Nokea
In treating depression in older adults, which of the following is considered the most effective treatment modality?
- A. Long-term pharmacological therapy with SSRIs
- B. Cognitive-behavioral therapy (CBT) combined with antidepressant medications
- C. Antidepressant medications alone
- D. Psychodynamic therapy to address unresolved issues from early life
Correct Answer: B
Rationale: The correct answer is B, cognitive-behavioral therapy (CBT) combined with antidepressant medications, for treating depression in older adults. CBT helps address negative thought patterns and behaviors associated with depression, while antidepressant medications provide physiological support. Combining both approaches has been shown to be more effective than either treatment alone in older adults.
A: Long-term pharmacological therapy with SSRIs may have side effects and limited effectiveness in older adults.
C: Antidepressant medications alone may not address the underlying psychological factors contributing to depression.
D: Psychodynamic therapy may not be as effective in older adults as it focuses on unresolved issues from early life rather than targeting current depressive symptoms.
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Mr. J has been admitted to the hospital from her own home. The admitting nurse notes that the patient has severe edema in the lower extremities, no hair on the legs, and ulcerations on her feet. These signs and symptoms are most likely indications of:
- A. A diet low in protein
- B. Exposure to the cold from a lack of heat
- C. Frequent falls and injuries because of an unsteady gait
- D. Circulatory problems related to age and a chronic illness
Correct Answer: D
Rationale: The correct answer is D: Circulatory problems related to age and a chronic illness. Severe edema, hair loss on the legs, and foot ulcerations are indicative of poor circulation, often seen in conditions like peripheral artery disease. Age and chronic illnesses can contribute to circulatory issues. A diet low in protein (choice A) would not directly cause these symptoms. Exposure to cold (choice B) would not explain the specific symptoms mentioned. Frequent falls (choice C) do not align with the symptoms provided.
Which of the following interview questions would be most appropriate when a nurse is assessing a client's respiratory function?
- A. Would you be interested in finding out more about environmental smoke?
- B. Did either of your parents experience lung disease?
- C. Have you ever worked in a job where you were exposed to dust, fumes, smoke, or other pollutants?
- D. What do you do to actively maintain your health?
Correct Answer: C
Rationale: The most appropriate interview question for assessing a client's respiratory function is C: "Have you ever worked in a job where you were exposed to dust, fumes, smoke, or other pollutants?" This question directly relates to potential occupational exposures that could impact respiratory health. It helps gather specific information relevant to respiratory assessment. Choice A is unrelated to respiratory function assessment. Choice B focuses on familial history, which is important but not as direct as occupational exposure. Choice D is too general and does not specifically address respiratory issues. Therefore, C is the most appropriate choice for assessing respiratory function.
Which of the following is the leading cause of hospitalization for older adults in the United States?
- A. Pneumonia
- B. Stroke
- C. Diabetes
- D. Congestive heart failure
Correct Answer: A
Rationale: The correct answer is A: Pneumonia. Older adults are more susceptible to pneumonia due to weakened immune systems and other health conditions. Pneumonia can lead to severe complications requiring hospitalization. Stroke (B) affects a significant number of older adults but is not the leading cause of hospitalization. Diabetes (C) and Congestive heart failure (D) are prevalent in older adults but are not the primary reason for hospitalization. Pneumonia's severity and impact on older adults' health make it the leading cause of hospitalization.
What is the most common barrier to effective pain management in older adults?
- A. Fear of addiction to opioid medications
- B. Insufficient healthcare provider knowledge of geriatric pain management
- C. Inadequate access to pain management specialists
- D. Reluctance of older adults to report pain
Correct Answer: D
Rationale: The correct answer is D because reluctance of older adults to report pain is a significant barrier to effective pain management. Older adults may underreport pain due to various factors such as fear of being seen as a burden, denial of aging-related changes, or belief that pain is a natural part of aging. This can lead to under-treatment of pain and decreased quality of life. Choices A, B, and C are not the most common barriers in this context. Fear of addiction to opioids, insufficient knowledge among healthcare providers, and inadequate access to specialists are important factors but are not as prevalent as older adults' reluctance to report pain.
What is the most effective intervention to prevent skin breakdown in immobile older adults?
- A. Frequent use of powder to keep skin dry
- B. Application of a thick layer of moisturizer
- C. Regular repositioning and use of pressure-relieving devices
- D. Ensuring complete bed rest to limit movement
Correct Answer: C
Rationale: The correct answer is C because regular repositioning and the use of pressure-relieving devices are essential to prevent skin breakdown in immobile older adults. Repositioning helps redistribute pressure, maintaining blood flow to the skin and preventing tissue damage. Pressure-relieving devices such as cushions or special mattresses further reduce pressure on vulnerable areas. Choices A and B do not address the root cause of skin breakdown and may even exacerbate the issue. Choice D is incorrect as complete bed rest can lead to further complications like pressure ulcers. In summary, choice C is the most effective intervention as it directly targets the risk factors for skin breakdown in immobile older adults.