NR 601 Midterm Exam Latest 2023 - 2024

NR 601 Midterm Exam (Latest 2023 - 2024) New Full Questions and Answers ( Included ) 100% Correct

• What are the 3 primary physiological changes of aging?: 1. Reduced physiological reserve of most

body systems, esp. cardiac, resp, renal.

• Reduced homeostatic mechanisms that fail to adjust regulatory systems (i.e. tempcontrol, fluid/lyte

balance, etc.).

• Impaired immunological function (infection risk is greater, autoimmune dz's moreprevalent)
• What is the preferred amount of exercise for elderly?: 30min/day 5 days/wkof moderate exercise.

If trying to lose wt: 60min/day.

• What are PFTs?: Group of tests that provide quantifiable measurement of lung function, used to dx

resp abnormalities or assess progression/resolution of lung dz.

4. What is FEV1?: Forced Expiratory Volume in 1 second (80-120%)

5. What is FVC?: Forced Vital Capacity (80-120%)

6. What is normal FEV1/FVC ratio?: <0.7 (70%)

7. What is GOLD 1 criteria?: MildFEV1 >/= 80% predicted

8. What is GOLD 2 criteria?: ModerateFEV1 50-79% predicted

9. What is GOLD 3 criteria?: SevereFEV1 30-49% predicted

10. What is GOLD 4 criteria?: Very severeFEV1 <30% predicted

11. What are the signal symptoms of COPD?: DyspneaChronic cough w/sputum

Decreased activity toleranceWheezing

12. What are characteristics of COPD?: Common, preventable, treatable.

Characterized by persistent airflow limitation.

Usually progressive, associated with enhanced chronic inflammatory response inairways and lungs to noxious particles/gases

Airway fibrosis, luminal plugs, airway inflammation, increased airway resistance,small airway dz.

Decreased elastic recoil of alveoli.

13. What are risk factors for COPD?: Smoking (increasing w/number of packyears)

Second hand smoke Environmental pollution (endotoxins, coal dust, mineral dust)

14. What is seen on phys exam in COPD?: May be normal in early states

As severity progresses: lung hyperinflation, decreased breath sounds, wheezes atbases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance), accessory muscle use, pursed lip 1 / 3

breathing, increased expiratory phase, neck veindistention.

• How is COPD diagnosed?: Spirometry is gold standard (pre and post bron-chodilator).

Irreversible airflow limitation is hallmark.

• How is COPD treated?: Bronchodilators: beta agonists (long/short), anticholin-ergics (long/short), or

combo.

• What is the MOA of beta agonists?: Stimulates beta-2-adrenergic receptors,increasing cyclic AMP,

resulting in relaxing airways.

• What is the MOA of anticholinergics?: Block the effect of acetylcholine onmuscarinic type 3

receptors, resulting in bronchodilation.

• Why are long-acting beta agonists prescribed for COPD?: They are formoderate airflow limitation.

They relieve symptoms, increase exercise tolerance, reduce number of exacerba-tions, improve QOL.

• What are some non pulmonary diagnoses that result in COPD-type symp-toms?: CHF

Hyperventilation syndromePanic attacks Vocal cord dysfunction Obstructive sleep apneaAspergillosis Chronic fatigue syndrome

21. What are signal symptoms of asthma?: WheezingShortness of breath

Cough (esp at night)Chest tightness

• What is chronic bronchitis?: Daily chronic cough w/increased sputum for atleast 3 consecutive

months in at least 2 consecutive years.

Usually worse on wakening.

May or may not be associated with COPD.

• What is emphysema?: Characterized by obstruction to airflow caused by ab-normal airspace

enlargement distal to terminal bronchioles.

Chronic inflammation/remodeling, trapping air, hindering effective O2/CO2 ex-change (all due to inflammatory mediators infiltrating airways).

24. What are signal symptoms of ischemic heart dz?: Chest painChest tightness

Chest discomfort

• What is ischemic heart dz?: Imbalance between supply and demand for bloodflow to myocardium

26. What are signal symptoms of lung CA?: CoughDyspnea

Wt loss Anorexia Hemoptysis

• What is lung CA?: Malignant neoplasm originating in parenchyma of lung/air-ways

28. What are signal symptoms of MI?: Prolonged CP (>20min duration)SOB

Confusion Weakness Worsening HF

• What is an MI?: Necrosis of heart tissue caused by lack of blood and O2 supplyto the heart

30. What are signal symptoms of pneumonia?: FeverChills

Hypothermia New cough w/or w/out sputumChest discomfort or dyspnea Fatigue

HA 2 / 3

Some older adults will be asymptomatic but may experience falls/confusion

• What is community acquired pneumonia?: Acute lower resp tract infection oflung parenchyma.

Can be bacterial or viral.

Bacterial is most common in older adults.

32. What are signal symptoms of a PE?: DyspneaCP on inspiration

Anxiety Presentation is variableSymptoms nonspecific Some asymptomatic

• What is PE description?: Occlusion of one or more pulmonary vessels bytraveling thrombus

originating from distant site.

• What are signal symptoms of tuberculosis?: Initially asymptomaticLater: productive, prolonged

cough Fatigue Low-grade feverNight sweats Poor appetite Hemoptysis Wt loss

Fever/sweats are less common in elderly

Symptoms in elderly are often attributed to other comorbidities

• What is tuberculosis?: Chronic, necrotizing infection caused by slow-growingacid-fast bacillus

(Mycobacterium tuberculosis).

Most common cause of death related to infectious dz worldwide.

36. What are signal symptoms of valvular heart dz?: Asymptomatic in earlystages

Fatigue Exertional dyspnea

• What is valvular heart dz?: Damage to valve(s) of the heart, causing cardiacdysfunction.

Most prevalent types in elderly: calcific and degenerative aortic valve dz

38. What is aortic stenosis?: Abnormal narrowing of aortic valve orifice

• What is aortic regurgitation?: Retrograde blood flow through incompetentaortic valve into L

ventricle during ventricular diastole

40. What is mitral stenosis?: Abnormal narrowing of mitral valve orifice

• What is mitral regurgitation?: Retrograde blood flow during systole from Lventricle into L atrium

through incompetent mitral valve

• What is mitral valve prolapse?: Mitral regurgitation associated with bulging ofone or both mitral

valve leaflets into L atrium during ventricular systole

• What are most common causes ofVHD in elderly?: Age-related degenerativecalcifications

Myxomatous degeneration Papillary muscle dysfunctionInfective endocarditis Rheumatic dz

• What happens in valvular regurgitation?: Portion of the ejected blood leaksback into the upstream

cardiac chamber

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