________ is a factor that contributes to a high incidence of falls in the elderly.

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.

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.

Correct Answer: A

Rationale: The correct answer is A: Mild cognitive impairment (MCI). MCI is often mistaken for normal aging because it involves subtle changes in memory and thinking abilities that are beyond what is expected for age but not severe enough to be classified as dementia. Individuals with MCI may experience forgetfulness or difficulty with complex tasks, which can be misconstrued as typical age-related changes. Alzheimer's disease (B), dementia with Lewy bodies (C), and vascular dementia (D) are all forms of dementia characterized by more significant cognitive decline and functional impairment compared to MCI, making them less likely to be confused with normal aging.

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).

Correct Answer: B

Rationale: The correct answer is B, cognitive-behavioral therapy (CBT) combined with antidepressant medications, for treating depression in older adults. CBT helps address negative thought patterns and behaviors associated with depression, while antidepressant medications provide physiological support. Combining both approaches has been shown to be more effective than either treatment alone in older adults. A: Long-term pharmacological therapy with SSRIs may have side effects and limited effectiveness in older adults. C: Antidepressant medications alone may not address the underlying psychological factors contributing to depression. D: Psychodynamic therapy may not be as effective in older adults as it focuses on unresolved issues from early life rather than targeting current depressive symptoms.

Correct Answer: D

Rationale: The correct answer is D because reluctance of older adults to report pain is a significant barrier to effective pain management. Older adults may underreport pain due to various factors such as fear of being seen as a burden, denial of aging-related changes, or belief that pain is a natural part of aging. This can lead to under-treatment of pain and decreased quality of life. Choices A, B, and C are not the most common barriers in this context. Fear of addiction to opioids, insufficient knowledge among healthcare providers, and inadequate access to specialists are important factors but are not as prevalent as older adults' reluctance to report pain.

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.

Correct Answer: C

Rationale: The correct answer is C: Cognitive-behavioral therapy (CBT) and physical therapy. CBT helps older adults manage pain through changing thought patterns and behaviors, improving coping skills. Physical therapy helps maintain mobility and reduce pain. Both approaches address the physical and psychological aspects of chronic pain, leading to better quality of life. Complete bed rest (A) can worsen pain and lead to muscle weakness. Unsupervised use of opioids (B) can be dangerous, leading to addiction and other health issues. Isolation and minimal social interaction (D) can contribute to depression and exacerbate pain.

Correct Answer: A

Rationale: Step 1: Gerontological nursing certification focuses on advanced knowledge and skills for caring for older adults. Step 2: This certification is not a requirement for all nurses in long-term care or limited to rehabilitation centers. Step 3: Nurses with various levels of education, not just a master's degree, can obtain gerontological certification. Therefore, option A is correct as it accurately states that gerontological nursing certification signifies advanced knowledge and skills specific to older adult care. Options B, C, and D are incorrect as they provide inaccurate information about the certification requirements and scope.