How does dehydration impact older adults more than younger adults?

Correct Answer: B

Rationale: The correct answer is B because older adults have reduced kidney function, which impairs their ability to concentrate urine and retain water. Additionally, they may have a diminished thirst sensation, making them less likely to drink enough fluids. This combination of factors makes older adults more vulnerable to dehydration compared to younger adults. Choice A is incorrect because older adults actually have a lower percentage of body water due to age-related changes in body composition. Choice C is incorrect as dehydration can indeed have a more significant impact on older adults due to their physiological changes. Choice D is incorrect as older adults are actually more prone to dehydration due to various age-related factors.

Correct Answer: D

Rationale: The correct answer is D because nursing interventions can focus on enhancing the client's quality of life, comfort, and emotional well-being even in the face of terminal illness. Nurses can provide support, educate the client and family, manage symptoms, and empower the client to find meaning and purpose in their life. This approach contributes to a higher level of wellness by addressing holistic needs beyond just medical interventions. Incorrect choices: A: Wellness can be achieved through various means, not just aggressive medical interventions. B: Wellness is still achievable in terms of emotional, social, and spiritual well-being even with a terminal illness. C: Wellness involves physical, emotional, social, and spiritual aspects beyond just the absence of disease.

Correct Answer: B

Rationale: The correct answer is B, cognitive-behavioral therapy (CBT) combined with antidepressant medications, for treating depression in older adults. CBT helps address negative thought patterns and behaviors associated with depression, while antidepressant medications provide physiological support. Combining both approaches has been shown to be more effective than either treatment alone in older adults. A: Long-term pharmacological therapy with SSRIs may have side effects and limited effectiveness in older adults. C: Antidepressant medications alone may not address the underlying psychological factors contributing to depression. D: Psychodynamic therapy may not be as effective in older adults as it focuses on unresolved issues from early life rather than targeting current depressive symptoms.

Correct Answer: A

Rationale: Step 1: Gerontological nursing certification focuses on advanced knowledge and skills for caring for older adults. Step 2: This certification is not a requirement for all nurses in long-term care or limited to rehabilitation centers. Step 3: Nurses with various levels of education, not just a master's degree, can obtain gerontological certification. Therefore, option A is correct as it accurately states that gerontological nursing certification signifies advanced knowledge and skills specific to older adult care. Options B, C, and D are incorrect as they provide inaccurate information about the certification requirements and scope.

Correct Answer: D

Rationale: The correct answer is D because reluctance of older adults to report pain is a significant barrier to effective pain management. Older adults may underreport pain due to various factors such as fear of being seen as a burden, denial of aging-related changes, or belief that pain is a natural part of aging. This can lead to under-treatment of pain and decreased quality of life. Choices A, B, and C are not the most common barriers in this context. Fear of addiction to opioids, insufficient knowledge among healthcare providers, and inadequate access to specialists are important factors but are not as prevalent as older adults' reluctance to report pain.

Correct Answer: C

Rationale: Step 1: Healthy People 2020 focuses on improving the health and well-being of all individuals, including older adults. Step 2: Identifying minimum levels of training for people who care for older adults is crucial to ensure quality care. Step 3: This issue aligns with the goal of promoting quality of care and safety for older adults. Step 4: Other choices are not directly addressed in Healthy People 2020 goals. Summary: Choice C is correct as it directly relates to improving the care of older adults, while the other choices focus on specific issues not highlighted in Healthy People 2020.

Correct Answer: A

Rationale: The correct answer is A: Decreased manual dexterity and inability to hold a toothbrush. As people age, they may experience decreased hand strength and motor skills, making it difficult to hold and manipulate objects like a toothbrush. This can lead to a decline in oral hygiene practices. Malocclusion of teeth (B) does not directly impact the ability to brush teeth. Decrease in taste acuity (C) may affect appetite but not tooth brushing habits. Lack of dental insurance (D) is a financial barrier and may affect access to dental care, but it does not directly impact the physical ability to brush teeth.

Correct Answer: A

Rationale: The correct answer is A because neglecting personal grooming indicates a lack of self-care, which is a common sign of ineffective coping after the loss of a loved one. This behavior suggests the client may be struggling emotionally and unable to engage in basic self-care tasks. Looking at old pictures, participating in social activities, and visiting the husband's grave are all healthy coping mechanisms that can help the client process her grief and maintain connections with her late husband.

Correct Answer: D

Rationale: The correct answer is D because assisting with upper endoscopy is not a standard nursing intervention for CHF. Nursing interventions for CHF focus on managing symptoms, medication adherence, and lifestyle modifications. Choices A, B, and C are correct as they address important aspects of CHF management such as monitoring symptoms, educating on medications, and promoting a low-sodium diet. Helping with an upper endoscopy is unrelated to the management of CHF and falls outside the scope of nursing care for this condition.