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An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and refuses to remain in the bed. Which intervention should the nurse use to promote and maintain his health?
- A. Have the health care provider speak to him.
- B. Use principles of the holistic health system.
- C. Ask about his perceptions and treatment ideas.
- D. Consult with a practitioner of Chinese medicine.
Correct Answer: C
Rationale: Rationale:
C is correct as it involves understanding the patient's beliefs and preferences, crucial in culturally competent care. A would not address the patient's perspective directly. B is broad and lacks specificity. D assumes all traditional Chinese individuals seek Chinese medicine, which may not be the case.
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Which physiological change in the brain is the reason the nurse allows more time for answering questions with older adults?
- A. Increased secretion of cholinesterase
- B. Decreased secretion of neurotransmitters
- C. Loss of spinal cord and brainstem neurons
- D. Atrophy of dendrites in the cerebral cortex
Correct Answer: D
Rationale: The correct answer is D: Atrophy of dendrites in the cerebral cortex. With aging, there is a natural decline in brain volume and synaptic connections, leading to reduced dendritic branching and synaptic density in the cerebral cortex. This affects processing speed and cognitive functions, requiring more time for older adults to respond to questions.
Rationale:
A: Increased secretion of cholinesterase is not a physiological change associated with aging that would require more time for answering questions.
B: Decreased secretion of neurotransmitters may occur with aging but is not the primary reason for slower processing speed in older adults.
C: Loss of spinal cord and brainstem neurons is not the main factor influencing older adults' response time to questions compared to atrophy of dendrites in the cerebral cortex.
Based on current demographic data, which of the following statements identifies a predictive trend regarding the health care needs of society?
- A. Most nurses will not need to care for older persons.
- B. More nursing services will be required to serve the needs of the population older than 85 years of age.
- C. Fewer nurses will be needed to care for older adults.
- D. Older adults expect their quality of life to be less than that of earlier generations at their ages.
Correct Answer: B
Rationale: The correct answer is B because demographic data shows an increasing aging population, leading to a higher demand for healthcare services for individuals over 85. This trend indicates a greater need for nursing services to cater to the specific health care needs of this age group. Option A is incorrect as the aging population will require more care. Option C is also incorrect as fewer nurses will not be sufficient to meet the increasing demand. Option D is irrelevant to the predictive trend of healthcare needs based on demographics.
The home care nurse is visiting an older female client whose husband died 6 months ago. What behavior by the client indicates ineffective coping?
- A. Neglecting personal grooming
- B. Looking at old pictures
- C. Participating in senior citizens' program
- D. Visiting her husband's grave
Correct Answer: A
Rationale: The correct answer is A because neglecting personal grooming indicates a lack of self-care, which is a common sign of ineffective coping after the loss of a loved one. This behavior suggests the client may be struggling emotionally and unable to engage in basic self-care tasks. Looking at old pictures, participating in social activities, and visiting the husband's grave are all healthy coping mechanisms that can help the client process her grief and maintain connections with her late husband.
A nurse interviewing a non–English-speaking client with an interpreter should: (Select all that apply.)
- A. Look and speak to the interpreter.
- B. Use technical terminology to ensure accuracy.
- C. Allow more time for the interview.
- D. Watch the client’s nonverbal communication.
Correct Answer: C, D, E
Rationale: The correct answers are C, D, and E. C is crucial as it allows for effective communication, D involves observing nonverbal cues, and E emphasizes the need for clear and concise language. A is incorrect as the nurse should address the client directly, not just the interpreter. B is incorrect as using technical terms may hinder understanding.
Which of the following medications should be avoided in older adults due to the increased risk of falls?
- A. Beta-blockers
- B. Benzodiazepines
- C. Statins
- D. Antihypertensives
Correct Answer: B
Rationale: The correct answer is B: Benzodiazepines. Benzodiazepines are central nervous system depressants that can cause drowsiness, dizziness, and confusion, increasing the risk of falls in older adults. They can also impair balance and coordination. Older adults are more sensitive to these effects due to age-related changes in metabolism and increased risk of cognitive impairment. Beta-blockers (A), statins (C), and antihypertensives (D) are generally safe in older adults and do not directly increase the risk of falls. Beta-blockers can sometimes cause dizziness but are more commonly associated with bradycardia. Statins are used to lower cholesterol levels and do not affect fall risk. Antihypertensives help lower blood pressure and can actually reduce the risk of falls by preventing conditions like orthostatic hypotension.