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: B

Rationale: The correct answer is B: Greater when used in conjunction with pharmacological therapy. This is because combining alternative therapies with pharmacological treatment can often provide a synergistic effect, resulting in better pain management outcomes. Alternative therapies such as physical therapy, acupuncture, or mindfulness techniques can complement the effects of medications, leading to improved pain relief. Options A and D are incorrect as age alone does not determine the effectiveness of alternative therapies. Option C is also incorrect as combining therapies can enhance overall pain management strategies.

Correct Answer: C

Rationale: The correct answer is C because regular repositioning every 2 hours, along with the use of pressure-relieving devices, is the most effective intervention to prevent pressure ulcers in older adults with limited mobility. Repositioning helps to redistribute pressure, reducing the risk of tissue damage. Pressure-relieving devices like cushions or mattresses further help to alleviate pressure points. Choice A is incorrect because strict bed rest and minimal repositioning can actually increase the risk of pressure ulcers by concentrating pressure on specific areas. Choice B is incorrect as high-protein diets and supplements alone do not address the primary cause of pressure ulcers, which is prolonged pressure on the skin. Choice D is incorrect because leaving wounds uncovered can increase the risk of infection and hinder the healing process.

Correct Answer: D

Rationale: The correct answer is D: Complicated medication regimens. Older adults often have multiple medical conditions requiring several medications, leading to confusion and difficulty in following complex regimens. This complexity increases the likelihood of medication nonadherence. Lack of health literacy (A) may contribute but is not the primary factor. High cost of medications (B) and limited access to healthcare providers (C) are important barriers, but they are not as directly linked to nonadherence as the complexity of medication regimens.

Correct Answer: D

Rationale: The correct answer is D because promoting independence without assistance to all clients may not always maintain safety for the elderly. Elderly individuals may require some level of assistance for certain activities to prevent falls or other safety risks. Providing assistance when needed is crucial for ensuring their safety. A: Modifying the environment to reduce obstacles and barriers to ambulation helps prevent falls. B: Consistent checks of ambulation abilities ensure early detection of any decline in mobility. C: Orienting to new surroundings and repeating as needed helps prevent confusion and disorientation.