NUR 257 MIDTERM QUESTIONS AND ANSWERS
2025/2026 UPDATE WITH COMPLETE SOLUTIONS.
what are common not normal behaviors in an older adult? Answer - severe
mood swings, uncontrolled laughing or crying, changes in cognitive ability and
excessive forgetfulness
true or false: changes in mental status are part of the normal aging process
Answer - false
the most common affective or mood disorder of old age Answer - depression
what might cause depression in an older adult? Answer - precipitating
events/loss, chronic illness, or chronic pain
what are s/s of depression in the older adult? Answer - fatigue, diminished
memory/concentration, irritability, somatic complaints, behavioral changes,
feelings of worthlessness, sleep disturbances, appetite disturbances with
excessive weight loss/gain, restlessness, impaired attention span, and suicidal
ideation
why might depression go untreated in an older adult? Answer - it goes
unrecognized or the patient does not want to seek medical treatment for it
how can we combat the high suicide risk in the older adult population?
Answer - routine assessments/screenings
,what assessment/screening tool is used for depression in older adults? Answer
- geriatric depression scale (GDS)
what is the treatment/management of depression? Answer - treat underlying
medical condition (chronic illness, chronic pain)
antidepressant medications
what can older adults on antidepressants become at risk for? Answer - adverse
effects: anticholinergic, cardiac and orthostatic adverse effects
drug interaction: med toxicity, hypotensive, falls
what patient education is needed for older adults on antidepressants? Answer
- elders to understand that it may take even longer than the typical 4-6 weeks
for symptoms to diminish
change positions slowly
maintain adequate hydration to avoid common side effects (nausea, dizziness,
and constipation)
acute confusional state Answer - delirium
what type of delirium has a higher mortality rate and why? Answer - stupor
(hypoalert-hypoactive) delirium because it tends not to be recognized; it is
quiet and often mistaken for depression
,which type of delirium is easier to diagnose? Answer - excessive activity
(hyperalert-hyperactive) delirium
require more attention because patient's thinking is disoriented
in what setting is delirium most commonly seen in older adults? why? Answer
- the hospital setting because it often indicates a medical illness
what happens if delirium is left untreated? Answer - changes in LOC,
irreversible brain damage, and death
what vital assessment piece do you need to know to determine dementia from
delirium? Answer - the patient's baseline
dementia is long term
delirium is abrupt onset
what screening tool is used for delirium in the hospital? Answer - CAM
what are the common causes of delirium? Answer - physical illness
infection (UTI or pneumonia)
medication polypharmacy
imbalanced fluid and electrolytes
alcohol or drug withdrawal
(it can be more than one of these at the same time)
, why is delirium a medical emergency? Answer - it is acute, quick onset, with an
underlying cause
if left untreated, it can cause death or brain damage
how is delirium treated? Answer - treat underlying cause
manage patient safety
manage behavioral problems
what is the most common type of dementia? Answer - AD
what are symptoms of early (mild) stages of AD? Answer - forgetfulness and
subtle memory loss
small difficulties in work or social activities but have adequate cognitive
function to compensate for the loss and continue to function independently.
what are symptoms of moderate stage of AD? Answer - forgetfulness is
manifested in many daily actions
impulsive behavior
difficulty with IADLs
personality changes
what are symptoms of terminal (severe) AD? Answer - patients are usually
immobile and require total care with ADLs
how does death occur with a patient diagnosed with AD? Answer -
complications such as pneumonia, malnutrition, or dehydration
2025/2026 UPDATE WITH COMPLETE SOLUTIONS.
what are common not normal behaviors in an older adult? Answer - severe
mood swings, uncontrolled laughing or crying, changes in cognitive ability and
excessive forgetfulness
true or false: changes in mental status are part of the normal aging process
Answer - false
the most common affective or mood disorder of old age Answer - depression
what might cause depression in an older adult? Answer - precipitating
events/loss, chronic illness, or chronic pain
what are s/s of depression in the older adult? Answer - fatigue, diminished
memory/concentration, irritability, somatic complaints, behavioral changes,
feelings of worthlessness, sleep disturbances, appetite disturbances with
excessive weight loss/gain, restlessness, impaired attention span, and suicidal
ideation
why might depression go untreated in an older adult? Answer - it goes
unrecognized or the patient does not want to seek medical treatment for it
how can we combat the high suicide risk in the older adult population?
Answer - routine assessments/screenings
,what assessment/screening tool is used for depression in older adults? Answer
- geriatric depression scale (GDS)
what is the treatment/management of depression? Answer - treat underlying
medical condition (chronic illness, chronic pain)
antidepressant medications
what can older adults on antidepressants become at risk for? Answer - adverse
effects: anticholinergic, cardiac and orthostatic adverse effects
drug interaction: med toxicity, hypotensive, falls
what patient education is needed for older adults on antidepressants? Answer
- elders to understand that it may take even longer than the typical 4-6 weeks
for symptoms to diminish
change positions slowly
maintain adequate hydration to avoid common side effects (nausea, dizziness,
and constipation)
acute confusional state Answer - delirium
what type of delirium has a higher mortality rate and why? Answer - stupor
(hypoalert-hypoactive) delirium because it tends not to be recognized; it is
quiet and often mistaken for depression
,which type of delirium is easier to diagnose? Answer - excessive activity
(hyperalert-hyperactive) delirium
require more attention because patient's thinking is disoriented
in what setting is delirium most commonly seen in older adults? why? Answer
- the hospital setting because it often indicates a medical illness
what happens if delirium is left untreated? Answer - changes in LOC,
irreversible brain damage, and death
what vital assessment piece do you need to know to determine dementia from
delirium? Answer - the patient's baseline
dementia is long term
delirium is abrupt onset
what screening tool is used for delirium in the hospital? Answer - CAM
what are the common causes of delirium? Answer - physical illness
infection (UTI or pneumonia)
medication polypharmacy
imbalanced fluid and electrolytes
alcohol or drug withdrawal
(it can be more than one of these at the same time)
, why is delirium a medical emergency? Answer - it is acute, quick onset, with an
underlying cause
if left untreated, it can cause death or brain damage
how is delirium treated? Answer - treat underlying cause
manage patient safety
manage behavioral problems
what is the most common type of dementia? Answer - AD
what are symptoms of early (mild) stages of AD? Answer - forgetfulness and
subtle memory loss
small difficulties in work or social activities but have adequate cognitive
function to compensate for the loss and continue to function independently.
what are symptoms of moderate stage of AD? Answer - forgetfulness is
manifested in many daily actions
impulsive behavior
difficulty with IADLs
personality changes
what are symptoms of terminal (severe) AD? Answer - patients are usually
immobile and require total care with ADLs
how does death occur with a patient diagnosed with AD? Answer -
complications such as pneumonia, malnutrition, or dehydration
