Nokea
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.
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A 78 yr old female presents to the ED with complaints of nausea and sudden onset shortness of breath. The initial workup includes ____________.
- A. upper endoscopy
- B. CT of the head
- C. liver function studies
- D. EKG and serial enzymes for determination of an MI
Correct Answer: D
Rationale: The correct answer is D, EKG and serial enzymes for determination of an MI. In this scenario, the patient's symptoms of nausea and sudden onset shortness of breath raise concern for a possible myocardial infarction (MI). Conducting an EKG and serial enzymes helps in diagnosing an MI by assessing for cardiac ischemia or injury. Upper endoscopy (choice A) is not indicated for these symptoms. A CT of the head (choice B) is unnecessary as the symptoms are suggestive of a cardiac issue, not a neurological one. Liver function studies (choice C) do not align with the presenting symptoms and are not a priority in this acute setting. Conducting an EKG and serial enzymes is the most appropriate initial workup to assess for a possible MI in this elderly patient with concerning symptoms.
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.
An older adult reports increasing loss of balance. Which teaching should the nurse implement?
- A. Exercise with light weights.
- B. Stand on one foot at a time while supported.
- C. Train with the use of sit-ups.
- D. Work out in a swimming pool.
Correct Answer: B
Rationale: The correct answer is B: Stand on one foot at a time while supported. This exercise helps improve balance by challenging the proprioceptive system. By standing on one foot while supported, the older adult can gradually strengthen their muscles and improve their balance. Other choices like exercising with light weights may not specifically target balance, training with sit-ups focuses more on core strength, and working out in a swimming pool may provide buoyancy but may not directly address the balance concern.
The nurse plans care for older adults who are in good health but isolated from their families. If the nurse's goal is to move the adults toward gerotranscendence, which intervention should the nurse use in the plan of care?
- A. Give a daily tea party for the group.
- B. Call each family to encourage visiting.
- C. Assist them to resume midlife patterns.
- D. Help each person with individual activities.
Correct Answer: D
Rationale: The correct answer is D: Help each person with individual activities. This intervention aligns with promoting gerotranscendence, as it focuses on supporting older adults in engaging in personal growth and reflection. By assisting individuals with meaningful activities tailored to their preferences and abilities, the nurse encourages self-discovery and personal fulfillment.
A: Giving a daily tea party for the group may foster social interaction but does not necessarily address individual growth or self-reflection.
B: Calling each family to encourage visiting may help reduce isolation but does not directly promote gerotranscendence.
C: Assisting them to resume midlife patterns may not be suitable as older adults may benefit more from exploring new activities and perspectives in their later years.
The nurse is providing an educational session to new employees, and the topic is abuse of the older adult. The nurse helps the employees identify that which client is most typical of a victim of abuse?
- A. 75 y.o man with moderate hypertension
- B. 68 y.o man with newly dx cataracts
- C. 90 y.o woman with advanced Parkinson's dz
- D. 70 y.o woman with early dx Lyme dz
Correct Answer: C
Rationale: The correct answer is C: 90 y.o woman with advanced Parkinson's dz. Older adults with advanced Parkinson's disease are more vulnerable to abuse due to their physical and cognitive impairments. They may be dependent on caregivers, making them easy targets for abuse. The other choices do not indicate significant vulnerability to abuse. Choice A is a common demographic but lacks specific vulnerability factors. Choice B with cataracts and Choice D with early Lyme disease do not inherently increase the risk of abuse.