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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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A family member of a resident in a long-term care facility inquires about the role of gerontological nursing certification. What is the most accurate response the nurse can provide?
- A. Gerontological nursing certification indicates that a nurse has advanced knowledge and skills specifically related to the care of older adults.'
- B. All nurses in long-term care must obtain gerontological certification after completing their initial training.'
- C. Certification in gerontology is only necessary for nurses working in rehabilitation centers.'
- D. Only nurses with a master's degree can achieve certification in gerontology.'
Correct Answer: A
Rationale: The correct answer is A: Gerontological nursing certification indicates that a nurse has advanced knowledge and skills specifically related to the care of older adults. This is accurate because gerontological nursing certification is a voluntary certification that demonstrates a nurse's specialized expertise in caring for the elderly population. Nurses who obtain this certification have undergone additional training and education in gerontological nursing, making them more competent in addressing the unique needs of older adults.
Choices B, C, and D are incorrect:
B: All nurses in long-term care must obtain gerontological certification after completing their initial training - This is false as gerontological certification is not mandatory for all nurses in long-term care.
C: Certification in gerontology is only necessary for nurses working in rehabilitation centers - This is incorrect as gerontological certification is beneficial for nurses caring for older adults in various settings, not just rehabilitation centers.
D: Only nurses with a master's degree can achieve certification in gerontology - This is not true as nurses with
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 physiological change in the brain is the reason the nurse allows more time for answering questions with older adults?
- A. Increased secretion of cholinesterase
- B. Decreased secretion of neurotransmitters
- C. Loss of spinal cord and brainstem neurons
- D. Atrophy of dendrites in the cerebral cortex
Correct Answer: D
Rationale: The correct answer is D: Atrophy of dendrites in the cerebral cortex. With aging, there is a natural decline in brain volume and synaptic connections, leading to reduced dendritic branching and synaptic density in the cerebral cortex. This affects processing speed and cognitive functions, requiring more time for older adults to respond to questions.
Rationale:
A: Increased secretion of cholinesterase is not a physiological change associated with aging that would require more time for answering questions.
B: Decreased secretion of neurotransmitters may occur with aging but is not the primary reason for slower processing speed in older adults.
C: Loss of spinal cord and brainstem neurons is not the main factor influencing older adults' response time to questions compared to atrophy of dendrites in the cerebral cortex.
A man is terminally ill with end-stage prostate cancer. Which is the best statement about this man’s wellness?
- A. Wellness can only be achieved with aggressive medical interventions.
- B. Wellness is not a real option for this client because he is terminally ill.
- C. Wellness is defined as the absence of disease.
- D. Nursing interventions can help empower a client to achieve a higher level of wellness.
Correct Answer: D
Rationale: The correct answer is D because nursing interventions can focus on enhancing the client's quality of life, comfort, and emotional well-being even in the face of terminal illness. Nurses can provide support, educate the client and family, manage symptoms, and empower the client to find meaning and purpose in their life. This approach contributes to a higher level of wellness by addressing holistic needs beyond just medical interventions.
Incorrect choices:
A: Wellness can be achieved through various means, not just aggressive medical interventions.
B: Wellness is still achievable in terms of emotional, social, and spiritual well-being even with a terminal illness.
C: Wellness involves physical, emotional, social, and spiritual aspects beyond just the absence of disease.
Which of the following interventions has been shown to delay the onset of dementia in older adults?
- A. Strict dietary restrictions
- B. Consistent mental and physical activity
- C. Regular social isolation for mental clarity
- D. Pharmacologic interventions to control hypertension
Correct Answer: B
Rationale: The correct answer is B: Consistent mental and physical activity. Engaging in mental and physical activities can help improve cognitive function, increase brain plasticity, and reduce the risk of cognitive decline. Regular stimulation of the brain through activities like puzzles, reading, and learning new skills can help delay the onset of dementia. Physical activity also promotes overall brain health by improving circulation and reducing inflammation.
Choices A, C, and D are incorrect:
A: Strict dietary restrictions may have some benefits for overall health, but there is limited evidence to suggest that it directly delays the onset of dementia.
C: Regular social isolation can actually increase the risk of cognitive decline and dementia, as social interaction is important for brain health.
D: Pharmacologic interventions to control hypertension may be important for overall health, but they are not specifically shown to delay the onset of dementia in older adults.