 during the seizure the pt. may have one-sided movement of an extremity,
experience unusual sensations, or have autonomic symptoms
 autonomic symptoms can be a change in heart rate, skin flushing,
and epigastric discomfort
 Unclassified seizures (idiopathic seizures)
o account for about half of all seizure activity
o occur for no reason
o do not fit into the generalized or partial classifications
FLASHING RED SIGN- change in LOC or mental status most reliable indicator of impending
seizure!!!!!!!
Secondary seizures (not considered epilepsy):
 underlying brain trauma, lesions, tumors
 metabolic disorders
 acute alcohol withdraws
 electrolyte disturbances (i.e., hyperkalemia, water intoxication, hypoglycemia)
 high fever
 stroke
 head injury
 substance abuse
 heart disease
Triggers of seizures:
 stress
 alcohol
 fatigue (not sleeping)
 foods and chemicals
Auras (preictal phase):
 unusual feeling
 abnormal sensations
 déjà vu
 perception of an offensive smell
 dizziness
 headache
 numbness