Correct Answer: C

Rationale: The correct answer is C: Being adequately nourished. Malnutrition weakens the immune system, making individuals more susceptible to infections like tuberculosis. Diabetes (A), living in crowded institutions (B), and immunosuppression (D) all lower immunity, increasing the risk of developing TB. In summary, adequate nutrition is not a risk factor for TB in the elderly, while diabetes, institutional living, and immunosuppression are.

Correct Answer: B

Rationale: The correct answer is B because a red, swollen 3-day-old wound in an older person indicates delayed wound healing, which is abnormal. The skin's ability to heal slows down with age due to decreased collagen production and compromised immune response. Thinner and more fragile skin (choice A) are typical changes in older individuals but not necessarily abnormal. Greater number of freckles (choice C) is a common age-related change due to accumulated sun exposure. Loss of hair on the extremities (choice D) can occur with aging but is not necessarily abnormal unless it is sudden and widespread.

Correct Answer: B

Rationale: The correct answer is B: administer the lowest dose of 2 mg. In older adults, especially the elderly, it is essential to start with the lowest effective dose of medication to minimize the risk of adverse effects. This approach follows the principle of "start low and go slow" when administering medications to older adults due to age-related changes in drug metabolism and increased sensitivity to medications. Administering the lowest effective dose helps to reduce the risk of potential complications such as respiratory depression, sedation, and falls. Choice A (administer the highest dose of 6 mg) is incorrect because starting with the highest dose can increase the risk of adverse effects in older adults. Choice C (avoid the narcotic because of the risk of addiction) is incorrect as it is important to manage pain effectively in post-operative patients, and opioids can be safely used under proper supervision. Choice D (administer the dose only when the client asks for the medication 2 times) is incorrect as pain management should be

Correct Answer: D

Rationale: The correct answer is D, dramatic loss of melanin. Melanin is a pigment responsible for skin color and does not play a role in the development of pressure ulcers. Shearing, decreased body weight, and malnutrition (decreased serum albumin) are all known risk factors for pressure ulcers in the elderly. Shearing can lead to tissue damage, decreased body weight can indicate poor nutrition and muscle wasting, and malnutrition can impair wound healing and skin integrity. Therefore, D is the correct answer as it does not contribute to the likelihood of an elderly person developing a pressure ulcer.

Correct Answer: D

Rationale: The correct answer is D: Age-related changes in liver function. As people age, there are changes in liver metabolism and blood flow, affecting the processing of anesthetic agents. Liver function declines with age, leading to slower drug metabolism and clearance, increasing the risk of adverse reactions. Decreased muscle mass (A) may affect drug distribution but not metabolism. Decreased renal function (B) can impact drug excretion but is not the primary reason for adverse reactions. Increased body fat (C) can alter drug distribution but is not the main factor in anesthesia reactions for older adults.