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: 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: 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: A

Rationale: The correct answer is A: Nocturia. Nocturia, or waking up at night to urinate, is a common symptom of benign prostatic hypertrophy (BPH) due to the enlarged prostate pressing on the urethra, causing urinary frequency and urgency. Other symptoms like weak urine stream, difficulty starting urination, incomplete emptying, and dribbling may also be present. Recurrent urinary tract infections (B) are less likely to be the initial symptom of BPH, as they are more commonly associated with urinary retention or obstruction. Functional incontinence (C) is not a typical symptom of BPH, as it is more related to mobility or cognitive issues. Hematuria (D) is not a common presenting symptom of BPH, as it is more indicative of other conditions like urinary tract infections or kidney stones.

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: 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 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: A

Rationale: The correct answer is A: Determine whether there are medication duplications. This is the first intervention the nurse should take because medication duplications can lead to potential drug interactions and adverse effects. By identifying duplicate medications, the nurse can prevent harm to the client. Choice B: Starting to educate the client on proper medication adherence may be important, but it is not the first priority in this scenario. Choice C: Monitoring the client's blood pressure closely is not directly related to the issue of multiple medications and should not be the first intervention. Choice D: Asking the client to stop taking some medications without proper assessment and consultation with a healthcare provider can be risky and may not address the issue of medication duplications.