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: B

Rationale: The correct answer is B, Cognitive Behavioral Therapy (CBT) combined with physical therapy. This intervention is effective in managing chronic pain in older adults because it addresses both the psychological and physical aspects of pain. CBT helps individuals change negative thought patterns and behaviors related to pain, leading to improved pain management. Physical therapy can help improve physical function and reduce pain through exercises and techniques. A: Increased use of narcotic medications may provide short-term relief but can lead to dependence and other negative side effects in older adults. C: Isolation can worsen mental health and exacerbate pain symptoms due to lack of social support and interaction. D: Surgery is not suitable for all types of chronic pain in older adults and should only be considered as a last resort after conservative interventions have been tried. In summary, B is the most effective intervention as it addresses both psychological and physical aspects of chronic pain in older adults, unlike the other options which may have limitations or negative consequences.

Correct Answer: A, B, C

Rationale: The correct answers are A, B, and C. A cultural assessment is important in healthcare settings to understand the patient's beliefs, values, and practices related to health and illness. A) Culture guides decision making about health, illness, and preventive care because beliefs and practices vary among cultures. B) Culture provides direction for individuals on how to interact during health care encounters as communication styles and expectations differ based on culture. C) Culture impacts attitudes toward aging as perceptions of aging, care for the elderly, and end-of-life decisions are influenced by cultural beliefs. D is incorrect because individuals within the same culture may still have diverse reactions in similar situations due to personal differences and experiences.

Correct Answer: C

Rationale: The correct answer is C: Being adequately nourished. Malnutrition weakens the immune system, making individuals more susceptible to infections like tuberculosis. Diabetes (A), living in crowded institutions (B), and immunosuppression (D) all lower immunity, increasing the risk of developing TB. In summary, adequate nutrition is not a risk factor for TB in the elderly, while diabetes, institutional living, and immunosuppression are.

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: A

Rationale: The correct answer is A because older adults are indeed the fastest growing population using computers and the Internet due to increasing digital literacy and accessibility. Choice B is incorrect as research shows older adults are increasingly using social networking sites. Choice C is incorrect as many older adults do perceive the Internet as a valuable resource. Choice D is also incorrect as older adults are utilizing the Internet to connect with their healthcare providers more frequently.

Correct Answer: B

Rationale: The correct answer is B because antibiotics are not standard therapy for congestive heart failure in the elderly. The rationale is that antibiotics are used to treat bacterial infections, not heart failure. A: ACE inhibitors are standard therapy as they help dilate blood vessels and reduce the workload on the heart. C: Diuretics help reduce fluid buildup in the body, which is beneficial for managing CHF symptoms. D: Beta blockers are used to reduce the heart's workload and help manage the stress response, making them standard therapy for CHF.

Correct Answer: A

Rationale: The correct answer is A: Hypertension. Hypertension, or high blood pressure, is the most common chronic condition affecting older adults in the U.S. This is because aging increases the risk of developing hypertension due to changes in blood vessels and the heart. Hypertension can lead to serious health complications such as heart disease and stroke. Summary: B: Osteoporosis primarily affects bone density and is more common in older women. C: Alzheimer's disease is a type of dementia that affects memory and cognitive function, but it is not as prevalent as hypertension among older adults. D: Diabetes is a chronic condition characterized by high blood sugar levels and while it is common, hypertension is more prevalent in older adults in the U.S.

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.