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Which of the following best describes the pathophysiology of delirium in older adults?
- A. It is caused by an acute inflammatory response to infection.
- B. It results from reversible metabolic changes, such as electrolyte imbalances.
- C. It is primarily related to neurodegeneration in the brain.
- D. It is caused by chronic stress responses and cortisol overproduction.
Correct Answer: B
Rationale: The correct answer is B: Delirium in older adults results from reversible metabolic changes, such as electrolyte imbalances. Delirium is a multifactorial condition often triggered by physiological imbalances, including electrolyte disturbances. These imbalances can disrupt normal brain function, leading to confusion and cognitive impairment. Other choices are incorrect: A is more typical of sepsis, C is more associated with conditions like dementia, and D is not a primary cause of delirium.
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Identify the best statement about gerontological nursing.
- A. Nurses have only recently become involved in the care of older adults.
- B. Gerontological care was the second specialty in which the American Nurses Association (ANA) offered a certification program.
- C. Purposes of gerontological nursing include the promotion of health and support for maximal independence.
- D. ANA certification is available only for gerontological nurses in research positions.
Correct Answer: C
Rationale: The correct answer is C because gerontological nursing focuses on promoting health and maximizing independence in older adults. This statement aligns with the core principles of gerontological nursing, which emphasize holistic care and quality of life for elderly individuals. Choice A is incorrect because nurses have been involved in caring for older adults for a long time. Choice B is incorrect because gerontological care was not the second specialty certified by the ANA. Choice D is incorrect because ANA certification is not limited only to research positions in gerontological nursing.
The nurse is providing an educational session to new employees, and the topic is abuse of the older adult. The nurse helps the employees identify that which client is most typical of a victim of abuse?
- A. 75 y.o man with moderate hypertension
- B. 68 y.o man with newly dx cataracts
- C. 90 y.o woman with advanced Parkinson's dz
- D. 70 y.o woman with early dx Lyme dz
Correct Answer: C
Rationale: The correct answer is C: 90 y.o woman with advanced Parkinson's dz. Older adults with advanced Parkinson's disease are more vulnerable to abuse due to their physical and cognitive impairments. They may be dependent on caregivers, making them easy targets for abuse. The other choices do not indicate significant vulnerability to abuse. Choice A is a common demographic but lacks specific vulnerability factors. Choice B with cataracts and Choice D with early Lyme disease do not inherently increase the risk of abuse.
Which racial or ethnic group has the highest life expectancy in the United States?
- A. Native Americans
- B. African Americans
- C. Hispanic Americans
- D. Asian and Pacific Island Americans
Correct Answer: D
Rationale: The correct answer is D: Asian and Pacific Island Americans. This group has the highest life expectancy in the US due to various factors such as healthy dietary habits, lower rates of smoking and alcohol consumption, access to quality healthcare, and strong social support systems. They also tend to engage in regular physical activity and have lower rates of obesity and chronic diseases compared to other racial or ethnic groups. In contrast, choices A, B, and C have lower life expectancies due to factors such as higher rates of poverty, inadequate healthcare access, systemic racism, and higher prevalence of chronic health conditions like diabetes and heart disease.
An older female patient states reading is difficult in the evening. Which intervention should the nurse implement?
- A. Put a high-intensity lamp at the head of her bed.
- B. Explain that the arcus senilis is interfering with vision.
- C. Put more powerful tubes in the fluorescent lights.
- D. Examine her retinas for signs of damage.
Correct Answer: A
Rationale: The correct answer is A because a high-intensity lamp can provide better lighting for reading, addressing the difficulty the patient experiences in the evening. This intervention can improve visibility and reduce strain on the eyes. Option B is incorrect as arcus senilis is a common age-related condition but not a direct cause of difficulty reading. Option C is incorrect as simply increasing the power of fluorescent lights may not address specific visual needs for reading. Option D is incorrect as examining the retinas may not directly address the patient's difficulty in reading and is not the most appropriate initial intervention.
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.