Older adults frequently experience a change in sexual activity. Which best explains this change?

Correct Answer: D

Rationale: The correct answer is D) Frequency and opportunities for sexual activity may decline. This change in sexual activity among older adults can be attributed to various factors such as declining physical health, loss of a partner, societal attitudes towards sexuality in older age, and changes in libido. As individuals age, they may experience health conditions that affect their physical abilities and overall energy levels, which can impact their desire and ability to engage in sexual activity. Additionally, older adults may face social barriers such as living in long-term care facilities where privacy and opportunities for sexual expression are limited. Option A is incorrect because the need for touch and physical intimacy remains important for many older adults, even though it may vary from person to person. Option B is incorrect as older adults exhibit a wide range of sexual preferences, just like individuals of any age group. Option C is incorrect because physical changes associated with aging, such as menopause or erectile dysfunction, can indeed impact sexual functioning in older adults. In an educational context, understanding the changes in sexual activity among older adults is crucial for healthcare providers, caregivers, and individuals themselves to provide appropriate support, address concerns, and promote overall well-being in later life. It highlights the importance of holistic care that considers the emotional, psychological, and social aspects of sexuality in the aging population.

Correct Answer: A

Rationale: In the context of a client diagnosed with Acute Respiratory Distress Syndrome (ARDS) being discharged from the hospital, the priority instruction for the nurse to discuss is option A) Avoid smoking and exposure to smoke. This instruction is crucial because smoking and exposure to smoke can further exacerbate respiratory issues in a client with ARDS, leading to complications and hindering the recovery process. Option B) Do not receive flu or pneumonia vaccines is incorrect because receiving these vaccines is actually important for individuals with ARDS to prevent additional respiratory infections that can worsen their condition. Vaccines help boost the immune system and reduce the risk of contracting illnesses that could further compromise respiratory function. Option C) Avoid any type of alcohol intake is not the priority instruction in this scenario. While alcohol can have negative effects on health, particularly in individuals with respiratory issues, it is not as immediately critical as avoiding smoking and smoke exposure for a client with ARDS. Option D) It will take about one month to recuperate is also incorrect because this statement provides general information about recovery time and does not address any specific actionable steps or precautions that the client needs to take post-discharge to ensure their safety and well-being. Educationally, this question highlights the importance of understanding the specific needs and precautions for clients with respiratory conditions like ARDS. It emphasizes the critical role nurses play in educating clients about lifestyle modifications and actions that can support their recovery and promote optimal health outcomes.

Correct Answer: B

Rationale: In the context of ARDS (Acute Respiratory Distress Syndrome), the correct answer is B) Barotrauma from excessive airway pressures. ARDS patients often require positive end-expiratory pressure (PEEP) therapy to improve oxygenation. However, prolonged or excessive PEEP can lead to barotrauma, where the increased pressure in the airways can damage lung tissue and cause complications such as pneumothorax or subcutaneous emphysema. Option A) Increased cardiac output is incorrect because PEEP therapy typically does not directly affect cardiac output in the context of ARDS. Option C) Decreased pulmonary compliance could be a possible consequence of ARDS itself, but it is not specifically related to the complication of PEEP therapy. Option D) Reduction in alveolar oxygen diffusion is not a direct complication of PEEP therapy but rather a potential consequence of ARDS pathology. Educationally, understanding the potential complications of PEEP therapy in ARDS patients is crucial for nurses caring for these critically ill individuals. Monitoring for signs of barotrauma, such as subcutaneous emphysema, asymmetrical chest movement, or sudden deterioration in oxygenation, is essential to prevent further harm and provide timely interventions. Nurses must also ensure proper PEEP settings and closely monitor the patient's response to therapy to optimize outcomes and prevent complications.

Correct Answer: D

Rationale: Increasing oxygen flow rate will usually improve oxygen saturation in patients with ventilation-perfusion mismatch, as occurs with pulmonary embolism. Because the problem is with perfusion, actions that improve ventilation, such as deep-breathing and coughing, sitting upright, and suctioning, are not likely to improve oxygenation.

Correct Answer: C

Rationale: In the context of caring for a patient with acute respiratory distress syndrome (ARDS), the correct answer is option C) The patient's PaO2 is 90 mm Hg, and the SaO2 is 92%. This information indicates that prone positioning, a technique used to improve oxygenation in ARDS patients by optimizing ventilation-perfusion matching, is effective. An increase in PaO2 and SaO2 levels suggests improved oxygen exchange, indicating the success of the intervention. Option A is incorrect because intact skin on the back is more indicative of pressure ulcer prevention rather than the effectiveness of prone positioning for ARDS. Option B is unrelated to the effectiveness of prone positioning and pertains more to infection control. Option D is also incorrect as minimal mucous return after endotracheal suctioning does not directly correlate with the effectiveness of prone positioning in ARDS management. Educationally, understanding the rationale behind the correct answer reinforces the importance of monitoring oxygenation parameters in patients with ARDS undergoing prone positioning. It highlights the significance of using evidence-based practice to assess the effectiveness of interventions and make informed clinical decisions to optimize patient outcomes.