A 75 yr old client is recovering from abdominal surgery. The DR. has ordered morphine 2-6 mg every 4 hrs prn for pain. As the nurse plans to administer this medication, what intervention would the nurse choose to administer this drug to an older person?

Correct Answer: B

Rationale: The correct answer is B: administer the lowest dose of 2 mg. In older adults, especially the elderly, it is essential to start with the lowest effective dose of medication to minimize the risk of adverse effects. This approach follows the principle of "start low and go slow" when administering medications to older adults due to age-related changes in drug metabolism and increased sensitivity to medications. Administering the lowest effective dose helps to reduce the risk of potential complications such as respiratory depression, sedation, and falls. Choice A (administer the highest dose of 6 mg) is incorrect because starting with the highest dose can increase the risk of adverse effects in older adults. Choice C (avoid the narcotic because of the risk of addiction) is incorrect as it is important to manage pain effectively in post-operative patients, and opioids can be safely used under proper supervision. Choice D (administer the dose only when the client asks for the medication 2 times) is incorrect as pain management should be

Correct Answer: D

Rationale: The correct answer is D, Standards of gerontological nursing practice, as the ANA Scope and Standards of Gerontological Nursing (2010) specifically outlines the accepted standards and guidelines for gerontological nursing practice. This document does not focus on skills and knowledge (Choice A), levels of practice (Choice B), or certification requirements (Choice C), but rather on setting the standards and expectations for gerontological nursing care. It is essential for nurses to adhere to these standards to provide high-quality care to older adults.

Correct Answer: B

Rationale: The correct answer is B because a red, swollen 3-day-old wound in an older person indicates delayed wound healing, which is abnormal. The skin's ability to heal slows down with age due to decreased collagen production and compromised immune response. Thinner and more fragile skin (choice A) are typical changes in older individuals but not necessarily abnormal. Greater number of freckles (choice C) is a common age-related change due to accumulated sun exposure. Loss of hair on the extremities (choice D) can occur with aging but is not necessarily abnormal unless it is sudden and widespread.

Correct Answer: B

Rationale: Correct Answer: B Rationale: The thymus gland is responsible for producing T-cells, crucial for immune responses. As individuals age, the thymus gland shrinks and becomes less efficient, reducing the production of new T-cells. This decline in T-cell production weakens the immune response in older adults, making them more susceptible to infections. Therefore, choice B is correct. Summary of Incorrect Choices: A: Aging does not increase the production of white blood cells. In fact, the immune system may weaken with age due to a decline in key immune cells. C: Aging does not improve the body's ability to recognize and fight off pathogens. Instead, it often leads to a decline in immune function. D: While some inflammatory responses may increase with age, excessive inflammation can actually be harmful and contribute to age-related diseases, rather than providing protection.

Correct Answer: B

Rationale: The correct answer is B because older adults with chronic conditions are often prescribed multiple medications to manage their various health issues, leading to polypharmacy and increased risk of adverse drug reactions. This challenge can result in medication mismanagement, drug interactions, and medication non-adherence. The other choices are incorrect because comorbidities are common in older adults, medical intervention is generally accepted, and older adults often experience declines in physical and cognitive health with age.

Correct Answer: A

Rationale: The correct answer is A: Monitor the client's blood glucose level. Tremors and confusion in a client with diabetes could indicate hypoglycemia. Monitoring blood glucose levels will confirm if the client's symptoms are due to low blood sugar. Providing a full meal (B) may worsen the situation by delaying the increase in blood sugar. Asking the client to rest (C) does not address the underlying cause. Administering insulin immediately (D) without knowing the current blood glucose level can further lower blood sugar levels. Hence, monitoring the blood glucose level is the most appropriate initial action.

Correct Answer: B

Rationale: The correct answer is B. Fewer than 50% of older adults utilize available preventive services. This is important for a community health initiative as it highlights a gap in healthcare utilization among seniors. By recognizing this statistic, the nurse can tailor the initiative to target the barriers preventing seniors from accessing preventive services. Rationale: 1. Option A is incorrect because stating that approximately 60% of older adults actively participate in preventive health services is misleading. The actual utilization rate is lower. 2. Option C is incorrect as it focuses on preference for alternative medicine rather than actual utilization of preventive health services. 3. Option D is incorrect as it states preventive health services are equally utilized by older and younger adults, which is not supported by data regarding senior healthcare utilization.

Correct Answer: D

Rationale: The correct answer is D: Age-related changes in liver function. As people age, there are changes in liver metabolism and blood flow, affecting the processing of anesthetic agents. Liver function declines with age, leading to slower drug metabolism and clearance, increasing the risk of adverse reactions. Decreased muscle mass (A) may affect drug distribution but not metabolism. Decreased renal function (B) can impact drug excretion but is not the primary reason for adverse reactions. Increased body fat (C) can alter drug distribution but is not the main factor in anesthesia reactions for older adults.

Correct Answer: D

Rationale: The correct answer is D because allowing the client to choose activities promotes autonomy by giving him control over his daily routine and decision-making. This empowers the client to maintain a sense of independence and self-determination, which is crucial in long-term care settings. Planning meals (A) and scheduling appointments (B) are important tasks but do not directly contribute to the client's autonomy. Decorating his room (C) is a thoughtful gesture but does not actively involve the client in decision-making or daily choices.