NR 226 Nurse Fundamentals Exam 2 – Elderly Care, Sleep & Electrolytes Nursing Review Guide
and Practice Questions
What is contributing to the increase in the older adult population? - ANS ✔✔increase in average
life span, the baby boomers, the growth of the population segment older than 85 years.
True or false, most older adults are inactive and can not care for themselves. - ANS ✔✔false:
Most older adults are active and involved members of their communities. A smaller number
have lost the ability to care for themselves, are confused or withdrawn, and/or are unable to
make decisions concerning their needs. Most older adults live in noninstitutional settings.
However, a smaller number have lost the ability to care for themselves.
True or false: Aging is directly correlated to disability and dependence of older adults. - ANS
✔✔Most older adults are active and involved members of their communities. A smaller number
have lost the ability to care for themselves, are confused or withdrawn, and/or are unable to
make decisions concerning their needs. Most older adults live in noninstitutional settings.
However, a smaller number have lost the ability to care for themselves.
What do you encourage the older population during your plan of care? - ANS ✔✔Do not
assume that all older adults have signs, symptoms, or behaviors representing disease and
decline or that these are the only factors you need to assess. You also need to identify an older
adult's strengths and abilities during the assessment and encourage independence as an
integral part of your plan of care
What is ageism? - ANS ✔✔discrimination against people because of increasing age.
what are some myths about older people? - ANS ✔✔they are disabled, unattractive, forgetful,
confused, rigid, boring, unfriendly, poor, unable to learn and understand new information, not
interested in sex, etc
What are some developmental tasks for older adults? - ANS ✔✔Change and loss of : Health,
significant others, a sense of being useful, socialization, income, and independent living
,Coping with: Retirement, Residence change, Death
Having: Adult children
You are doing an assessment of an elderly patient and he is having trouble understanding you.
Would you conclude he is confused? - ANS ✔✔If an older adult is unable to understand your
visual or auditory cues, your assessment data will likely be inaccurate or misleading, leading you
to incorrectly conclude that the older adult is confused.
How would you speak with a person with hearing impairment? - ANS ✔✔When a person has a
hearing impairment, speak directly to the patient in clear, low-pitched tones and move to a
quiet area to reduce background noise.
how would you care for a patient with vision impairment? - ANS ✔✔When caring for people
with visual impairments, sit or stand at eye level and face them. Always encourage the use of
assistive devices such as glasses and hearing aids.
Your patient is having trouble remembering things during his history. What can you do to
complete a through assessment? - ANS ✔✔Memory deficits, if present, affect the accuracy and
completeness of your assessment; may need to enlist help of family member or caregiver. The
additional person supplements information with the consent of the older adult, but the older
adult remains the primary source of the interview.
What should you look for in the elderly as early indicators of acute illness? - ANS ✔✔Note
changes in mental status, occurrence and reason for falls, dehydration, decrease in appetite,
loss of function, dizziness, and incontinence because these symptoms are not frequently
present in younger adults.
What are some physiological changes of skin in older adults? - ANS ✔✔With aging the skin loses
resilience and moisture. The epithelial layer thins, and elastic collagen fibers shrink and become
,rigid. Wrinkles of the face and neck reflect lifelong patterns of muscle activity and facial
expressions, the pull of gravity on tissue, and diminished elasticity. Spots and lesions are often
present on the skin.
What are some changes in elderly vision? - ANS ✔✔Visual acuity declines with age. This is often
the result of retinal damage, reduced pupil size, development of opacities in the lens, or loss of
lens elasticity.
Presbyopia, is common.
Glare effects increase.
Pupils are smaller and react slower.
Difficulty with going from bright to dark environments.
Changes in color vision makes it difficult to distinguish between blue and green.
Diseases include cataract, macular degeneration, diabetic retinopathy, and retinal detachment.
What are some changes in elderly hearing? - ANS ✔✔Auditory changes are often subtle.
Common change is presbycusis, which affects the ability to hear high-pitched sounds and
conversational speech and is typically bilateral, affecting more men than women. Inspect the
external auditory canal for the presence of cerumen.
What are some changes in elderly tasting? - ANS ✔✔Salivary secretion is reduced, and taste
buds atrophy and lose sensitivity. Health conditions, treatments, and/or medications often alter
taste. It is often a challenge to promote optimal nutrition in an older patient because of the loss
of smell and changes in taste.
What are some changes in elderly thorax and lungs? - ANS ✔✔Because of changes in the
musculoskeletal system, the configuration of the thorax sometimes changes. Vertebral changes
caused by osteoporosis lead to dorsal kyphosis, the curvature of the thoracic spine. Calcification
, of the costal cartilage causes decreased mobility of the ribs. The chest wall gradually becomes
stiffer. Lung expansion decreases, and the person is less able to cough deeply. If kyphosis or
chronic obstructive lung disease is present, breath sounds become distant. Older adult is more
susceptible to pneumonia and other bacterial or viral infections.
Respiratory muscle strength decreases
anteroposterior diameter of thorax increases
What are some changes in elderly heart and vascular system? - ANS ✔✔The body tries to
compensate for decreased cardiac output by increasing the heart rate during exercise; takes
longer for an older adult's rate to return to baseline. Systolic and/or diastolic blood pressures
are sometimes abnormally high. Although a common chronic condition, hypertension is not a
normal aging change and predisposes older adults to heart failure, stroke, renal failure,
coronary heart disease, and peripheral vascular disease.
decreased contractile strength of the myocardium which leads to decrease in cardiac output.
Peripheral pulses frequently are still palpable but weaker in lower extremities.
What are some physiological changes in elderly breast? - ANS ✔✔As estrogen production
diminishes, the milk ducts of the breasts are replaced by fat, making breast tissue less firm.
Decreased muscle mass, tone, and elasticity result in smaller breasts in older women. In
addition, the breasts sag. Gynecomastia, enlarged breasts in men, is often the result of
medication side effects, hormonal changes, or obesity. Both older men and women are at risk of
breast cancer.
What are some physiological changes in elderly GI and abdomen? - ANS ✔✔Abdomen increases
in size due to an increase in the amount of fatty tissue in the trunk. Because muscle tone and
elasticity decrease, it also becomes more protuberant. Gastrointestinal function changes include
a slowing of peristalsis and alterations in secretions. Alterations in the lower gastrointestinal
tract lead to constipation, flatulence, or diarrhea.
and Practice Questions
What is contributing to the increase in the older adult population? - ANS ✔✔increase in average
life span, the baby boomers, the growth of the population segment older than 85 years.
True or false, most older adults are inactive and can not care for themselves. - ANS ✔✔false:
Most older adults are active and involved members of their communities. A smaller number
have lost the ability to care for themselves, are confused or withdrawn, and/or are unable to
make decisions concerning their needs. Most older adults live in noninstitutional settings.
However, a smaller number have lost the ability to care for themselves.
True or false: Aging is directly correlated to disability and dependence of older adults. - ANS
✔✔Most older adults are active and involved members of their communities. A smaller number
have lost the ability to care for themselves, are confused or withdrawn, and/or are unable to
make decisions concerning their needs. Most older adults live in noninstitutional settings.
However, a smaller number have lost the ability to care for themselves.
What do you encourage the older population during your plan of care? - ANS ✔✔Do not
assume that all older adults have signs, symptoms, or behaviors representing disease and
decline or that these are the only factors you need to assess. You also need to identify an older
adult's strengths and abilities during the assessment and encourage independence as an
integral part of your plan of care
What is ageism? - ANS ✔✔discrimination against people because of increasing age.
what are some myths about older people? - ANS ✔✔they are disabled, unattractive, forgetful,
confused, rigid, boring, unfriendly, poor, unable to learn and understand new information, not
interested in sex, etc
What are some developmental tasks for older adults? - ANS ✔✔Change and loss of : Health,
significant others, a sense of being useful, socialization, income, and independent living
,Coping with: Retirement, Residence change, Death
Having: Adult children
You are doing an assessment of an elderly patient and he is having trouble understanding you.
Would you conclude he is confused? - ANS ✔✔If an older adult is unable to understand your
visual or auditory cues, your assessment data will likely be inaccurate or misleading, leading you
to incorrectly conclude that the older adult is confused.
How would you speak with a person with hearing impairment? - ANS ✔✔When a person has a
hearing impairment, speak directly to the patient in clear, low-pitched tones and move to a
quiet area to reduce background noise.
how would you care for a patient with vision impairment? - ANS ✔✔When caring for people
with visual impairments, sit or stand at eye level and face them. Always encourage the use of
assistive devices such as glasses and hearing aids.
Your patient is having trouble remembering things during his history. What can you do to
complete a through assessment? - ANS ✔✔Memory deficits, if present, affect the accuracy and
completeness of your assessment; may need to enlist help of family member or caregiver. The
additional person supplements information with the consent of the older adult, but the older
adult remains the primary source of the interview.
What should you look for in the elderly as early indicators of acute illness? - ANS ✔✔Note
changes in mental status, occurrence and reason for falls, dehydration, decrease in appetite,
loss of function, dizziness, and incontinence because these symptoms are not frequently
present in younger adults.
What are some physiological changes of skin in older adults? - ANS ✔✔With aging the skin loses
resilience and moisture. The epithelial layer thins, and elastic collagen fibers shrink and become
,rigid. Wrinkles of the face and neck reflect lifelong patterns of muscle activity and facial
expressions, the pull of gravity on tissue, and diminished elasticity. Spots and lesions are often
present on the skin.
What are some changes in elderly vision? - ANS ✔✔Visual acuity declines with age. This is often
the result of retinal damage, reduced pupil size, development of opacities in the lens, or loss of
lens elasticity.
Presbyopia, is common.
Glare effects increase.
Pupils are smaller and react slower.
Difficulty with going from bright to dark environments.
Changes in color vision makes it difficult to distinguish between blue and green.
Diseases include cataract, macular degeneration, diabetic retinopathy, and retinal detachment.
What are some changes in elderly hearing? - ANS ✔✔Auditory changes are often subtle.
Common change is presbycusis, which affects the ability to hear high-pitched sounds and
conversational speech and is typically bilateral, affecting more men than women. Inspect the
external auditory canal for the presence of cerumen.
What are some changes in elderly tasting? - ANS ✔✔Salivary secretion is reduced, and taste
buds atrophy and lose sensitivity. Health conditions, treatments, and/or medications often alter
taste. It is often a challenge to promote optimal nutrition in an older patient because of the loss
of smell and changes in taste.
What are some changes in elderly thorax and lungs? - ANS ✔✔Because of changes in the
musculoskeletal system, the configuration of the thorax sometimes changes. Vertebral changes
caused by osteoporosis lead to dorsal kyphosis, the curvature of the thoracic spine. Calcification
, of the costal cartilage causes decreased mobility of the ribs. The chest wall gradually becomes
stiffer. Lung expansion decreases, and the person is less able to cough deeply. If kyphosis or
chronic obstructive lung disease is present, breath sounds become distant. Older adult is more
susceptible to pneumonia and other bacterial or viral infections.
Respiratory muscle strength decreases
anteroposterior diameter of thorax increases
What are some changes in elderly heart and vascular system? - ANS ✔✔The body tries to
compensate for decreased cardiac output by increasing the heart rate during exercise; takes
longer for an older adult's rate to return to baseline. Systolic and/or diastolic blood pressures
are sometimes abnormally high. Although a common chronic condition, hypertension is not a
normal aging change and predisposes older adults to heart failure, stroke, renal failure,
coronary heart disease, and peripheral vascular disease.
decreased contractile strength of the myocardium which leads to decrease in cardiac output.
Peripheral pulses frequently are still palpable but weaker in lower extremities.
What are some physiological changes in elderly breast? - ANS ✔✔As estrogen production
diminishes, the milk ducts of the breasts are replaced by fat, making breast tissue less firm.
Decreased muscle mass, tone, and elasticity result in smaller breasts in older women. In
addition, the breasts sag. Gynecomastia, enlarged breasts in men, is often the result of
medication side effects, hormonal changes, or obesity. Both older men and women are at risk of
breast cancer.
What are some physiological changes in elderly GI and abdomen? - ANS ✔✔Abdomen increases
in size due to an increase in the amount of fatty tissue in the trunk. Because muscle tone and
elasticity decrease, it also becomes more protuberant. Gastrointestinal function changes include
a slowing of peristalsis and alterations in secretions. Alterations in the lower gastrointestinal
tract lead to constipation, flatulence, or diarrhea.
