Correct Answer: A

Rationale: The correct answer is A because as individuals age, there is a decrease in renal function leading to reduced renal clearance of drugs. This results in a longer drug half-life and potentially increased drug accumulation in the body. Choice B is incorrect as aging often leads to a decrease in hepatic metabolism, not faster metabolism. Choice C is incorrect because aging can actually lead to reduced gastrointestinal absorption due to changes in the gastrointestinal tract. Choice D is incorrect as aging can result in decreased circulation, which may affect drug distribution negatively.

Correct Answer: B

Rationale: The correct answer is B: Installing safety bars and removing tripping hazards. This strategy addresses environmental factors that contribute to falls in older adults. Safety bars provide support, while removing tripping hazards reduces the risk of accidents. Restricting mobility (choice A) can lead to muscle weakness and increase fall risk. Increasing medication dosages (choice C) can cause side effects like dizziness, increasing fall risk. Providing frequent sedation (choice D) can impair alertness and balance, also increasing fall risk. Thus, choice B is the most effective strategy to reduce falls by modifying the physical environment.

Correct Answer: A

Rationale: The correct answer is A: Primarily in the last 30 years. This is because advancements in research methodologies, technology, and increased awareness of aging population's health needs have led to a significant increase in research rigor and scope in the past few decades. Choice B is too broad and vague. Choice C is incorrect as research on older adults' health outcomes predates the establishment of Medicare. Choice D is too limited in scope, as research on older adults' health outcomes has been ongoing for more than just the last decade.

Correct Answer: D

Rationale: The correct answer is D, Standards of gerontological nursing practice, as the ANA Scope and Standards of Gerontological Nursing (2010) specifically outlines the accepted standards and guidelines for gerontological nursing practice. This document does not focus on skills and knowledge (Choice A), levels of practice (Choice B), or certification requirements (Choice C), but rather on setting the standards and expectations for gerontological nursing care. It is essential for nurses to adhere to these standards to provide high-quality care to older adults.

Correct Answer: C

Rationale: The correct answer is C: The patient's advanced directives and wishes. This is crucial in end-of-life care as it ensures that the patient's preferences and values are respected. By evaluating the advanced directives and wishes, the nurse can provide care that aligns with the patient's goals and desires. This promotes autonomy and dignity in the patient's end-of-life experience. Choice A (Patient's financial situation) is not as crucial as the patient's wishes in end-of-life care, as financial considerations should not dictate the quality of care provided. Choice B (The family’s expectations) is important, but the patient's wishes should take precedence as it is their care and preferences that should be the primary focus. Choice D (The patient's history of medication use) is relevant for overall care but not as crucial in end-of-life care as honoring the patient's wishes and directives.