Nokea
An older female patient states reading is difficult in the evening. Which intervention should the nurse implement?
- A. Put a high-intensity lamp at the head of her bed.
- B. Explain that the arcus senilis is interfering with vision.
- C. Put more powerful tubes in the fluorescent lights.
- D. Examine her retinas for signs of damage.
Correct Answer: A
Rationale: The correct answer is A because a high-intensity lamp can provide better lighting for reading, addressing the difficulty the patient experiences in the evening. This intervention can improve visibility and reduce strain on the eyes. Option B is incorrect as arcus senilis is a common age-related condition but not a direct cause of difficulty reading. Option C is incorrect as simply increasing the power of fluorescent lights may not address specific visual needs for reading. Option D is incorrect as examining the retinas may not directly address the patient's difficulty in reading and is not the most appropriate initial intervention.
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Which of the following best describes the pathophysiology of delirium in older adults?
- A. It is caused by an acute inflammatory response to infection.
- B. It results from reversible metabolic changes, such as electrolyte imbalances.
- C. It is primarily related to neurodegeneration in the brain.
- D. It is caused by chronic stress responses and cortisol overproduction.
Correct Answer: B
Rationale: The correct answer is B: Delirium in older adults results from reversible metabolic changes, such as electrolyte imbalances. Delirium is a multifactorial condition often triggered by physiological imbalances, including electrolyte disturbances. These imbalances can disrupt normal brain function, leading to confusion and cognitive impairment. Other choices are incorrect: A is more typical of sepsis, C is more associated with conditions like dementia, and D is not a primary cause of delirium.
In managing older adults with multiple chronic conditions, which factor has the most significant impact on reducing hospital readmissions?
- A. Minimizing polypharmacy
- B. Frequent medication adjustments
- C. Home health care support
- D. Specialized geriatric assessments
Correct Answer: C
Rationale: The correct answer is C: Home health care support. This is because having access to home health care support can provide ongoing monitoring, medication management, and assistance with activities of daily living, which can help prevent complications and reduce the need for hospital readmissions.
Minimizing polypharmacy (A) is important but may not have as significant an impact as continuous home health care support. Frequent medication adjustments (B) may lead to confusion and potential adverse effects in older adults. Specialized geriatric assessments (D) are beneficial but may not directly address the day-to-day support needed to prevent hospital readmissions.
An older patient worries that simple tasks, like balancing a checkbook, take longer. How should the nurse respond?
- A. “Normal brain changes with aging slow central processing, so don’t worry.”
- B. “This is abnormal and needs immediate physician evaluation.”
- C. “Changes in brain function lead to decreased intellectual performance.”
- D. “Any change in function is concerning and needs evaluation.”
Correct Answer: A
Rationale: Step 1: Acknowledge patient's concern.
Step 2: Educate on normal aging changes affecting cognitive function.
Step 3: Reassure patient that slight delays in tasks are common.
Step 4: Encourage healthy habits to support cognitive function.
Step 5: Emphasize the importance of monitoring any significant changes.
Summary:
Choice A is correct as it addresses the concern, educates on normal aging changes, reassures the patient, and provides guidance on monitoring. Choices B, C, and D are incorrect because they either suggest immediate evaluation without considering normal aging changes or provide inaccurate information about brain function in aging.
In managing frailty, what is the most important factor for improving strength and overall function in older adults?
- A. High-protein diet
- B. Medication management
- C. Regular strength training exercises
- D. Limiting physical activity to prevent injury
Correct Answer: C
Rationale: Certainly! Regular strength training exercises are crucial for improving strength and overall function in older adults with frailty. Strength training helps build muscle mass, improve balance, and increase mobility, leading to enhanced functional abilities. It also helps prevent falls and maintain independence. High-protein diet (A) supports muscle health but alone is not sufficient. Medication management (B) is important but not the primary factor for physical function. Limiting physical activity (D) can worsen frailty by causing deconditioning and loss of muscle strength.
Which racial or ethnic group has the highest life expectancy in the United States?
- A. Native Americans
- B. African Americans
- C. Hispanic Americans
- D. Asian and Pacific Island Americans
Correct Answer: D
Rationale: The correct answer is D: Asian and Pacific Island Americans. This group has the highest life expectancy in the US due to various factors such as healthy dietary habits, lower rates of smoking and alcohol consumption, access to quality healthcare, and strong social support systems. They also tend to engage in regular physical activity and have lower rates of obesity and chronic diseases compared to other racial or ethnic groups. In contrast, choices A, B, and C have lower life expectancies due to factors such as higher rates of poverty, inadequate healthcare access, systemic racism, and higher prevalence of chronic health conditions like diabetes and heart disease.