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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Which of the following is the most important intervention to prevent pressure ulcers in older adults?
- A. Regular repositioning every 2 hours
- B. Administering pain medications before repositioning
- C. Encouraging excessive hydration
- D. Using restrictive bandages
Correct Answer: A
Rationale: The correct answer is A: Regular repositioning every 2 hours. Repositioning helps to relieve pressure on vulnerable areas, improving blood flow and preventing tissue damage. This intervention is evidence-based and recommended in pressure ulcer prevention guidelines. Administering pain medications before repositioning (B) does not address the root cause of pressure ulcers. Encouraging excessive hydration (C) may have other health benefits but does not directly prevent pressure ulcers. Using restrictive bandages (D) can actually increase pressure and worsen the risk of pressure ulcers.
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.
What is the best indicator of a successful transition to hospice care for older adults?
- A. Complete cessation of all medical treatments
- B. Improvement in physical strength
- C. Relief from physical, emotional, and spiritual suffering
- D. Long-term emotional stability
Correct Answer: C
Rationale: The correct answer is C: Relief from physical, emotional, and spiritual suffering. This is the best indicator of a successful transition to hospice care for older adults because hospice care focuses on providing comfort and improving quality of life rather than curative treatments. Relief from suffering aligns with the goals of hospice care, addressing the holistic needs of patients. Choice A is incorrect as complete cessation of all medical treatments may not be appropriate for all patients in hospice care. Choice B is incorrect as improvement in physical strength may not be the primary goal in hospice care. Choice D is incorrect as long-term emotional stability is important but not necessarily the best indicator of a successful transition to hospice care.
An older patient worries that simple tasks, like balancing a checkbook, take longer. How should the nurse respond?
- A. “Normal brain changes with aging slow central processing, so don’t worry.”
- B. “This is abnormal and needs immediate physician evaluation.”
- C. “Changes in brain function lead to decreased intellectual performance.”
- D. “Any change in function is concerning and needs evaluation.”
Correct Answer: A
Rationale: Step 1: Acknowledge patient's concern.
Step 2: Educate on normal aging changes affecting cognitive function.
Step 3: Reassure patient that slight delays in tasks are common.
Step 4: Encourage healthy habits to support cognitive function.
Step 5: Emphasize the importance of monitoring any significant changes.
Summary:
Choice A is correct as it addresses the concern, educates on normal aging changes, reassures the patient, and provides guidance on monitoring. Choices B, C, and D are incorrect because they either suggest immediate evaluation without considering normal aging changes or provide inaccurate information about brain function in aging.
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.
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