1
NR 601 Midterm Exam Study
Guide Weeks 1-4 content
Week 1: Reading: Complete
Dunphy, L.M., Winland-Brown, J. E., Porter, B.O. & Thomas, D.J. (2019). Primary Care-The art and
science of Advanced Practice Nursing-An interprofessional approach. (5th ed.) Philadelphia: F.A.
Davis Company.
Ch.77 Primary Care of Older Adults p. 1281-1292; (WO 1.1-1.3)
Ch.77: Medications in the Elderly p.1292-1293; (WO 1.5)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Chapter 1: Changes with Aging (p.2-4); (WO 1.1-1.3)
Chapter 2: Health Promotion (p.6-18); (WO 1.2)
Chapter 3: Exercise in Older Adults (p.19-22); (WO 1.1-1.3)
Chapter 4: Comprehensive Geriatric Assessment (p.26-33); (WO 1.4)
Chapter 17: Polypharmacy (p.470-473); (WO2.3)
Lessons: Complete
Videos: Complete
DE: Complete (if applicable)
Week 2: Readings: Complete
Dunphy, L.M., Winland-Brown, J. E., Porter, B.O. & Thomas, D.J. (2019). Primary Care-The art and
science of Advanced Practice Nursing-An interprofessional approach. (5th ed.) Philadelphia: F.A.
Davis Company.
Chapter 28: Common Respiratory Complaints (p.357-361); (WO2.1-2.3)
Chapter 29: Sleep apnea (p. 363-370); (WO2.4)
Chapter 30: Pneumonia (p.375-384); (WO2.1)
Chapter 31:(397-423); (WO 2.1-2.4)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Chapter 8: Chest Disorders; (WO2.1)
Assessment of the respiratory system (p.154); (WO 2.1)
Chronic obstructive pulmonary disease (p.164-170); (WO2.1-2.2)
Pneumonia (p.191-196); (WO2.1-2.2)
Lessons: Complete
Videos: Complete
DE: Complete (if applicable)
,2
Week 3: Readings: Complete
Dunphy, L.M., Winland-Brown, J. E., Porter, B.O. & Thomas, D.J. (2019). Primary Care-The art and
science of Advanced Practice Nursing-An interprofessional approach. (5th ed.) Philadelphia: F.A.
Davis Company.
Chapter 70: Sleep Wake Disorders: Insomnia (p.1167-1173) (WO3.3)
Chapter 64: Overview, Stress & Anxiety and Depressed Mood (p. 1055-1058) (WO3.1, 3.2)
Chapter 67: Major Depressive disorder (p.1100-1110) (WO3.1, 3.2)
Chapter 68: Generalized anxiety disorder (p. 1129-1135) (WO3.1-3.2)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Anxiety (p.434-436) (WO3.1-3.2)
Bipolar disorder (p.436-438) (WO3.1-3.2)
Depression (p.451-456) (WO3.1-3.2)
Insomnia (p.461-462) (WO3.3)
Grief and Bereavement (p.459-460) (WO3.5)
Prescription drug misuse (p.436-465) (WO3.4)
Lessons: Complete
Videos: Complete
Week 4: Readings: Complete
DE: Complete (if applicable)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Osteoarthritis and Osteoporosis (p.851-870); (WO 4.1-4.3)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Osteoarthritis (p.315-319); (WO 4.1-4.2)
Rheumatoid arthritis (p.322-325); (WO4.2)
Lessons: Complete
Videos: Complete
DE: Complete (if applicable)
Week Topics
1 Developmental changes
,3
Review Kennedy and Dunphy readings for age related changes
Replicative senescence is theory states that cells can replicate or divide a specific number of times.
This ability tends to decrease with age.
Oxidative damage is the cumulative result of the aerobic metabolism, which generates chemicals
called free radicals. Free radicals may interact with other chemicals in the body and cause damage to
cells.
Telomere shortening is a theory that links aging to a reduction in cell division.
Weakening of the immune response leaves older adults more vulnerable to infection and
debilitating diseases.
Physiological
Age related Change Functional Change Implications
Integumentary System
Loss of dermal and Loss of subcutaneous tissue Prone to skin breakdown and
epidermal thickness and thin epidermis. injury
Decreased vascularity • Atrophy of sweat glands • Alteration in thermoregulatory
resulting in decreased sweat response
production
• Fluid requirements may
• Decreased body odor change seasonally
• Decreased heat loss • Loss of skin water
• Dryness • Increased risk of heat stroke
Respiratory System
Decreased lung tissue Decreased vital capacity Reduced overall efficiency of
elasticity ventilatory exchange
Cilia atrophy Change in mucociliary Increased susceptibility to
transport infection
Decreased respiratory • Reduced ability to handle Increased risk of atelectasis
muscle strength secretions and reduced
effectiveness against noxious
foreign particles
• Partial inflation of lungs at
rest
, 4
Cardiovascular System
Heart valves thicken and Reduced stroke volume, Decreased responsiveness to
become fibrotic cardiac output; may be stress
altered
Fibroelastic thickening of Slower heart rate Increased prevalence of
the sinoatrial node; arrhythmias
decreased number of
pacemaker cells
Decreased baroreceptor Decreased sensitivity to Prone to loss of balance, which
sensitivity (stretch changes in blood pressure increases the risk for falls
receptors)
GI
Liver becomes smaller Decreased storage capacity
Decreased muscle tone Altered motility Increases risk of constipation,
functional bowel syndrome,
esophageal spasm, diverticular
disease
Decreased basal metabolic May need fewer calories
rate (rate at which fuel is
converted into energy)
Lab results- Dunphy Table 77.2
Lab Test Normal Changes with age Comments
UA
Protein 0-5mg/100ml Rises slightly May be due to kidney changes
with age, urinary tract
infection, renal pathology
Specific Gravity 1.005-1.020 Lower max in Decline in nephrons impairs
elderly 1.016-1.022 ability to concentrate urine
NR 601 Midterm Exam Study
Guide Weeks 1-4 content
Week 1: Reading: Complete
Dunphy, L.M., Winland-Brown, J. E., Porter, B.O. & Thomas, D.J. (2019). Primary Care-The art and
science of Advanced Practice Nursing-An interprofessional approach. (5th ed.) Philadelphia: F.A.
Davis Company.
Ch.77 Primary Care of Older Adults p. 1281-1292; (WO 1.1-1.3)
Ch.77: Medications in the Elderly p.1292-1293; (WO 1.5)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Chapter 1: Changes with Aging (p.2-4); (WO 1.1-1.3)
Chapter 2: Health Promotion (p.6-18); (WO 1.2)
Chapter 3: Exercise in Older Adults (p.19-22); (WO 1.1-1.3)
Chapter 4: Comprehensive Geriatric Assessment (p.26-33); (WO 1.4)
Chapter 17: Polypharmacy (p.470-473); (WO2.3)
Lessons: Complete
Videos: Complete
DE: Complete (if applicable)
Week 2: Readings: Complete
Dunphy, L.M., Winland-Brown, J. E., Porter, B.O. & Thomas, D.J. (2019). Primary Care-The art and
science of Advanced Practice Nursing-An interprofessional approach. (5th ed.) Philadelphia: F.A.
Davis Company.
Chapter 28: Common Respiratory Complaints (p.357-361); (WO2.1-2.3)
Chapter 29: Sleep apnea (p. 363-370); (WO2.4)
Chapter 30: Pneumonia (p.375-384); (WO2.1)
Chapter 31:(397-423); (WO 2.1-2.4)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Chapter 8: Chest Disorders; (WO2.1)
Assessment of the respiratory system (p.154); (WO 2.1)
Chronic obstructive pulmonary disease (p.164-170); (WO2.1-2.2)
Pneumonia (p.191-196); (WO2.1-2.2)
Lessons: Complete
Videos: Complete
DE: Complete (if applicable)
,2
Week 3: Readings: Complete
Dunphy, L.M., Winland-Brown, J. E., Porter, B.O. & Thomas, D.J. (2019). Primary Care-The art and
science of Advanced Practice Nursing-An interprofessional approach. (5th ed.) Philadelphia: F.A.
Davis Company.
Chapter 70: Sleep Wake Disorders: Insomnia (p.1167-1173) (WO3.3)
Chapter 64: Overview, Stress & Anxiety and Depressed Mood (p. 1055-1058) (WO3.1, 3.2)
Chapter 67: Major Depressive disorder (p.1100-1110) (WO3.1, 3.2)
Chapter 68: Generalized anxiety disorder (p. 1129-1135) (WO3.1-3.2)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Anxiety (p.434-436) (WO3.1-3.2)
Bipolar disorder (p.436-438) (WO3.1-3.2)
Depression (p.451-456) (WO3.1-3.2)
Insomnia (p.461-462) (WO3.3)
Grief and Bereavement (p.459-460) (WO3.5)
Prescription drug misuse (p.436-465) (WO3.4)
Lessons: Complete
Videos: Complete
Week 4: Readings: Complete
DE: Complete (if applicable)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Osteoarthritis and Osteoporosis (p.851-870); (WO 4.1-4.3)
Kennedy-Malone, L., Plank, L. M., & Duffy, E. G. (2019). Advanced practice nursing in the care of older
adults (2nd ed.). Philadelphia: F.A. Davis Company.
Osteoarthritis (p.315-319); (WO 4.1-4.2)
Rheumatoid arthritis (p.322-325); (WO4.2)
Lessons: Complete
Videos: Complete
DE: Complete (if applicable)
Week Topics
1 Developmental changes
,3
Review Kennedy and Dunphy readings for age related changes
Replicative senescence is theory states that cells can replicate or divide a specific number of times.
This ability tends to decrease with age.
Oxidative damage is the cumulative result of the aerobic metabolism, which generates chemicals
called free radicals. Free radicals may interact with other chemicals in the body and cause damage to
cells.
Telomere shortening is a theory that links aging to a reduction in cell division.
Weakening of the immune response leaves older adults more vulnerable to infection and
debilitating diseases.
Physiological
Age related Change Functional Change Implications
Integumentary System
Loss of dermal and Loss of subcutaneous tissue Prone to skin breakdown and
epidermal thickness and thin epidermis. injury
Decreased vascularity • Atrophy of sweat glands • Alteration in thermoregulatory
resulting in decreased sweat response
production
• Fluid requirements may
• Decreased body odor change seasonally
• Decreased heat loss • Loss of skin water
• Dryness • Increased risk of heat stroke
Respiratory System
Decreased lung tissue Decreased vital capacity Reduced overall efficiency of
elasticity ventilatory exchange
Cilia atrophy Change in mucociliary Increased susceptibility to
transport infection
Decreased respiratory • Reduced ability to handle Increased risk of atelectasis
muscle strength secretions and reduced
effectiveness against noxious
foreign particles
• Partial inflation of lungs at
rest
, 4
Cardiovascular System
Heart valves thicken and Reduced stroke volume, Decreased responsiveness to
become fibrotic cardiac output; may be stress
altered
Fibroelastic thickening of Slower heart rate Increased prevalence of
the sinoatrial node; arrhythmias
decreased number of
pacemaker cells
Decreased baroreceptor Decreased sensitivity to Prone to loss of balance, which
sensitivity (stretch changes in blood pressure increases the risk for falls
receptors)
GI
Liver becomes smaller Decreased storage capacity
Decreased muscle tone Altered motility Increases risk of constipation,
functional bowel syndrome,
esophageal spasm, diverticular
disease
Decreased basal metabolic May need fewer calories
rate (rate at which fuel is
converted into energy)
Lab results- Dunphy Table 77.2
Lab Test Normal Changes with age Comments
UA
Protein 0-5mg/100ml Rises slightly May be due to kidney changes
with age, urinary tract
infection, renal pathology
Specific Gravity 1.005-1.020 Lower max in Decline in nephrons impairs
elderly 1.016-1.022 ability to concentrate urine
