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What is the primary role of the gerontological nurse when providing end-of-life care for a terminally ill older adult?
- A. To offer aggressive curative treatments to extend life
- B. To focus on pain management and comfort care, ensuring dignity
- C. To administer sedatives to prevent distress
- D. To encourage family members to make all decisions for the patient
Correct Answer: B
Rationale: The correct answer, B, is the primary role of the gerontological nurse when providing end-of-life care for a terminally ill older adult. This choice emphasizes the importance of pain management, comfort care, and preserving the patient's dignity. The nurse's focus should be on enhancing the quality of life and ensuring the patient's comfort rather than pursuing aggressive curative treatments (A). Administering sedatives (C) should be based on individual needs and preferences, not as a blanket approach. While family involvement is crucial, the nurse should still advocate for the patient's autonomy and preferences, rather than solely relying on family decisions (D).
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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.
Mr J., an 80 yr old who has had flu like symptoms with diarrhea and has vomited 4 times in the last 24 hours is seen in the ED. Mr. J seems confused and is lethargic. The nurse notes that Mr. J has dry skin, a brown tongue, sunken cheeks and concentrated urine. This array of symptoms indicates:
- A. congestive heart failure
- B. dehydration
- C. urinary tract infection
- D. bowel obstruction
Correct Answer: B
Rationale: The correct answer is B: dehydration. Mr. J's symptoms of flu-like illness, diarrhea, vomiting, confusion, lethargy, dry skin, brown tongue, sunken cheeks, and concentrated urine are indicative of severe dehydration. Dehydration can lead to electrolyte imbalances, decreased blood volume, and impaired organ function, resulting in confusion and lethargy. Skin changes, dry mucous membranes, and concentrated urine are also classic signs of dehydration. The other choices (A, C, D) do not align with the constellation of symptoms presented by Mr. J and are less likely based on the information provided.
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.
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.
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