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What is a major risk factor for pressure ulcers in older adults?
- A. Lack of sleep
- B. Malnutrition and dehydration
- C. Excessive physical activity
- D. High blood pressure
Correct Answer: B
Rationale: The correct answer is B: Malnutrition and dehydration. Malnutrition and dehydration are major risk factors for pressure ulcers in older adults because they can lead to poor skin integrity, reduced tissue resilience, and impaired wound healing. Lack of sleep (choice A) may contribute to overall health issues but is not a direct risk factor for pressure ulcers. Excessive physical activity (choice C) can increase the risk of injury but does not directly cause pressure ulcers. High blood pressure (choice D) is a risk factor for cardiovascular issues but is not specifically linked to the development of pressure ulcers.
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The term health disparity is defined as
- A. The systematic elimination of the culture of another resulting in decreased wellness.
- B. Differences in health outcomes among groups.
- C. The difference between an expected incidence and prevalence and that which actually occurs in a comparison population group.
- D. The existence of more than one group with differing values and perspective.
Correct Answer: B
Rationale: The correct answer is B because health disparity refers to variations in health outcomes among different groups due to factors such as socioeconomic status, race, ethnicity, etc. This definition accurately captures the essence of health disparity as it highlights the unequal distribution of health outcomes.
Choice A is incorrect because it refers to cultural elimination, which is not the definition of health disparity. Choice C is incorrect as it talks about differences in expected and actual incidence, not health outcomes among groups. Choice D is incorrect as it focuses on values and perspectives rather than health outcomes.
The home care nurse is performing an environmental assessment in the home of an older adult. Which of the following requires immediate nursing action?
- A. Unsecured scattered rugs
- B. Operable smoke detector
- C. Prefilled medication cassette
- D. Unsecured scattered rugs
Correct Answer: A
Rationale: The correct answer is A: Unsecured scattered rugs. This requires immediate nursing action as it poses a significant fall risk for the older adult. Rugs can cause tripping hazards, leading to potential injuries. The nurse should secure or remove the rugs to ensure the safety of the patient.
Summary of other choices:
B: Operable smoke detector - While important for safety, it does not require immediate nursing action as it is already in working condition.
C: Prefilled medication cassette - This is not an immediate safety concern and can be addressed during routine medication management.
D: Unsecured scattered rugs (repeated) - This choice is the same as the correct answer, so it is incorrect.
A nurse is caring for a culturally diverse patient who has missed follow-up appointments. The patient says: “You don’t understand—in my culture, we don’t do things like that.” The nurse understands which of the following about the patient’s culture?
- A. The culture does not value Western medicine.
- B. The culture has a different orientation to time than Western medicine.
- C. The culture is an interdependent culture.
- D. The culture does not believe in preventative care.
Correct Answer: B
Rationale: The correct answer is B: The culture has a different orientation to time than Western medicine. This is because the patient's statement about not following up on appointments due to cultural reasons suggests a difference in the perception and importance of time. In some cultures, time is more fluid and flexible compared to the rigid scheduling of Western medicine. This understanding helps the nurse provide culturally sensitive care.
Choices A, C, and D are incorrect:
A: The culture does not value Western medicine - This is not necessarily implied by the patient's statement about cultural differences.
C: The culture is an interdependent culture - The patient's statement does not provide direct evidence of the culture being interdependent.
D: The culture does not believe in preventative care - There is no indication in the patient's statement that the culture does not believe in preventative care.
Which of the following medications should be avoided in older adults due to the increased risk of falls?
- A. Beta-blockers
- B. Benzodiazepines
- C. Statins
- D. Antihypertensives
Correct Answer: B
Rationale: The correct answer is B: Benzodiazepines. Benzodiazepines are central nervous system depressants that can cause drowsiness, dizziness, and confusion, increasing the risk of falls in older adults. They can also impair balance and coordination. Older adults are more sensitive to these effects due to age-related changes in metabolism and increased risk of cognitive impairment. Beta-blockers (A), statins (C), and antihypertensives (D) are generally safe in older adults and do not directly increase the risk of falls. Beta-blockers can sometimes cause dizziness but are more commonly associated with bradycardia. Statins are used to lower cholesterol levels and do not affect fall risk. Antihypertensives help lower blood pressure and can actually reduce the risk of falls by preventing conditions like orthostatic hypotension.
An older women tells the nurse that her husband seldom brushes his teeth as he did in the past. A reason why older clients stop participating in daily oral hygiene, such as brushing the teeth, include:
- A. Decreased manual dexterity and inability to hold a tooth brush
- B. Malocclusion of teeth
- C. Decrease in taste acuity
- D. Lack of dental insurance
Correct Answer: A
Rationale: The correct answer is A: Decreased manual dexterity and inability to hold a toothbrush. As people age, they may experience decreased hand strength and motor skills, making it difficult to hold and manipulate objects like a toothbrush. This can lead to a decline in oral hygiene practices. Malocclusion of teeth (B) does not directly impact the ability to brush teeth. Decrease in taste acuity (C) may affect appetite but not tooth brushing habits. Lack of dental insurance (D) is a financial barrier and may affect access to dental care, but it does not directly impact the physical ability to brush teeth.