An older woman with a UTI reports mild symptoms and a low-grade fever. Why didn’t she develop a higher temperature?

Correct Answer: B

Rationale: The correct answer is B because normal age-related immune changes can result in a lower fever response to illness in older adults. As people age, their immune system may not respond as vigorously to infections, leading to a muted fever response. This explains why the older woman with a UTI experienced only mild symptoms and a low-grade fever. Choice A is incorrect because the seriousness of a UTI does not necessarily correlate with the presence or absence of a fever. Choice C is incorrect as older adults can still develop fevers in response to infections. Choice D is incorrect as it is too broad and does not specifically address the age-related immune changes that impact fever response in older adults.

Correct Answer: A

Rationale: The correct answer is A: Decreased lean body mass and decreased glomerular filtration rate. 1. Decreased lean body mass: With aging, there is a natural decline in muscle mass which can affect the distribution and metabolism of digoxin, potentially increasing its concentration in the body. 2. Decreased glomerular filtration rate: As individuals age, there is a decrease in kidney function, particularly in the glomerular filtration rate, which can lead to decreased excretion of digoxin, resulting in its accumulation and potential toxicity. Therefore, these age-related changes can place the older client at risk for digoxin toxicity. Summary: B: Increased muscle mass and improved renal function - This choice is incorrect as aging is associated with decreased muscle mass and declining renal function. C: Higher levels of albumin and increased drug metabolism - This choice is incorrect as aging is typically associated with decreased albumin levels and slower drug metabolism. D: Decreased hepatic function and increased body fluid

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: A, B

Rationale: Step-by-step rationale: 1. Cultural awareness is crucial for understanding one's own biases and recognizing cultural differences. 2. Cultural knowledge involves understanding diverse cultural practices, beliefs, and values. 3. Cultural skills refer to the ability to effectively communicate and adapt care to meet individual cultural needs. 4. Cultural connections, while important, do not directly relate to providing culturally competent care. In summary, A and B are correct as they form the foundation for providing culturally competent care, while C and D do not encompass all aspects necessary for culturally competent care.

Correct Answer: C

Rationale: The correct answer is C because it states that the exact cause of super-centenarians' longevity and good health is not known. This acknowledges the uncertainty and complexity of the situation, highlighting the need for further research and understanding. Explanation for why the other choices are incorrect: A: Genetic makeup alone may not fully explain super-centenarians' survival, as there are likely additional factors involved. B: Living in wealthier areas does not guarantee longevity or good health, as there are many other factors at play. D: While quality medical care and improved social conditions can contribute to health, they are not the sole reasons for super-centenarians' exceptional longevity.

Correct Answer: A

Rationale: The correct answer is A because it accurately reflects the multifactorial nature of diabetes in older adults. Age-related changes, coupled with lifestyle factors like poor diet and lack of exercise, contribute to the high incidence of diabetes in this population. This statement acknowledges the complexity of diabetes in older adults. B is incorrect because while nurses should have knowledge about diabetes in older adults, the statement does not specifically address the multifactorial nature of the disease in this population. C is incorrect because ethnicity can indeed play a role in diabetes risk and should not be dismissed outright. D is incorrect because the development of diabetes is not considered a normal age-related change; it is a medical condition that can be influenced by various factors.

Correct Answer: B

Rationale: The correct answer is B because in most cultures, including Western ones, older adults are more likely to initially seek traditional or cultural methods of treatment before resorting to biomedical professionals. This is often due to cultural beliefs and practices ingrained in societies. A is incorrect because personalistic or magicoreligious beliefs still exist in Western societies alongside biomedical principles. C is incorrect because Ayurvedic medicine is a traditional Indian system of medicine, not the same as traditional Chinese medicine. D is incorrect because the belief in balancing opposite qualities is characteristic of holistic or traditional medicine practices, not necessarily magicoreligious belief systems.

Correct Answer: B

Rationale: The correct answer is B: Identifying goals of care through open conversations with the patient and family. This is crucial because palliative care for older adults should be person-centered and align with their preferences and values. By engaging in open conversations, healthcare providers can understand the individual's goals, values, and wishes, allowing for care to be tailored accordingly. This approach emphasizes holistic care beyond just managing pain and considers the patient's emotional, spiritual, and social needs. Incorrect choices: A: Focusing primarily on managing pain with medications overlooks the importance of addressing other aspects of care. C: Avoiding advanced medical treatments is not always appropriate as each situation should be assessed individually. D: Prescribing hospice care immediately may not be necessary or desired by the patient, as it depends on their specific needs and preferences.

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.