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 best indicator of a successful transition to hospice care for older adults?
- A. Complete cessation of all medical treatments
- B. Improvement in physical strength
- C. Relief from physical, emotional, and spiritual suffering
- D. Long-term emotional stability
Correct Answer: C
Rationale: The correct answer is C: Relief from physical, emotional, and spiritual suffering. This is the best indicator of a successful transition to hospice care for older adults because hospice care focuses on providing comfort and improving quality of life rather than curative treatments. Relief from suffering aligns with the goals of hospice care, addressing the holistic needs of patients. Choice A is incorrect as complete cessation of all medical treatments may not be appropriate for all patients in hospice care. Choice B is incorrect as improvement in physical strength may not be the primary goal in hospice care. Choice D is incorrect as long-term emotional stability is important but not necessarily the best indicator of a successful transition to hospice care.
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.
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
What is the primary factor contributing to medication nonadherence in older adults?
- A. Lack of health literacy
- B. High cost of medications
- C. Limited access to healthcare providers
- D. Complicated medication regimens
Correct Answer: D
Rationale: The correct answer is D: Complicated medication regimens. Older adults often have multiple medical conditions requiring several medications, leading to confusion and difficulty in following complex regimens. This complexity increases the likelihood of medication nonadherence. Lack of health literacy (A) may contribute but is not the primary factor. High cost of medications (B) and limited access to healthcare providers (C) are important barriers, but they are not as directly linked to nonadherence as the complexity of medication regimens.
All of the following conditions except___ can cause renal failure, especially in the older adult.
- A. diabetes mellitus
- B. prostate hypertrophy causing obstruction of urine thru the urethra
- C. heart failure
- D. ingesting more than 4 gms of acetaminophen (Tylenol) per day consistently for 2 years
Correct Answer: D
Rationale: The correct answer is D. Ingesting excessive acetaminophen can lead to liver damage, not renal failure. Diabetes mellitus, prostate hypertrophy causing urinary obstruction, and heart failure are known to cause renal failure due to their effects on kidney function. Diabetic nephropathy can damage the kidneys over time, prostate hypertrophy can obstruct urine flow and lead to kidney damage, and heart failure can result in decreased blood flow to the kidneys, causing renal failure. Thus, D is the correct answer as it does not directly cause renal failure, unlike the other choices.