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: C

Rationale: The correct answer is C: Free radical theory. This theory states that aging is caused by the accumulation of damage from free radicals in the body, which can be countered by antioxidants found in fruits and vegetables. Thus, the nurse considering the importance of a diet high in fruits and vegetables aligns with the free radical theory. Incorrect choices: A: Oxidative stress theory focuses on the imbalance between free radicals and antioxidants, not specifically on fruits and vegetables. B: Immunological theory relates to the immune system's role in aging, not directly linked to diet. D: Telomere theory concerns the role of telomeres in aging, not directly related to the benefits of fruits and vegetables.

Correct Answer: A

Rationale: The correct answer is A because as individuals age, there is a decrease in renal function leading to reduced renal clearance of drugs. This results in a longer drug half-life and potentially increased drug accumulation in the body. Choice B is incorrect as aging often leads to a decrease in hepatic metabolism, not faster metabolism. Choice C is incorrect because aging can actually lead to reduced gastrointestinal absorption due to changes in the gastrointestinal tract. Choice D is incorrect as aging can result in decreased circulation, which may affect drug distribution negatively.

Correct Answer: B

Rationale: The correct answer is B because Mezey and Fulmer (2002) justify gerontological nursing research by emphasizing that it positively influences outcomes from nursing care. This is supported by evidence showing how research in gerontological nursing can lead to improved quality of care for older adults. Other choices are incorrect: A is not directly supported by the justification provided by Mezey and Fulmer (2002), C is too specific and not the main focus of their justification, and D is not mentioned in the justification and does not address the impact of research on nursing care outcomes.

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: Rationale for Correct Answer B: "Channeling Your Inner Strength Toward Wellness" 1. Focuses on a positive approach to aging by emphasizing inner strength and wellness. 2. Aligns with the ALF's philosophy of viewing aging from a health perspective. 3. Encourages residents to take an active role in their well-being and empowers them. 4. Promotes a holistic view of health by addressing physical, mental, and emotional aspects. Summary of Incorrect Choices: A: "The Many Chronic Illnesses of Aging" - Focuses on negative aspects and does not promote a proactive approach to health. C: "Maximizing Function As You Age" - While important, it may not fully capture the holistic nature of health and wellness. D: "Conserving Your Strength As You Age" - Does not emphasize active engagement in promoting wellness and may promote a passive approach.

Correct Answer: B

Rationale: The correct answer is B: Increasing protein intake. Protein is crucial for maintaining muscle mass and strength in older adults, aiding in the prevention and management of malnutrition. Protein also supports immune function and wound healing. Reducing calorie intake (A) can exacerbate malnutrition, as older adults need adequate nutrition. Avoiding all fats (C) is not recommended as healthy fats are essential for brain health and nutrient absorption. Limiting hydration (D) can lead to dehydration and worsen malnutrition. In summary, increasing protein intake is the most important factor in managing malnutrition in older adults due to its vital role in maintaining overall health and preventing muscle loss.

Correct Answer: D

Rationale: The correct answer is D because facing the patient rather than the interpreter promotes direct communication and builds trust. This approach allows for better non-verbal communication cues to be exchanged between the nurse and the patient. Conversely, choice A is incorrect as interpreters are vital for accurate communication even if the nurse speaks the same language. Choice B is incorrect because using technical terms or metaphors may confuse the interpreter and patient. Choice C is incorrect as using family members as interpreters can compromise confidentiality and accuracy.

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.