All of the following except___ are considered standard therapy for an elderly person with congestive heart failure (CHF).

Correct Answer: B

Rationale: The correct answer is B because antibiotics are not standard therapy for congestive heart failure in the elderly. The rationale is that antibiotics are used to treat bacterial infections, not heart failure. A: ACE inhibitors are standard therapy as they help dilate blood vessels and reduce the workload on the heart. C: Diuretics help reduce fluid buildup in the body, which is beneficial for managing CHF symptoms. D: Beta blockers are used to reduce the heart's workload and help manage the stress response, making them standard therapy for CHF.

Correct Answer: B

Rationale: The correct answer is B because antibiotics are not standard therapy for congestive heart failure in the elderly. The rationale is that antibiotics are used to treat bacterial infections, not heart failure. A: ACE inhibitors are standard therapy as they help dilate blood vessels and reduce the workload on the heart. C: Diuretics help reduce fluid buildup in the body, which is beneficial for managing CHF symptoms. D: Beta blockers are used to reduce the heart's workload and help manage the stress response, making them standard therapy for CHF.

Correct Answer: C

Rationale: The correct answer is C because it highlights a common issue in nursing education where gerontological nursing content is often underrepresented, with less than 25% of the curriculum dedicated to geriatric care. This is accurate as many nursing programs prioritize other areas over gerontology. A is incorrect as gerontological nursing integration has historically been lacking in nursing curricula. B is incorrect because undergraduate programs often lack extensive coverage of gerontological nursing compared to other specialties like psychiatric nursing. D is incorrect as accreditation does not guarantee specific proportions of gerontological nursing content in the curriculum. Thus, choice C is the most accurate statement regarding gerontological nursing education.

Correct Answer: C

Rationale: The correct answer is C, regular exercise to improve strength and balance. This is the most effective strategy for preventing falls in older adults because it helps increase muscle strength, improve balance, and enhance coordination, reducing the risk of falls. Exercise also improves overall mobility and flexibility, which are essential for preventing falls. Installing bed alarms (A) may alert staff after a fall but does not prevent falls. Using medications to sedate the patient (B) can increase the risk of falls due to dizziness and impaired balance. Restricting movement (D) can lead to muscle weakness and loss of balance, increasing the risk of falls.

Correct Answer: C

Rationale: The correct answer is C: The patient's advanced directives and wishes. This is crucial in end-of-life care as it ensures that the patient's preferences and values are respected. By evaluating the advanced directives and wishes, the nurse can provide care that aligns with the patient's goals and desires. This promotes autonomy and dignity in the patient's end-of-life experience. Choice A (Patient's financial situation) is not as crucial as the patient's wishes in end-of-life care, as financial considerations should not dictate the quality of care provided. Choice B (The family’s expectations) is important, but the patient's wishes should take precedence as it is their care and preferences that should be the primary focus. Choice D (The patient's history of medication use) is relevant for overall care but not as crucial in end-of-life care as honoring the patient's wishes and directives.

Correct Answer: A, B, C

Rationale: The correct answers are A, B, and C. A cultural assessment is important in healthcare settings to understand the patient's beliefs, values, and practices related to health and illness. A) Culture guides decision making about health, illness, and preventive care because beliefs and practices vary among cultures. B) Culture provides direction for individuals on how to interact during health care encounters as communication styles and expectations differ based on culture. C) Culture impacts attitudes toward aging as perceptions of aging, care for the elderly, and end-of-life decisions are influenced by cultural beliefs. D is incorrect because individuals within the same culture may still have diverse reactions in similar situations due to personal differences and experiences.

Correct Answer: D

Rationale: The correct answer is D, Standards of gerontological nursing practice, as the ANA Scope and Standards of Gerontological Nursing (2010) specifically outlines the accepted standards and guidelines for gerontological nursing practice. This document does not focus on skills and knowledge (Choice A), levels of practice (Choice B), or certification requirements (Choice C), but rather on setting the standards and expectations for gerontological nursing care. It is essential for nurses to adhere to these standards to provide high-quality care to older adults.

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.

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.