Nokea
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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The home care nurse is visiting an older female client whose husband died 6 months ago. What behavior by the client indicates ineffective coping?
- A. Neglecting personal grooming
- B. Looking at old pictures
- C. Participating in senior citizens' program
- D. Visiting her husband's grave
Correct Answer: A
Rationale: The correct answer is A because neglecting personal grooming indicates a lack of self-care, which is a common sign of ineffective coping after the loss of a loved one. This behavior suggests the client may be struggling emotionally and unable to engage in basic self-care tasks. Looking at old pictures, participating in social activities, and visiting the husband's grave are all healthy coping mechanisms that can help the client process her grief and maintain connections with her late husband.
In the document “Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older Adults” developed by the American Association of Colleges of Nursing and the Hartford Institute for Geriatric Nursing, recommendations include which of the following?
- A. Provision of a free-standing course in gerontology within the curriculum
- B. Integration of gerontological content throughout the curriculum
- C. Requirement of gerontological certification for all students before completion of a BSN program
- D. Structured clinical experiences with older adults across the continuum of care
Correct Answer: B
Rationale: The correct answer is B: Integration of gerontological content throughout the curriculum. This is because integrating gerontological content throughout the curriculum ensures that nursing students are exposed to and learn about caring for older adults in various courses, rather than just in a standalone course. This approach better prepares students to provide holistic care to older adults in different clinical settings.
A: Provision of a free-standing course in gerontology within the curriculum may limit exposure to gerontological content and may not provide a comprehensive understanding of caring for older adults.
C: Requiring gerontological certification for all students before completion of a BSN program is not mentioned in the document and may not be feasible or necessary for all nursing students.
D: While structured clinical experiences with older adults across the continuum of care are essential, this alone may not ensure that students receive a comprehensive education in gerontological care if the content is not integrated throughout the curriculum.
What is the most significant predictor of successful aging in older adults?
- A. Financial security
- B. Physical fitness and health
- C. Social engagement and support
- D. Mental resilience
Correct Answer: C
Rationale: The correct answer is C: Social engagement and support. Social engagement has been identified as a crucial factor in successful aging, as it contributes to emotional well-being, cognitive function, and overall quality of life. Older adults with strong social networks tend to have better physical and mental health outcomes. Social support can help individuals cope with stress, reduce feelings of loneliness and isolation, and provide a sense of purpose and belonging. Financial security (A) is important but not the most significant predictor. Physical fitness and health (B) are essential but do not solely determine successful aging. Mental resilience (D) is valuable, but the social aspect plays a more significant role in aging successfully.
The home care nurse is performing an environmental assessment in the home of an older adult. Which of the following requires immediate nursing action?
- A. Unsecured scattered rugs
- B. Operable smoke detector
- C. Prefilled medication cassette
- D. Unsecured scattered rugs
Correct Answer: A
Rationale: The correct answer is A: Unsecured scattered rugs. This requires immediate nursing action as it poses a significant fall risk for the older adult. Rugs can cause tripping hazards, leading to potential injuries. The nurse should secure or remove the rugs to ensure the safety of the patient.
Summary of other choices:
B: Operable smoke detector - While important for safety, it does not require immediate nursing action as it is already in working condition.
C: Prefilled medication cassette - This is not an immediate safety concern and can be addressed during routine medication management.
D: Unsecured scattered rugs (repeated) - This choice is the same as the correct answer, so it is incorrect.
Which of the following interview questions would be most appropriate when a nurse is assessing a client's respiratory function?
- A. Would you be interested in finding out more about environmental smoke?
- B. Did either of your parents experience lung disease?
- C. Have you ever worked in a job where you were exposed to dust, fumes, smoke, or other pollutants?
- D. What do you do to actively maintain your health?
Correct Answer: C
Rationale: The most appropriate interview question for assessing a client's respiratory function is C: "Have you ever worked in a job where you were exposed to dust, fumes, smoke, or other pollutants?" This question directly relates to potential occupational exposures that could impact respiratory health. It helps gather specific information relevant to respiratory assessment. Choice A is unrelated to respiratory function assessment. Choice B focuses on familial history, which is important but not as direct as occupational exposure. Choice D is too general and does not specifically address respiratory issues. Therefore, C is the most appropriate choice for assessing respiratory function.