An older woman retires after a long career as an elementary school principal and begins to volunteer in the local library reading to children. The older woman is very pleased with her volunteer activities. This is consistent with which theory of aging?

Correct Answer: A

Rationale: The correct answer is A: Role theory. Role theory suggests that individuals continue to seek fulfilling roles and activities in older age to maintain a sense of purpose and identity. In this scenario, the older woman's transition from a career as a school principal to volunteering at the library aligns with the idea of seeking meaningful roles. B: Disengagement theory posits that older adults withdraw from society as they age, which contradicts the woman's active engagement in volunteering. C: Age-stratification theory focuses on how age influences opportunities and constraints within society, not on individual choices like volunteering. D: Social exchange theory emphasizes reciprocal relationships and benefits gained from social interactions, which is not the primary focus in this scenario.

Correct Answer: D

Rationale: The correct answer is D. Intermittent claudication, defined as pain in the lower extremities with walking that improves with rest, is a classic symptom of moderate to severe PAD. This occurs due to inadequate blood flow to the muscles during exercise. Other choices are incorrect: A is typically associated with syncope or fainting; B is more indicative of cardiovascular or pulmonary issues; and C is more commonly seen in mesenteric ischemia.

Correct Answer: D

Rationale: The correct answer is D: Serum triiodothyronine (T3) and gastric pepsin. Aging typically leads to a decrease in serum T3 levels due to reduced thyroid function. Gastric pepsin production also decreases with age, impacting digestion. A: Creatinine clearance and insulin secretion typically decrease with kidney and pancreatic function decline, not necessarily solely due to aging. B: Blood CO2 levels and saliva production are not directly affected by aging but can be influenced by various health conditions. C: Left ventricle-wall thickness may increase with age due to conditions like hypertension, and skin healing time can be affected by various factors other than just aging. In summary, the correct answer stands out as age-related declines in serum T3 and gastric pepsin levels are more directly linked to the aging process compared to the other choices.

Correct Answer: B

Rationale: The correct answer is B because straining to void can lead to increased vagal stimulation, resulting in decreased blood pressure upon standing (orthostatic hypotension). A: age and walker use don't directly increase risk. C: a leg cast may not directly affect blood pressure. D: Premarin use is not a common cause of orthostatic hypotension.

Correct Answer: C

Rationale: The correct answer is C: Coordinating care among healthcare providers. This is the most important consideration for providing care to older adults with multiple chronic conditions because it ensures that all aspects of their health are managed comprehensively and efficiently. Coordinating care among healthcare providers helps prevent medication interactions, duplicate tests, and conflicting treatment plans. It also promotes better communication and collaboration among the healthcare team, leading to improved outcomes for the patient. A: Treating each condition independently is not ideal as it may result in conflicting treatment plans and overlook the holistic nature of managing multiple chronic conditions. B: Using a single medication for all conditions is not appropriate as different conditions may require specific medications tailored to each individual's needs. D: Limiting social interactions to reduce stress is not directly related to managing multiple chronic conditions and may have negative effects on the overall well-being of the older adults.

Correct Answer: B

Rationale: The correct answer is B because regular physical activity and joint mobility exercises help improve joint flexibility, reduce pain, and increase strength. This intervention can enhance overall physical function and quality of life for older adults with arthritis. Complete bed rest (A) can lead to muscle weakness and joint stiffness, worsening arthritis symptoms. Increased use of opioid painkillers (C) can have adverse side effects and may not address the root cause of arthritis. Strictly limiting daily activities (D) can lead to decreased mobility and functional decline in older adults.

Correct Answer: B

Rationale: The correct answer is B: Cognitive decline or dementia. Elder abuse risk assessment in gerontological nursing involves considering cognitive decline or dementia as the most important factor. This is because individuals with cognitive impairments are more vulnerable and may have difficulty recognizing and reporting abuse. Family history of violence (A), history of physical ailments (C), and medication regimen (D) are important factors to consider but do not directly impact the elder abuse risk assessment as significantly as cognitive decline or dementia.

Correct Answer: B

Rationale: The correct answer is B because polypharmacy in older adults increases the risk of adverse drug reactions and interactions due to multiple medications being taken concurrently. This can lead to medication errors, decreased adherence, drug toxicity, and increased healthcare costs. Choice A is incorrect as polypharmacy does not improve overall quality of life but rather can negatively impact it. Choice C is incorrect as polypharmacy does not prevent age-related health conditions but can exacerbate them. Choice D is incorrect as polypharmacy has a significant impact on health outcomes in older adults.

Correct Answer: B

Rationale: The correct answer is B: Providing palliative care focused on symptom management and comfort. This is the most appropriate intervention for an older adult with advanced heart failure as it prioritizes quality of life by focusing on alleviating symptoms and ensuring comfort. High-dose diuretics (choice A) may lead to electrolyte imbalances and worsen the patient's condition. Initiating aggressive cardiac surgery (choice C) may be too risky and invasive for an older adult with advanced heart failure. Enforcing strict bed rest (choice D) can lead to deconditioning and muscle wasting, further compromising the patient's quality of life.