Nokea
An 81 yr old female presents to the ED with altered level of consciousness. All of the following except____ are possible causes for this condition.
- A. peripheral arterial disease
- B. hypoglycemia
- C. pneumonia
- D. hypotension from dehydration
Correct Answer: A
Rationale: The correct answer is A: peripheral arterial disease. Altered level of consciousness in an 81-year-old female is unlikely to be directly caused by peripheral arterial disease. Instead, hypoglycemia, pneumonia, and hypotension from dehydration are common causes of altered mental status in the elderly. Hypoglycemia can lead to brain dysfunction, pneumonia can cause low oxygen levels affecting brain function, and dehydration-induced hypotension can reduce blood flow to the brain. Therefore, peripheral arterial disease is not typically a direct cause of altered consciousness in this scenario.
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What is the most common cause of hospitalization for older adults with diabetes?
- A. Stroke
- B. Hypoglycemia
- C. Diabetic ketoacidosis
- D. Infection
Correct Answer: D
Rationale: The correct answer is D: Infection. Older adults with diabetes are more vulnerable to infections due to weakened immune systems caused by high blood sugar levels. Infections can lead to severe complications and hospitalization. Stroke (A) is a common complication of diabetes but not the most common cause of hospitalization. Hypoglycemia (B) and diabetic ketoacidosis (C) are acute complications of diabetes but are less common causes of hospitalization compared to infections.
Identify the Healthy People 2020 emerging issues in the health of older adults.
- A. Coordinating care for the older adult population
- B. Assisting older adults in the management of their own care
- C. Identifying levels of training for those caring for older adults
- D. Making community resources available for older adults
Correct Answer: A
Rationale: The correct answer is A: Coordinating care for the older adult population. This is a key emerging issue in the health of older adults as it focuses on improving the integration and coordination of healthcare services to ensure comprehensive and efficient care delivery. This includes addressing the complex needs of older adults, promoting continuity of care, and enhancing communication among healthcare providers.
Rationale:
1. Coordinating care addresses the holistic needs of older adults.
2. It aims to prevent fragmented care and improve health outcomes.
3. Enhances collaboration among healthcare providers and community resources.
4. Promotes patient-centered care and improves quality of life for older adults.
Other Choices:
B: Assisting older adults in the management of their own care - While important, this focuses on individual responsibility rather than systemic coordination.
C: Identifying levels of training for those caring for older adults - Relevant but not a primary emerging issue in the health of older adults.
D: Making community resources available for older adults - Important, but
A home care nurse discusses turning a patient every 2 hours, but the patient’s daughter removes the turning clock. The best response by the nurse is:
- A. “You must follow my guidelines and turn her every 2 hours, or I will not be able to take care of her.”
- B. “I understand that you value your culture, but culture cannot stop you from providing good care to your mother.”
- C. “I understand that you care very much for your mother. Perhaps caring for her is too much for you.”
- D. “How can we best work together to provide the best care for your mother?”
Correct Answer: D
Rationale: The correct answer is D because it demonstrates empathy, collaboration, and a patient-centered approach. By asking how to work together, the nurse acknowledges the daughter's concerns and fosters a collaborative relationship. This approach respects the daughter's role in her mother's care and encourages open communication.
Choice A is incorrect as it uses a threatening tone and may alienate the daughter, leading to a breakdown in communication. Choice B is incorrect as it dismisses the daughter's cultural values, which are important in providing holistic care. Choice C is incorrect as it suggests that the daughter is incapable of caring for her mother, which can be disempowering and offensive.
What is the most common cause of delirium in hospitalized older adults?
- A. Medication side effects
- B. Sleep deprivation
- C. Urinary tract infections (UTIs)
- D. Electrolyte imbalances
Correct Answer: C
Rationale: The correct answer is C: Urinary tract infections (UTIs). UTIs are a common cause of delirium in hospitalized older adults due to their impact on the central nervous system. UTIs can lead to systemic inflammation and affect cognitive function, resulting in delirium. Other choices like medication side effects, sleep deprivation, and electrolyte imbalances can contribute to delirium but are not as common or direct as UTIs in this population.
An older man is transferred to a hospice facility with end-stage disease. Which is a suitable nursing intervention for this older adult and his family according to the goals of long-term care?
- A. Decrease the analgesic dose to prevent sedation.
- B. Provide a basin and towels for morning self-care.
- C. Inform family members about strict visiting hours.
- D. Facilitate family rituals related to death and dying.
Correct Answer: D
Rationale: The correct answer is D: Facilitate family rituals related to death and dying. In end-of-life care, it is essential to support the older adult and their family in their cultural and spiritual practices to promote comfort and closure. This intervention aligns with the goals of long-term care by addressing the psychological and emotional needs of the patient and family. Providing a basin and towels (B) focuses on physical self-care, which may not be a priority in end-stage disease. Decreasing analgesic dose (A) can compromise pain management and quality of life. Informing family members about strict visiting hours (C) can hinder emotional support and connection during this critical time.