In managing frailty, what is the most important factor for improving strength and overall function in older adults?

Correct Answer: C

Rationale: Certainly! Regular strength training exercises are crucial for improving strength and overall function in older adults with frailty. Strength training helps build muscle mass, improve balance, and increase mobility, leading to enhanced functional abilities. It also helps prevent falls and maintain independence. High-protein diet (A) supports muscle health but alone is not sufficient. Medication management (B) is important but not the primary factor for physical function. Limiting physical activity (D) can worsen frailty by causing deconditioning and loss of muscle strength.

Correct Answer: B

Rationale: The most effective approach to improve quality of life in older adults with Alzheimer's disease is non-pharmacological interventions like music therapy and structured routines. This is because these interventions have been shown to reduce behavioral symptoms, enhance cognitive function, and promote overall well-being without the potential side effects of pharmacological treatments. Music therapy can help calm and stimulate memory recall, while structured routines provide predictability and familiarity, reducing confusion and agitation. Pharmacological management of behavioral symptoms alone may not address the root causes of the behaviors and can lead to adverse effects. Physical immobilization is harmful and can worsen cognitive decline. Sedatives can have detrimental effects on cognition and may increase the risk of falls and other complications. Therefore, non-pharmacological interventions are the most effective and holistic approach to enhancing the quality of life for older adults with Alzheimer's disease.

Correct Answer: B

Rationale: The correct answer is B: Delirium in older adults results from reversible metabolic changes, such as electrolyte imbalances. Delirium is a multifactorial condition often triggered by physiological imbalances, including electrolyte disturbances. These imbalances can disrupt normal brain function, leading to confusion and cognitive impairment. Other choices are incorrect: A is more typical of sepsis, C is more associated with conditions like dementia, and D is not a primary cause of delirium.

Correct Answer: C

Rationale: The correct answer is C because regular repositioning every 2 hours, along with the use of pressure-relieving devices, is the most effective intervention to prevent pressure ulcers in older adults with limited mobility. Repositioning helps to redistribute pressure, reducing the risk of tissue damage. Pressure-relieving devices like cushions or mattresses further help to alleviate pressure points. Choice A is incorrect because strict bed rest and minimal repositioning can actually increase the risk of pressure ulcers by concentrating pressure on specific areas. Choice B is incorrect as high-protein diets and supplements alone do not address the primary cause of pressure ulcers, which is prolonged pressure on the skin. Choice D is incorrect because leaving wounds uncovered can increase the risk of infection and hinder the healing process.

Correct Answer: D

Rationale: The correct answer is D, EKG and serial enzymes for determination of an MI. In this scenario, the patient's symptoms of nausea and sudden onset shortness of breath raise concern for a possible myocardial infarction (MI). Conducting an EKG and serial enzymes helps in diagnosing an MI by assessing for cardiac ischemia or injury. Upper endoscopy (choice A) is not indicated for these symptoms. A CT of the head (choice B) is unnecessary as the symptoms are suggestive of a cardiac issue, not a neurological one. Liver function studies (choice C) do not align with the presenting symptoms and are not a priority in this acute setting. Conducting an EKG and serial enzymes is the most appropriate initial workup to assess for a possible MI in this elderly patient with concerning symptoms.