An older man is transferred to a hospice facility with end-stage disease. Which is a suitable nursing intervention for this older adult and his family according to the goals of long-term care?

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: 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: 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: D

Rationale: The correct answer is D because reviewing a menu with the older man allows for personalized food selection, taking into account his preferences and dietary restrictions. This approach promotes adherence to a healthy eating plan, leading to better cholesterol management and overall wellness. Choice A is not the best option as simply instructing him to increase dietary fiber may not address his specific dietary needs. Choice B suggests asking the health care provider for a low-fat diet, which may not consider the individual's food preferences or cultural background. Choice C of scheduling a consultation with a dietitian is a good option, but it may not be as immediately accessible or practical as reviewing a menu together with the individual.

Correct Answer: A

Rationale: The correct answer is A because walking is a physical activity that promotes cardiovascular health, strength, and overall well-being. Regular exercise like walking 3-5 times per week for 30 minutes can help improve circulation, maintain healthy weight, and reduce the risk of chronic diseases. Cooking healthy meals (choice B) is important for nutrition but may not directly promote physical activity. Reading and knitting (choice C) are mentally stimulating but do not provide the physical benefits of exercise. Taking vitamins daily (choice D) is important for overall health but does not substitute for physical activity.

Correct Answer: B

Rationale: The correct answer is B: Disengagement theory. This theory suggests that as people age, they naturally withdraw or disengage from societal roles and responsibilities. Mandatory retirement at age 65 aligns with this theory as it reflects the societal expectation of older individuals stepping back from work roles. Role theory (A) focuses on how individuals adapt to various social roles throughout their lives, not specifically related to retirement. Age-stratification theory (C) emphasizes how age impacts societal structures and opportunities, not retirement policies. Social exchange theory (D) focuses on relationships and interactions based on the exchange of resources, not specifically related to retirement age policies.

Correct Answer: A

Rationale: The correct answer is A: Crusting. Crusting on the skin of an older client can indicate a potential complication such as an infection or skin condition. It suggests that there may be an issue with the skin's integrity, leading to the formation of crusts. Wrinkling (B) and thinning/loss of elasticity (C) are common age-related changes and not necessarily indicative of a complication. Choice D is a duplicate of choice A, so it is incorrect. In summary, crusting is a sign of a potential skin complication, while the other choices are more likely to be normal age-related changes.

Correct Answer: C

Rationale: The correct answer is C because loss of vision in one eye is not a typical sign or symptom of Parkinson's disease. A, B, and D are all common signs of Parkinson's disease. A - Mask-like facial expressions result from decreased facial muscle movement. B - Shuffling gait is a characteristic walking pattern in Parkinson's patients. D - Tremors without intention (at rest) are a classic symptom of Parkinson's disease due to disrupted brain signals. Therefore, C is the odd one out as it is not directly associated with Parkinson's disease manifestations.

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.