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: C

Rationale: The correct answer is C: Cognitive-behavioral therapy (CBT) and physical therapy. CBT helps older adults manage pain through changing thought patterns and behaviors, improving coping skills. Physical therapy helps maintain mobility and reduce pain. Both approaches address the physical and psychological aspects of chronic pain, leading to better quality of life. Complete bed rest (A) can worsen pain and lead to muscle weakness. Unsupervised use of opioids (B) can be dangerous, leading to addiction and other health issues. Isolation and minimal social interaction (D) can contribute to depression and exacerbate pain.

Correct Answer: C

Rationale: Rationale: C is correct as it involves understanding the patient's beliefs and preferences, crucial in culturally competent care. A would not address the patient's perspective directly. B is broad and lacks specificity. D assumes all traditional Chinese individuals seek Chinese medicine, which may not be the case.

Correct Answer: B

Rationale: The correct answer is B: high likelihood of orthostatic hypotension upon rising quickly. Orthostatic hypotension is a common issue in the elderly, causing a sudden drop in blood pressure when standing up quickly, leading to dizziness and falls. This factor directly contributes to the high incidence of falls in the elderly. Increased muscle mass and tone (A) actually reduce the risk of falls, while improving eyesight in dim light (C) would decrease the risk. Constipation (D) is not directly related to falls in the elderly.

Correct Answer: A

Rationale: The correct answer is A because the TimeSlips program involves providing a picture as a creative prompt for group members to collaboratively create a story. This technique stimulates imagination and communication in cognitively impaired individuals. Choice B is incorrect as recording responses is not specific to the TimeSlips method. Choice C is incorrect as complimenting contributions is not a core component of the TimeSlips program. Choice D is incorrect as reading back the story during the session does not align with the collaborative, creative process of TimeSlips.

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).

Correct Answer: C

Rationale: The correct answer is C - Difficulty walking and balance issues. Frailty in older adults is characterized by physical weakness, decreased muscle strength, and reduced functional capacity. Difficulty walking and balance issues are key indicators of frailty as they reflect a decline in physical capabilities. Increased muscle mass (A) is not a sign of frailty but rather a positive indicator of strength. Unexplained weight gain (B) may not necessarily be related to frailty. Improved cognitive function (D) is unrelated to physical frailty.

Correct Answer: C, D, E

Rationale: The correct answers are C, D, and E. C is crucial as it allows for effective communication, D involves observing nonverbal cues, and E emphasizes the need for clear and concise language. A is incorrect as the nurse should address the client directly, not just the interpreter. B is incorrect as using technical terms may hinder understanding.

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.