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: A

Rationale: The correct answer is A: peripheral arterial disease. Altered level of consciousness in an 81-year-old female is unlikely to be directly caused by peripheral arterial disease. Instead, hypoglycemia, pneumonia, and hypotension from dehydration are common causes of altered mental status in the elderly. Hypoglycemia can lead to brain dysfunction, pneumonia can cause low oxygen levels affecting brain function, and dehydration-induced hypotension can reduce blood flow to the brain. Therefore, peripheral arterial disease is not typically a direct cause of altered consciousness in this scenario.

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.

Correct Answer: C

Rationale: Certainly! Regular strength training exercises are crucial for improving strength and overall function in older adults with frailty. Strength training helps build muscle mass, improve balance, and increase mobility, leading to enhanced functional abilities. It also helps prevent falls and maintain independence. High-protein diet (A) supports muscle health but alone is not sufficient. Medication management (B) is important but not the primary factor for physical function. Limiting physical activity (D) can worsen frailty by causing deconditioning and loss of muscle strength.

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: 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: D

Rationale: The correct answer is D: Lack of physical exercise contributes the most to aging-related cognitive decline. Regular physical exercise increases blood flow to the brain, promotes neurogenesis, and enhances cognitive function. It also reduces the risk of developing conditions such as dementia and Alzheimer's disease. Chronic stress (A) can impact cognitive function, but it is not the primary factor in aging-related decline. Poor nutrition (B) can negatively affect brain health, but exercise has a more significant impact. Social isolation (C) is also detrimental to cognitive health, but physical exercise has been shown to have a more substantial influence on cognitive decline in aging individuals.

Correct Answer: B

Rationale: The correct answer is B because the Nurse Competence in Aging (NCA) initiative focuses on developing resources for nurses to access evidence-based information on topics related to the care of older adults. This is evident in the initiative's goal to enhance the knowledge and skills of nurses caring for older adults. The other choices are incorrect because A is not specific to the NCA initiative, C pertains to scholarships rather than resources for accessing information, and D is incorrect as the NCA initiative did not develop the first certification in gerontological nursing.

Correct Answer: C

Rationale: The correct answer is C: Relief from physical, emotional, and spiritual suffering. This is the best indicator of a successful transition to hospice care for older adults because hospice care focuses on providing comfort and improving quality of life rather than curative treatments. Relief from suffering aligns with the goals of hospice care, addressing the holistic needs of patients. Choice A is incorrect as complete cessation of all medical treatments may not be appropriate for all patients in hospice care. Choice B is incorrect as improvement in physical strength may not be the primary goal in hospice care. Choice D is incorrect as long-term emotional stability is important but not necessarily the best indicator of a successful transition to hospice care.