Nokea
An older man in a nursing home has high cholesterol (245 mg/dL). Which intervention helps him achieve the highest level of wellness?
- A. Instruct him about increasing dietary fiber.
- B. Ask the health care provider for a low-fat diet.
- C. Schedule a consultation for him with the dietitian.
- D. Review a menu with him to choose suitable foods.
Correct Answer: D
Rationale: The correct answer is D because reviewing a menu with the older man allows for personalized food selection, taking into account his preferences and dietary restrictions. This approach promotes adherence to a healthy eating plan, leading to better cholesterol management and overall wellness.
Choice A is not the best option as simply instructing him to increase dietary fiber may not address his specific dietary needs. Choice B suggests asking the health care provider for a low-fat diet, which may not consider the individual's food preferences or cultural background. Choice C of scheduling a consultation with a dietitian is a good option, but it may not be as immediately accessible or practical as reviewing a menu together with the individual.
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Which of the following is the most common reason for hospitalization in older adults?
- A. Osteoarthritis
- B. Stroke
- C. Pneumonia
- D. Heart failure
Correct Answer: C
Rationale: The correct answer is C: Pneumonia. Older adults are more susceptible to pneumonia due to weakened immune systems and underlying health conditions. Pneumonia can lead to severe complications, requiring hospitalization. Osteoarthritis (A) primarily affects joints and does not typically lead to hospitalization. Stroke (B) and heart failure (D) are serious conditions but may not be as common for hospitalization as pneumonia in older adults. Pneumonia's impact on the respiratory system and its ability to progress rapidly make it the most common reason for hospitalization in this population.
Intra-renal renal failure can be caused by all of the following conditions except______
- A. certain aminoglycoside antibiotics
- B. glomerulonephritis
- C. kidney stones
- D. diabetic or hypertensive nephrosclerosis
Correct Answer: C
Rationale: The correct answer is C: kidney stones. Intra-renal renal failure refers to damage within the kidney itself. Kidney stones mainly affect the urinary tract rather than directly causing damage within the kidney. A: certain aminoglycoside antibiotics can cause intra-renal renal failure by damaging the kidney tubules. B: glomerulonephritis is inflammation of the glomeruli in the kidney, leading to intra-renal renal failure. D: diabetic or hypertensive nephrosclerosis can cause intra-renal renal failure due to long-term damage to the kidney's blood vessels and structures.
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.
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.
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.