A nurse is caring for a 70 yr old client with pain related to osteoarthritis. The pain is relatively constant. The client is prescribed pharmacological treatment for the pain. In suggesting alternative therapies to the client, the nurse would consider their effectiveness to be:

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: Home health care support. This is because having access to home health care support can provide ongoing monitoring, medication management, and assistance with activities of daily living, which can help prevent complications and reduce the need for hospital readmissions. Minimizing polypharmacy (A) is important but may not have as significant an impact as continuous home health care support. Frequent medication adjustments (B) may lead to confusion and potential adverse effects in older adults. Specialized geriatric assessments (D) are beneficial but may not directly address the day-to-day support needed to prevent hospital readmissions.

Correct Answer: A

Rationale: The correct answer is A because a high-intensity lamp can provide better lighting for reading, addressing the difficulty the patient experiences in the evening. This intervention can improve visibility and reduce strain on the eyes. Option B is incorrect as arcus senilis is a common age-related condition but not a direct cause of difficulty reading. Option C is incorrect as simply increasing the power of fluorescent lights may not address specific visual needs for reading. Option D is incorrect as examining the retinas may not directly address the patient's difficulty in reading and is not the most appropriate initial intervention.

Correct Answer: D

Rationale: The correct answer is D: Facilitate family rituals related to death and dying. In end-of-life care, it is essential to support the older adult and their family in their cultural and spiritual practices to promote comfort and closure. This intervention aligns with the goals of long-term care by addressing the psychological and emotional needs of the patient and family. Providing a basin and towels (B) focuses on physical self-care, which may not be a priority in end-stage disease. Decreasing analgesic dose (A) can compromise pain management and quality of life. Informing family members about strict visiting hours (C) can hinder emotional support and connection during this critical time.

Correct Answer: D

Rationale: The correct answer is D because it demonstrates empathy, collaboration, and a patient-centered approach. By asking how to work together, the nurse acknowledges the daughter's concerns and fosters a collaborative relationship. This approach respects the daughter's role in her mother's care and encourages open communication. Choice A is incorrect as it uses a threatening tone and may alienate the daughter, leading to a breakdown in communication. Choice B is incorrect as it dismisses the daughter's cultural values, which are important in providing holistic care. Choice C is incorrect as it suggests that the daughter is incapable of caring for her mother, which can be disempowering and offensive.

Correct Answer: D

Rationale: The correct answer is D because reviewing a menu with the older man allows for personalized food selection, taking into account his preferences and dietary restrictions. This approach promotes adherence to a healthy eating plan, leading to better cholesterol management and overall wellness. Choice A is not the best option as simply instructing him to increase dietary fiber may not address his specific dietary needs. Choice B suggests asking the health care provider for a low-fat diet, which may not consider the individual's food preferences or cultural background. Choice C of scheduling a consultation with a dietitian is a good option, but it may not be as immediately accessible or practical as reviewing a menu together with the individual.

Correct Answer: A

Rationale: The correct answer is A: Physical exercise. Engaging in physical exercise has been shown to improve blood flow to the brain, promote the growth of new brain cells, and enhance cognitive function. This helps maintain brain health and may reduce the risk of developing dementia. Other choices are not as directly related to brain health. B: Stimulating mental activity is important but not as effective as physical exercise in preventing dementia. C: Socialization is beneficial for overall well-being but does not have a direct impact on brain health. D: Crossword puzzles are a form of mental stimulation, but physical exercise has a greater impact on brain health.

Correct Answer: A

Rationale: The correct answer is A because walking is a physical activity that promotes cardiovascular health, strength, and overall well-being. Regular exercise like walking 3-5 times per week for 30 minutes can help improve circulation, maintain healthy weight, and reduce the risk of chronic diseases. Cooking healthy meals (choice B) is important for nutrition but may not directly promote physical activity. Reading and knitting (choice C) are mentally stimulating but do not provide the physical benefits of exercise. Taking vitamins daily (choice D) is important for overall health but does not substitute for physical activity.

Correct Answer: C

Rationale: The correct answer is C: Pneumonia. Older adults are more susceptible to pneumonia due to weakened immune systems and underlying health conditions. Pneumonia can lead to severe complications, requiring hospitalization. Osteoarthritis (A) primarily affects joints and does not typically lead to hospitalization. Stroke (B) and heart failure (D) are serious conditions but may not be as common for hospitalization as pneumonia in older adults. Pneumonia's impact on the respiratory system and its ability to progress rapidly make it the most common reason for hospitalization in this population.