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.
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________ is a factor that contributes to a high incidence of falls in the elderly.
- A. increased muscle mass and tone
- B. high likelihood of orthostatic hypotension upon rising quickly
- C. increasing acuity in eyesight in dim light
- D. constipation
Correct Answer: B
Rationale: The correct answer is B: high likelihood of orthostatic hypotension upon rising quickly. Orthostatic hypotension is a common issue in the elderly, causing a sudden drop in blood pressure when standing up quickly, leading to dizziness and falls. This factor directly contributes to the high incidence of falls in the elderly. Increased muscle mass and tone (A) actually reduce the risk of falls, while improving eyesight in dim light (C) would decrease the risk. Constipation (D) is not directly related to falls in the elderly.
A nurse interviewing a non–English-speaking client with an interpreter should: (Select all that apply.)
- A. Look and speak to the interpreter.
- B. Use technical terminology to ensure accuracy.
- C. Allow more time for the interview.
- D. Watch the client’s nonverbal communication.
Correct Answer: C, D, E
Rationale: The correct answers are C, D, and E. C is crucial as it allows for effective communication, D involves observing nonverbal cues, and E emphasizes the need for clear and concise language. A is incorrect as the nurse should address the client directly, not just the interpreter. B is incorrect as using technical terms may hinder understanding.
A retirement community is divided into different communities with different activities available for the residents. There is one community for individuals ages 65 to 74 years, one for individuals ages 75 to 85 years, and one for individuals older than age 85 years. This is consistent with which theory of aging?
- A. Role theory
- B. Disengagement theory
- C. Age-stratification theory
- D. Social exchange theory
Correct Answer: C
Rationale: The correct answer is C: Age-stratification theory. This theory suggests that age is a powerful determinant of social organization. In the given scenario, the retirement community is structured based on age groups, indicating stratification by age. This separation aligns with the concept of age-based social hierarchies and differing opportunities and resources based on age.
Choice A (Role theory) focuses on how individuals adapt to social roles as they age, which is not directly reflected in the scenario. Choice B (Disengagement theory) posits that aging individuals withdraw from societal roles, which is not evident in the active engagement of residents in different age-specific communities. Choice D (Social exchange theory) emphasizes the relationships individuals form based on rewards and costs, which is not the primary focus in the scenario compared to the age-based stratification.
An older adult who is a traditional Chinese man has a blood pressure of 80/54 mm Hg and refuses to remain in the bed. Which intervention should the nurse use to promote and maintain his health?
- A. Have the health care provider speak to him.
- B. Use principles of the holistic health system.
- C. Ask about his perceptions and treatment ideas.
- D. Consult with a practitioner of Chinese medicine.
Correct Answer: C
Rationale: Rationale:
C is correct as it involves understanding the patient's beliefs and preferences, crucial in culturally competent care. A would not address the patient's perspective directly. B is broad and lacks specificity. D assumes all traditional Chinese individuals seek Chinese medicine, which may not be the case.
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.