An 81 yr old female presents to the ED with altered level of consciousness. All of the following except____ are possible causes for this condition.

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: 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: D

Rationale: The correct answer is D: Facilitate family rituals related to death and dying. In end-of-life care, it is essential to support the older adult and their family in their cultural and spiritual practices to promote comfort and closure. This intervention aligns with the goals of long-term care by addressing the psychological and emotional needs of the patient and family. Providing a basin and towels (B) focuses on physical self-care, which may not be a priority in end-stage disease. Decreasing analgesic dose (A) can compromise pain management and quality of life. Informing family members about strict visiting hours (C) can hinder emotional support and connection during this critical time.

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: D

Rationale: The correct answer is D because promoting independence without assistance to all clients may not always maintain safety for the elderly. Elderly individuals may require some level of assistance for certain activities to prevent falls or other safety risks. Providing assistance when needed is crucial for ensuring their safety. A: Modifying the environment to reduce obstacles and barriers to ambulation helps prevent falls. B: Consistent checks of ambulation abilities ensure early detection of any decline in mobility. C: Orienting to new surroundings and repeating as needed helps prevent confusion and disorientation.

Correct Answer: B

Rationale: The correct answer is B because it directly addresses the older woman's emotional response to the instructions, showing empathy and understanding. By asking how she feels, the nurse can uncover any concerns or fears she may have, leading to effective communication and tailored support. Moving on to medication (A) ignores the woman's distress, potentially worsening the situation. Instructing the interpreter to repeat instructions (C) may not address the underlying issue. Having the woman repeat instructions (D) does not acknowledge her emotional state and may not resolve her tension.

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: 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: Regular repositioning every 2 hours. Repositioning helps to relieve pressure on vulnerable areas, improving blood flow and preventing tissue damage. This intervention is evidence-based and recommended in pressure ulcer prevention guidelines. Administering pain medications before repositioning (B) does not address the root cause of pressure ulcers. Encouraging excessive hydration (C) may have other health benefits but does not directly prevent pressure ulcers. Using restrictive bandages (D) can actually increase pressure and worsen the risk of pressure ulcers.