Nokea
Nursing interventions for the client with CHF include all of the following except_____
- A. education about daily weights, correct procedure and meaning of changes
- B. monitoring of clients as medications are introduced or titrated to therapeutic levels
- C. education about food esp. sodium levels
- D. assisting with upper endoscopy
Correct Answer: D
Rationale: The correct answer is D because assisting with upper endoscopy is not a standard nursing intervention for CHF. Nursing interventions for CHF focus on managing symptoms, medication adherence, and lifestyle modifications. Choices A, B, and C are correct as they address important aspects of CHF management such as monitoring symptoms, educating on medications, and promoting a low-sodium diet. Helping with an upper endoscopy is unrelated to the management of CHF and falls outside the scope of nursing care for this condition.
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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.
The gerontological nurse collaborates with the wound care team about an older patient who has an ulcer. How is this nurse demonstrating leadership in the care of older people?
- A. Assessing older adults effectively
- B. Facilitating access to eldercare programs
- C. Coordinating members of the health care team
- D. Empowering older adults to manage chronic illness
Correct Answer: C
Rationale: The correct answer is C: Coordinating members of the health care team. This demonstrates leadership as the nurse is taking charge of organizing and communicating with various healthcare professionals to ensure the best care for the older patient. By collaborating with the wound care team, the nurse shows effective coordination and communication skills, which are crucial in managing complex cases in older adults. Assessing older adults effectively (choice A) is important but does not specifically address leadership in coordinating care. Facilitating access to eldercare programs (choice B) is important but does not directly demonstrate leadership in coordinating care. Empowering older adults to manage chronic illness (choice D) is important for patient education but does not directly show leadership in coordinating the healthcare team.
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.
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.
A family member asks if vitamin C will prevent aging. The nurse considers which theory?
- A. Free radical theory
- B. Immunological theory
- C. Oxidative stress theory
- D. Telomere theory
Correct Answer: A
Rationale: The correct answer is A: Free radical theory. Vitamin C is thought to prevent aging by combatting free radicals, which are highly reactive molecules that can damage cells and contribute to aging. Vitamin C acts as an antioxidant, neutralizing free radicals and protecting cells from oxidative damage. Immunological theory (B) focuses on the role of the immune system in aging. Oxidative stress theory (C) is related to free radical theory but does not specifically address the role of vitamin C. Telomere theory (D) pertains to the shortening of telomeres, which are protective structures at the end of chromosomes, but is not directly related to the role of vitamin C in preventing aging.