What is the primary factor contributing to medication nonadherence in older adults?
- A. Lack of health literacy
- B. High cost of medications
- C. Limited access to healthcare providers
- D. Complicated medication regimens
Correct Answer: D
Rationale: The correct answer is D: Complicated medication regimens. Older adults often have multiple medical conditions requiring several medications, leading to confusion and difficulty in following complex regimens. This complexity increases the likelihood of medication nonadherence. Lack of health literacy (A) may contribute but is not the primary factor. High cost of medications (B) and limited access to healthcare providers (C) are important barriers, but they are not as directly linked to nonadherence as the complexity of medication regimens.
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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.
When assessing the health status of super-centenarians in a long-term care facility, which statement is most accurate regarding their general capabilities?
- A. A significant number of super-centenarians are dependent on full-time nursing care for daily activities.
- B. Many super-centenarians exhibit a high level of functional independence despite their advanced age.
- C. The majority of super-centenarians are unable to engage in social activities due to health limitations.
- D. Most super-centenarians experience severe cognitive decline that affects their daily living.
Correct Answer: B
Rationale: The correct answer is B because super-centenarians, who are individuals aged 110 years or older, often exhibit a high level of functional independence despite their advanced age. This is supported by research showing that many super-centenarians maintain physical and cognitive abilities that allow them to perform daily activities without significant assistance. This statement aligns with the concept of successful aging, where individuals maintain autonomy and independence in later years.
Option A is incorrect because a significant number of super-centenarians are not dependent on full-time nursing care for daily activities. Option C is incorrect as many super-centenarians can still engage in social activities despite health limitations. Option D is incorrect as most super-centenarians do not experience severe cognitive decline that affects their daily living.
Mandatory retirement at age 65 years is consistent with which theory of aging?
- A. Role theory
- B. Disengagement theory
- C. Age-stratification theory
- D. Social exchange theory
Correct Answer: B
Rationale: The correct answer is B: Disengagement theory. This theory suggests that as people age, they naturally withdraw or disengage from societal roles and responsibilities. Mandatory retirement at age 65 aligns with this theory as it reflects the societal expectation of older individuals stepping back from work roles. Role theory (A) focuses on how individuals adapt to various social roles throughout their lives, not specifically related to retirement. Age-stratification theory (C) emphasizes how age impacts societal structures and opportunities, not retirement policies. Social exchange theory (D) focuses on relationships and interactions based on the exchange of resources, not specifically related to retirement age policies.
All of the following nursing actions except____________ will help maintain safety for the elderly.
- A. Modify environment to reduce obstacles and barriers to ambulation
- B. Provide for consistent, regular checks of clients' ambulation abilities
- C. Orient to new surroundings and repeat frequently as needed
- D. Promote independence without assistance to all clients
Correct Answer: D
Rationale: The correct answer is D because promoting independence without assistance to all clients may not always maintain safety for the elderly. Elderly individuals may require some level of assistance for certain activities to prevent falls or other safety risks. Providing assistance when needed is crucial for ensuring their safety.
A: Modifying the environment to reduce obstacles and barriers to ambulation helps prevent falls.
B: Consistent checks of ambulation abilities ensure early detection of any decline in mobility.
C: Orienting to new surroundings and repeating as needed helps prevent confusion and disorientation.
The nurse prepares an older woman, who is Polish, for discharge through an interpreter and notes that she becomes tense during the instructions about elimination. Which intervention should the nurse implement?
- A. Move on to the discussion about medication.
- B. Ask the older woman how she feels about this topic.
- C. Instruct the interpreter to repeat the instructions.
- D. Have the older woman repeat the instructions for clarity.
Correct Answer: B
Rationale: The correct answer is B because it directly addresses the older woman's emotional response to the instructions, showing empathy and understanding. By asking how she feels, the nurse can uncover any concerns or fears she may have, leading to effective communication and tailored support. Moving on to medication (A) ignores the woman's distress, potentially worsening the situation. Instructing the interpreter to repeat instructions (C) may not address the underlying issue. Having the woman repeat instructions (D) does not acknowledge her emotional state and may not resolve her tension.