NR 226 Exam 2 – Nursing Leadership & Management Practice Questions and
Study Guide
Chapter 14: Older Adults - ANS ✔✔Over the age of 65- many adults in their 70s consider
themselves middle-aged
everyone ages at their own rates- lots of variation in the age group
Presbyopia - ANS ✔✔vision loss due to aging
pupils are smaller and react slower
presbycusis - ANS ✔✔age related hearing loss- affects the ability to hear high pitched sounds
and conversational speech
affects more men than women
Delirium - ANS ✔✔Acute confusional state- a potentially reversible cognitive impairment that
can be caused from electrolyte imbalances, untreated pain, infection, cerebral anoxia,
hypoglycemia, medication effects, tumors, subdural hematoma, and brain bleed or
hemorrhage- can also accompany pneumonia or a UTI- also can be from sleep deprivation
is a medical emergency
Dementia - ANS ✔✔Generalized impairment of intellectual functioning
gradual, progressive, and irreversible cerebral dysfunction
,-Alzheimer's is a form
Depression - ANS ✔✔A mood disturbance characterized by feelings of sadness and despair
most common yet is most untreated and undetected impairment in older adulthood
can be acute or chronic
Health - ANS ✔✔Heart disease is the leading cause of death in older adults, next is cancer,
chronic lung disease, and stroke
COPD caused by tobacco smoke causes progression
*hypertension and pain are not normal signs of aging
Restorative Care - ANS ✔✔Care for adults is either for continuing recovery from acute illness or
addressing chronic conditions that affect daily functioning
the goal is to regain or improve prior level of independence, and ADLs
Chapter 43: Sleep - ANS ✔✔some patients have preexisting sleep disturbances and others
develop sleep problems as a result of an illness or hospitalization
Circadian Rhythms (diurnal) - ANS ✔✔day-night cycle- controlled by the hypothalamus
the biological rhythm of sleep frequently becomes synchronized with other body functions
,affected by light, temperature, social activities, and work routines
circadian cycle controls body temperature, heart rate, blood pressure, hormone secretions,
sensory acuity, and mood predictable changes
sleeping promotes healing and regulates metabolism
Stages of the Adult Sleep Cycle - ANS ✔✔1. Presleep: the person is aware only of a gradually
developing sleepiness- normally lasts 10 to 30 minutes (can last hours in person with difficulty
sleeping)
Once asleep, normally pass through 4 or 5 complete sleep cycles per night- each consist of 4
stages of NREM and a period of REM- a cycle lasts 90 to 100 minutes
NREM stage 1- NREM stage 2- NREM stage 3- NREM stage 4- NREM stage 3- NREM stage 2- REM
sleep- NREM stage 2, 3, 4 ,3, 2, rem, etc.
usually hit REM sleep after 90 minutes, with 75-80% of sleep being in NREM
Non-Rapid Eye Movement Stages (NREM) - ANS ✔✔Stage 1: when the patient starts to fall
asleep, decrease in pulse, decrease in bp, decrease in RR, decrease in brainwaves, very light
sleep, eyes rolling side to slide, lasts for a few minutes
Stage 2: light sleep- can be easily aroused, BP starts to drop, everything continues to decrease
Stage 3: medium depth sleep- not easily aroused, rates are all still dropping, snoring occurs
, Stage 4: Delta sleep, or deep sleep- very difficult to arouse, rarely moving, muscles are
completely relaxed, dreaming may or may not occur- the body releases HGH for repair and
renewal or epithelial and brain cells
dreams can occur during REM AND NREM but are more vivid and elaborate during REM
Sleep disorders - ANS ✔✔conditions that, if untreated, generally cause disturbed nighttime
sleep that results in one of three problems: insomnia, abnormal movements or sensation during
sleep or when awakening at night, or excessive daytime sleepiness (Hypersomnolence)
Parasomnias - ANS ✔✔undesirable behaviors that occur usually during sleep
Polysomnogram - ANS ✔✔uses EEG, EMG, and EOG to monitor stages of sleep and wakefulness
during the night
Recommended Hours of Sleep - ANS ✔✔infants: 16+ hours a day
toddlers: 11-12 hours on average per day- lots of naps
preschoolers: 12 hours a night
School age: 9-10 hours
Adolescents: about 7.5 hours
Teens: 8-10 hours
young adults: 6 to 8.5 hours
older adults: 6 hours or less
Sleep Disorders - ANS ✔✔Insomnia: adjustment sleep disorder (acute insomnia), inadequate
sleep hygiene, behavioral insomnia of childhood, insomnia caused by medical condition
Study Guide
Chapter 14: Older Adults - ANS ✔✔Over the age of 65- many adults in their 70s consider
themselves middle-aged
everyone ages at their own rates- lots of variation in the age group
Presbyopia - ANS ✔✔vision loss due to aging
pupils are smaller and react slower
presbycusis - ANS ✔✔age related hearing loss- affects the ability to hear high pitched sounds
and conversational speech
affects more men than women
Delirium - ANS ✔✔Acute confusional state- a potentially reversible cognitive impairment that
can be caused from electrolyte imbalances, untreated pain, infection, cerebral anoxia,
hypoglycemia, medication effects, tumors, subdural hematoma, and brain bleed or
hemorrhage- can also accompany pneumonia or a UTI- also can be from sleep deprivation
is a medical emergency
Dementia - ANS ✔✔Generalized impairment of intellectual functioning
gradual, progressive, and irreversible cerebral dysfunction
,-Alzheimer's is a form
Depression - ANS ✔✔A mood disturbance characterized by feelings of sadness and despair
most common yet is most untreated and undetected impairment in older adulthood
can be acute or chronic
Health - ANS ✔✔Heart disease is the leading cause of death in older adults, next is cancer,
chronic lung disease, and stroke
COPD caused by tobacco smoke causes progression
*hypertension and pain are not normal signs of aging
Restorative Care - ANS ✔✔Care for adults is either for continuing recovery from acute illness or
addressing chronic conditions that affect daily functioning
the goal is to regain or improve prior level of independence, and ADLs
Chapter 43: Sleep - ANS ✔✔some patients have preexisting sleep disturbances and others
develop sleep problems as a result of an illness or hospitalization
Circadian Rhythms (diurnal) - ANS ✔✔day-night cycle- controlled by the hypothalamus
the biological rhythm of sleep frequently becomes synchronized with other body functions
,affected by light, temperature, social activities, and work routines
circadian cycle controls body temperature, heart rate, blood pressure, hormone secretions,
sensory acuity, and mood predictable changes
sleeping promotes healing and regulates metabolism
Stages of the Adult Sleep Cycle - ANS ✔✔1. Presleep: the person is aware only of a gradually
developing sleepiness- normally lasts 10 to 30 minutes (can last hours in person with difficulty
sleeping)
Once asleep, normally pass through 4 or 5 complete sleep cycles per night- each consist of 4
stages of NREM and a period of REM- a cycle lasts 90 to 100 minutes
NREM stage 1- NREM stage 2- NREM stage 3- NREM stage 4- NREM stage 3- NREM stage 2- REM
sleep- NREM stage 2, 3, 4 ,3, 2, rem, etc.
usually hit REM sleep after 90 minutes, with 75-80% of sleep being in NREM
Non-Rapid Eye Movement Stages (NREM) - ANS ✔✔Stage 1: when the patient starts to fall
asleep, decrease in pulse, decrease in bp, decrease in RR, decrease in brainwaves, very light
sleep, eyes rolling side to slide, lasts for a few minutes
Stage 2: light sleep- can be easily aroused, BP starts to drop, everything continues to decrease
Stage 3: medium depth sleep- not easily aroused, rates are all still dropping, snoring occurs
, Stage 4: Delta sleep, or deep sleep- very difficult to arouse, rarely moving, muscles are
completely relaxed, dreaming may or may not occur- the body releases HGH for repair and
renewal or epithelial and brain cells
dreams can occur during REM AND NREM but are more vivid and elaborate during REM
Sleep disorders - ANS ✔✔conditions that, if untreated, generally cause disturbed nighttime
sleep that results in one of three problems: insomnia, abnormal movements or sensation during
sleep or when awakening at night, or excessive daytime sleepiness (Hypersomnolence)
Parasomnias - ANS ✔✔undesirable behaviors that occur usually during sleep
Polysomnogram - ANS ✔✔uses EEG, EMG, and EOG to monitor stages of sleep and wakefulness
during the night
Recommended Hours of Sleep - ANS ✔✔infants: 16+ hours a day
toddlers: 11-12 hours on average per day- lots of naps
preschoolers: 12 hours a night
School age: 9-10 hours
Adolescents: about 7.5 hours
Teens: 8-10 hours
young adults: 6 to 8.5 hours
older adults: 6 hours or less
Sleep Disorders - ANS ✔✔Insomnia: adjustment sleep disorder (acute insomnia), inadequate
sleep hygiene, behavioral insomnia of childhood, insomnia caused by medical condition
