A nurse is caring for a culturally diverse patient who has missed follow-up appointments. The patient says: “You don’t understand—in my culture, we don’t do things like that.” The nurse understands which of the following about the patient’s culture?

Correct Answer: B

Rationale: The correct answer is B: The culture has a different orientation to time than Western medicine. This is because the patient's statement about not following up on appointments due to cultural reasons suggests a difference in the perception and importance of time. In some cultures, time is more fluid and flexible compared to the rigid scheduling of Western medicine. This understanding helps the nurse provide culturally sensitive care. Choices A, C, and D are incorrect: A: The culture does not value Western medicine - This is not necessarily implied by the patient's statement about cultural differences. C: The culture is an interdependent culture - The patient's statement does not provide direct evidence of the culture being interdependent. D: The culture does not believe in preventative care - There is no indication in the patient's statement that the culture does not believe in preventative care.

Correct Answer: B

Rationale: The correct answer is B, cognitive-behavioral therapy (CBT) combined with antidepressant medications, for treating depression in older adults. CBT helps address negative thought patterns and behaviors associated with depression, while antidepressant medications provide physiological support. Combining both approaches has been shown to be more effective than either treatment alone in older adults. A: Long-term pharmacological therapy with SSRIs may have side effects and limited effectiveness in older adults. C: Antidepressant medications alone may not address the underlying psychological factors contributing to depression. D: Psychodynamic therapy may not be as effective in older adults as it focuses on unresolved issues from early life rather than targeting current depressive symptoms.

Correct Answer: B

Rationale: The correct answer is B because older adults have reduced kidney function, which impairs their ability to concentrate urine and retain water. Additionally, they may have a diminished thirst sensation, making them less likely to drink enough fluids. This combination of factors makes older adults more vulnerable to dehydration compared to younger adults. Choice A is incorrect because older adults actually have a lower percentage of body water due to age-related changes in body composition. Choice C is incorrect as dehydration can indeed have a more significant impact on older adults due to their physiological changes. Choice D is incorrect as older adults are actually more prone to dehydration due to various age-related factors.

Correct Answer: A

Rationale: The correct answer is A: Decreased manual dexterity and inability to hold a toothbrush. As people age, they may experience decreased hand strength and motor skills, making it difficult to hold and manipulate objects like a toothbrush. This can lead to a decline in oral hygiene practices. Malocclusion of teeth (B) does not directly impact the ability to brush teeth. Decrease in taste acuity (C) may affect appetite but not tooth brushing habits. Lack of dental insurance (D) is a financial barrier and may affect access to dental care, but it does not directly impact the physical ability to brush teeth.

Correct Answer: A

Rationale: The correct answer is A: Pneumonia. Older adults are more susceptible to pneumonia due to weakened immune systems and other health conditions. Pneumonia can lead to severe complications requiring hospitalization. Stroke (B) affects a significant number of older adults but is not the leading cause of hospitalization. Diabetes (C) and Congestive heart failure (D) are prevalent in older adults but are not the primary reason for hospitalization. Pneumonia's severity and impact on older adults' health make it the leading cause of hospitalization.

Correct Answer: C

Rationale: The correct answer is C because a room with hardwood floor and large windows overlooking a garden area offers a safe, non-slip surface for exercise and natural light for a pleasant environment. Hardwood floors are ideal for exercise to prevent slipping, and the large windows provide a view of the garden area, which can enhance motivation and mood. The other choices are incorrect because A has throw rugs, which can cause tripping hazards, B lacks natural light and ventilation, and D has a linoleum floor which may not be as safe for exercise compared to hardwood.

Correct Answer: A

Rationale: The correct answer is A: Free radical theory. Vitamin C is thought to prevent aging by combatting free radicals, which are highly reactive molecules that can damage cells and contribute to aging. Vitamin C acts as an antioxidant, neutralizing free radicals and protecting cells from oxidative damage. Immunological theory (B) focuses on the role of the immune system in aging. Oxidative stress theory (C) is related to free radical theory but does not specifically address the role of vitamin C. Telomere theory (D) pertains to the shortening of telomeres, which are protective structures at the end of chromosomes, but is not directly related to the role of vitamin C in preventing aging.

Correct Answer: B

Rationale: The correct answer is B: Integration of gerontological content throughout the curriculum. This is because integrating gerontological content throughout the curriculum ensures that nursing students are exposed to and learn about caring for older adults in various courses, rather than just in a standalone course. This approach better prepares students to provide holistic care to older adults in different clinical settings. A: Provision of a free-standing course in gerontology within the curriculum may limit exposure to gerontological content and may not provide a comprehensive understanding of caring for older adults. C: Requiring gerontological certification for all students before completion of a BSN program is not mentioned in the document and may not be feasible or necessary for all nursing students. D: While structured clinical experiences with older adults across the continuum of care are essential, this alone may not ensure that students receive a comprehensive education in gerontological care if the content is not integrated throughout the curriculum.

Correct Answer: B

Rationale: The correct answer, B, is the primary role of the gerontological nurse when providing end-of-life care for a terminally ill older adult. This choice emphasizes the importance of pain management, comfort care, and preserving the patient's dignity. The nurse's focus should be on enhancing the quality of life and ensuring the patient's comfort rather than pursuing aggressive curative treatments (A). Administering sedatives (C) should be based on individual needs and preferences, not as a blanket approach. While family involvement is crucial, the nurse should still advocate for the patient's autonomy and preferences, rather than solely relying on family decisions (D).