A 78 yr old female presents to the ED with complaints of nausea and sudden onset shortness of breath. The initial workup includes ____________.

Correct Answer: D

Rationale: The correct answer is D, EKG and serial enzymes for determination of an MI. In this scenario, the patient's symptoms of nausea and sudden onset shortness of breath raise concern for a possible myocardial infarction (MI). Conducting an EKG and serial enzymes helps in diagnosing an MI by assessing for cardiac ischemia or injury. Upper endoscopy (choice A) is not indicated for these symptoms. A CT of the head (choice B) is unnecessary as the symptoms are suggestive of a cardiac issue, not a neurological one. Liver function studies (choice C) do not align with the presenting symptoms and are not a priority in this acute setting. Conducting an EKG and serial enzymes is the most appropriate initial workup to assess for a possible MI in this elderly patient with concerning symptoms.

Correct Answer: D

Rationale: The correct answer is D. Ingesting excessive acetaminophen can lead to liver damage, not renal failure. Diabetes mellitus, prostate hypertrophy causing urinary obstruction, and heart failure are known to cause renal failure due to their effects on kidney function. Diabetic nephropathy can damage the kidneys over time, prostate hypertrophy can obstruct urine flow and lead to kidney damage, and heart failure can result in decreased blood flow to the kidneys, causing renal failure. Thus, D is the correct answer as it does not directly cause renal failure, unlike the other choices.

Correct Answer: B

Rationale: The correct answer is B because social isolation is not directly related to decreased tactile sensations. A, C, and D are consequences of decreased tactile sensations in older individuals. A can occur due to not feeling the temperature, C due to not feeling pressure and injury, and D due to decreased sensation causing falls. Social isolation is more related to emotional or psychological factors rather than physical sensations. It is crucial to differentiate between physical consequences and social consequences when considering the effects of decreased tactile sensations in older individuals.

Correct Answer: B

Rationale: The correct answer is B because super-centenarians, who are individuals aged 110 years or older, often exhibit a high level of functional independence despite their advanced age. This is supported by research showing that many super-centenarians maintain physical and cognitive abilities that allow them to perform daily activities without significant assistance. This statement aligns with the concept of successful aging, where individuals maintain autonomy and independence in later years. Option A is incorrect because a significant number of super-centenarians are not dependent on full-time nursing care for daily activities. Option C is incorrect as many super-centenarians can still engage in social activities despite health limitations. Option D is incorrect as most super-centenarians do not experience severe cognitive decline that affects their daily living.

Correct Answer:

Rationale: Correct Answer: Regular physical activity and healthy diet Rationale: 1. Regular physical activity helps maintain cardiovascular health, muscle strength, and balance in older adults, reducing the risk of falls and chronic diseases. 2. A healthy diet provides essential nutrients for overall health and helps prevent conditions like obesity, diabetes, and heart disease. 3. Both components are key in primary prevention by promoting overall well-being, reducing the risk of age-related health issues, and enhancing quality of life. Incorrect Choices: A: Annual health screenings - While important for early detection, screenings alone do not prevent health issues. B: Social isolation prevention programs - Important for mental health, but not primary prevention. C: Routine medication management - Important for managing existing conditions, not primary prevention. D: Memory enhancement exercises - Beneficial for cognitive health but not primary prevention for physical health issues in older adults.