NURS 601 Midterm Study Guide Exam with Verified
Questions and Answers
CGA - Correct Answer *Purpose: Physical health is related to psychosocial,
functional ability, and safe environment
*Most beneficial for the vulnerable older adult
*Domains: Physical, functional, + psychological health, socioenvironmental support
+ quality of life measures
*Functional health: shows how they can care for themselves day to day
Beers Criteria - Correct Answer *American Geriatric Society
*Purpose: improve medication selection; avoid dangerous medications
*Tailored for 65 and older in all settings except hospice and palliative care
*Stresses importance of de-prescribing to avoid polypharmacy and drug reactions
Health Promotion - Correct Answer *Vaccine schedules: tetanus, diphtheria,
pneumococcal, flu
*CRC screening: ages 50-75
*BC screening: biennial screening ages 50-74
*Smoking cessation
*Aerobic exercise and strength training
*AAA screening
Physical Changes - Correct Answer *Lab changes can be affected by dehydration
(increased ESR due to inflammation, reduced physiological reserves due to thinner
skin, less subcutaneous tissue and fat)
*Mini nutritional assessment for obesity
Functional Domain - Correct Answer *Purpose: how the older adult cares for
themselves
*Screening tools: Brody + lawton, Barthel index (both assess instrumental ADLs)
*Functional change is often the first/only sign of a new or changed disease process
Pulmonary Function Tests - Correct Answer Complete activity, understand results,
FEV1 and what it means
Asthma - Correct Answer *Chronic, inflammatory, obstructive disease
*Caused by intrinsic factors (stress) or extrinsic factors (environment)
*REVERSIBLE! hyperactivity of bronchi and bronchioles to a variety of stimuli
Intermittent asthma - Correct Answer *Intermittent symptoms less than 2 days per
week
*Nighttime less than twice per month
, *Normal peak expiratory flow between exacerbations
*FEV1 >80%; PFT variability ≥20%
*No daily meds
*SABA PRN < twice per week
*Step up meds if control is not achieved
*Step down meds if controlled for 3 months
Mild Persistent Asthma - Correct Answer *Symptoms more than twice a week but
not daily
*Several times at night per month
*FEV1 >80%; PFT variability 20-30%
*Daily low dose ICS; alternate LTRA, cromolyn, nedocromil, or theophylline
*Rescue: SABA PRN not to exceed 3-4 times/day
Moderate Persistent Asthma - Correct Answer *Symptoms are daily but not
continual
*Night time symptoms more than ones a week but not nightly
*Exacerbations affect sleep and activity
*FEV1 60-80% predicted; PFT variability > 30%
*Daily meds: Low dose ICS + LABA or medium dose ICS + LTRA
*Rescue: SABA PRN not to exceed 3-4 times/day
Severe Persistent Asthma - Correct Answer *Continuous daily symptoms
*Frequent nighttime symptoms
*Frequent exacerbations
*Physical activities limited by asthma
*FEV1 < 60%; PFT variability > 30%
*Daily meds: low dose ICS + LABA or medium dose ICS + LTRA
*Rescue SABA PRN, not to exceed 3-4 times/day
*Consider oral steroids
COPD - Correct Answer *Gold standard: spirometry
*Levels: mild (FEV1>80%), Mod (FEV1 >50<80%), Sev (FEV1>30<50%), Ver sev
(FEV1 <30%)
*Oxygen is shown to DECREASE mortality
*Labs: CBC (evaluate eosinophil level), alpha-1-antitrypisin level
CAP - Correct Answer *Acute inflammation of acute inflammation of lung
parenchyma; usually infectious
*70-80%and of cases are over the age of 60
*S. penumoniae, gram + (40%))
*H. Influenzae, legionella
*TX: uncomplicated-azithromycin, clarithromycin, doxy
*TX: with comorbidities-resp. fluoroquinolone
Questions and Answers
CGA - Correct Answer *Purpose: Physical health is related to psychosocial,
functional ability, and safe environment
*Most beneficial for the vulnerable older adult
*Domains: Physical, functional, + psychological health, socioenvironmental support
+ quality of life measures
*Functional health: shows how they can care for themselves day to day
Beers Criteria - Correct Answer *American Geriatric Society
*Purpose: improve medication selection; avoid dangerous medications
*Tailored for 65 and older in all settings except hospice and palliative care
*Stresses importance of de-prescribing to avoid polypharmacy and drug reactions
Health Promotion - Correct Answer *Vaccine schedules: tetanus, diphtheria,
pneumococcal, flu
*CRC screening: ages 50-75
*BC screening: biennial screening ages 50-74
*Smoking cessation
*Aerobic exercise and strength training
*AAA screening
Physical Changes - Correct Answer *Lab changes can be affected by dehydration
(increased ESR due to inflammation, reduced physiological reserves due to thinner
skin, less subcutaneous tissue and fat)
*Mini nutritional assessment for obesity
Functional Domain - Correct Answer *Purpose: how the older adult cares for
themselves
*Screening tools: Brody + lawton, Barthel index (both assess instrumental ADLs)
*Functional change is often the first/only sign of a new or changed disease process
Pulmonary Function Tests - Correct Answer Complete activity, understand results,
FEV1 and what it means
Asthma - Correct Answer *Chronic, inflammatory, obstructive disease
*Caused by intrinsic factors (stress) or extrinsic factors (environment)
*REVERSIBLE! hyperactivity of bronchi and bronchioles to a variety of stimuli
Intermittent asthma - Correct Answer *Intermittent symptoms less than 2 days per
week
*Nighttime less than twice per month
, *Normal peak expiratory flow between exacerbations
*FEV1 >80%; PFT variability ≥20%
*No daily meds
*SABA PRN < twice per week
*Step up meds if control is not achieved
*Step down meds if controlled for 3 months
Mild Persistent Asthma - Correct Answer *Symptoms more than twice a week but
not daily
*Several times at night per month
*FEV1 >80%; PFT variability 20-30%
*Daily low dose ICS; alternate LTRA, cromolyn, nedocromil, or theophylline
*Rescue: SABA PRN not to exceed 3-4 times/day
Moderate Persistent Asthma - Correct Answer *Symptoms are daily but not
continual
*Night time symptoms more than ones a week but not nightly
*Exacerbations affect sleep and activity
*FEV1 60-80% predicted; PFT variability > 30%
*Daily meds: Low dose ICS + LABA or medium dose ICS + LTRA
*Rescue: SABA PRN not to exceed 3-4 times/day
Severe Persistent Asthma - Correct Answer *Continuous daily symptoms
*Frequent nighttime symptoms
*Frequent exacerbations
*Physical activities limited by asthma
*FEV1 < 60%; PFT variability > 30%
*Daily meds: low dose ICS + LABA or medium dose ICS + LTRA
*Rescue SABA PRN, not to exceed 3-4 times/day
*Consider oral steroids
COPD - Correct Answer *Gold standard: spirometry
*Levels: mild (FEV1>80%), Mod (FEV1 >50<80%), Sev (FEV1>30<50%), Ver sev
(FEV1 <30%)
*Oxygen is shown to DECREASE mortality
*Labs: CBC (evaluate eosinophil level), alpha-1-antitrypisin level
CAP - Correct Answer *Acute inflammation of acute inflammation of lung
parenchyma; usually infectious
*70-80%and of cases are over the age of 60
*S. penumoniae, gram + (40%))
*H. Influenzae, legionella
*TX: uncomplicated-azithromycin, clarithromycin, doxy
*TX: with comorbidities-resp. fluoroquinolone
