The home care nurse is visiting an older female client whose husband died 6 months ago. What behavior by the client indicates ineffective coping?

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: B

Rationale: The correct answer, B, is the primary role of the gerontological nurse when providing end-of-life care for a terminally ill older adult. This choice emphasizes the importance of pain management, comfort care, and preserving the patient's dignity. The nurse's focus should be on enhancing the quality of life and ensuring the patient's comfort rather than pursuing aggressive curative treatments (A). Administering sedatives (C) should be based on individual needs and preferences, not as a blanket approach. While family involvement is crucial, the nurse should still advocate for the patient's autonomy and preferences, rather than solely relying on family decisions (D).

Correct Answer: C

Rationale: Rationale: C is correct as it involves understanding the patient's beliefs and preferences, crucial in culturally competent care. A would not address the patient's perspective directly. B is broad and lacks specificity. D assumes all traditional Chinese individuals seek Chinese medicine, which may not be the case.

Correct Answer: B

Rationale: The correct answer is B: Integration of gerontological content throughout the curriculum. This is because integrating gerontological content throughout the curriculum ensures that nursing students are exposed to and learn about caring for older adults in various courses, rather than just in a standalone course. This approach better prepares students to provide holistic care to older adults in different clinical settings. A: Provision of a free-standing course in gerontology within the curriculum may limit exposure to gerontological content and may not provide a comprehensive understanding of caring for older adults. C: Requiring gerontological certification for all students before completion of a BSN program is not mentioned in the document and may not be feasible or necessary for all nursing students. D: While structured clinical experiences with older adults across the continuum of care are essential, this alone may not ensure that students receive a comprehensive education in gerontological care if the content is not integrated throughout the curriculum.

Correct Answer: B

Rationale: The correct answer is B: Malnutrition and dehydration. Malnutrition and dehydration are major risk factors for pressure ulcers in older adults because they can lead to poor skin integrity, reduced tissue resilience, and impaired wound healing. Lack of sleep (choice A) may contribute to overall health issues but is not a direct risk factor for pressure ulcers. Excessive physical activity (choice C) can increase the risk of injury but does not directly cause pressure ulcers. High blood pressure (choice D) is a risk factor for cardiovascular issues but is not specifically linked to the development of pressure ulcers.

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.

Correct Answer: B

Rationale: The correct answer is B: Benzodiazepines. Benzodiazepines are central nervous system depressants that can cause drowsiness, dizziness, and confusion, increasing the risk of falls in older adults. They can also impair balance and coordination. Older adults are more sensitive to these effects due to age-related changes in metabolism and increased risk of cognitive impairment. Beta-blockers (A), statins (C), and antihypertensives (D) are generally safe in older adults and do not directly increase the risk of falls. Beta-blockers can sometimes cause dizziness but are more commonly associated with bradycardia. Statins are used to lower cholesterol levels and do not affect fall risk. Antihypertensives help lower blood pressure and can actually reduce the risk of falls by preventing conditions like orthostatic hypotension.

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.