Nokea
Findings from a health history indicate that the patient takes daily supplements of the antioxidants beta carotene, vitamin C, and vitamin E. This health practice reflects which of the following theories of biological aging?
- A. Free radicals
- B. Crosslinking
- C. Somatic mutation
- D. Telomere-telomerase depletion
Correct Answer: A
Rationale: Free radicals are natural by-products of many normal cellular processes and are also created under the influence of environmental factors such as smog, tobacco smoke, and radiation. Numerous natural protective mechanisms are in place to prevent oxidative damage. Recent research has focused on the roles of various antioxidants, including vitamins C and E, in slowing down the oxidative process and, ultimately, the aging process. The somatic mutation theory focuses on spontaneous mutations. The crosslinking theory is based upon lipids, proteins, CHO, and nucleic acid reactions. The telomere-telomerase depletion theory focuses on the loss of telomeres, repeated sequences at the ends of DNA.
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The nurse is assessing the nutritional status of an older-adult patient using the SCALES acronym. Which of the following should the nurse assess when completing the 'S'?
- A. Serum potassium level
- B. Sadness or mood change
- C. Social support
- D. Sexual intimacy
Correct Answer: B
Rationale: The acronym SCALES can be used to remind the nurses to assess important nutritional indicators. In the case of the 'S,' the nurse is to assess sadness or mood changes.
The nurse is planning care for an alert and active older-adult patient who takes multiple medications for persistent cardiac and respiratory disease and lives with a daughter who works during the day. Which nursing diagnosis is most appropriate?
- A. Risk for injury as evidenced by exposure to toxic chemical (drug-drug interactions)
- B. Social isolation related to social behavior incongruent with norms (weakness and fatigue)
- C. Disabled family coping related to differing coping styles between support person and patient
- D. Caregiver role strain related to increase in care needs
Correct Answer: A
Rationale: The patient's age and multiple medications indicate a risk for injury caused by interactions between the multiple drugs being taken and a decreased drug metabolism rate. The patient data do not indicate problems with social isolation, caregiver role strain, or compromised family coping.
Which of the following actions should the nurse consider when developing the plan of care for an older adult who is hospitalized for an acute illness?
- A. Use a standardized geriatric nursing care plan.
- B. Minimize activity level during hospitalization.
- C. Plan for transfer to a long-term care facility after the hospitalization.
- D. Consider preadmission functional abilities when setting patient goals.
Correct Answer: D
Rationale: The plan of care for older persons should be individualized and based on the patient's current functional abilities. A standardized geriatric nursing care plan will not address individual patient needs and strengths. A patient's need for discharge to a long-term care facility is variable. Activity level should be designed to allow the patient to retain functional abilities while hospitalized and also to allow any additional rest needed for recovery from the acute process.
The nurse is caring for patients in a geriatric family practice clinic with a primary health care provider. Which of the following actions should the nurse do when caring for older persons who live in rural areas?
- A. Assess the patient for persistent diseases that are unique to rural areas.
- B. Ensure transportation to appointments with the health care provider.
- C. Schedule appointments for the patient in an urban area for better health care.
- D. Obtain adequate medications for the patient to last for 4-6 months.
Correct Answer: B
Rationale: Transportation can be a barrier to accessing health services in rural areas. There are no persistent diseases unique to rural areas. Because medications may change, the nurse should help the patient plan for obtaining medications through alternate means such as the mail or delivery services, not by purchasing large quantities of the medications. The patient living in a rural area may lose the benefits of a familiar situation and social support by moving to an urban area.
The home health nurse is caring for an older-adult patient who lives alone and is taking seven different prescribed medications for persistent health problems. Which of the following nursing interventions would be most appropriate to ensure medication regimen adherence?
- A. Use a marked pillbox to set up the patient's medications.
- B. Discuss the option of moving to an assisted-living facility.
- C. Remind the patient about the importance of taking medications.
- D. Visit the patient daily to administer the prescribed medications.
Correct Answer: A
Rationale: Since forgetting to take medications is a common cause of medication errors in older persons, the use of medication reminder devices is helpful when older persons have multiple medications to take. There is no indication that the patient needs to move to assisted living or that the patient does not understand the importance of medication regimen adherence. Home health care is not designed for the patient who needs ongoing assistance with activities of daily living (ADLs) or instrumental ADLs (IADLs).