The nurse is caring for a 78-year-old client who is taking an anticholinergic medication and complains of dry mouth. Which of the following would be most appropriate for the nurse to suggest?

Correct Answer: B

Rationale: The correct answer is B: Rinse the mouth with a mouthwash. Anticholinergic medications can cause dry mouth due to decreased saliva production. Rinsing with a mouthwash can help moisturize the oral mucosa and provide temporary relief. Chewing hard candies (choice A) may provide temporary relief but can also increase the risk of dental caries. Using more seasonings on food (choice C) and drinking decaffeinated beverages often (choice D) do not directly address the dry mouth concern.

Correct Answer: A

Rationale: The correct answer is A: glomerular filtration rate of 14 mL/minute. A GFR of 14 mL/minute indicates severe kidney dysfunction, warranting hemodialysis to filter waste products and excess fluids from the blood. B: BUN 16 mg/dL, C: serum magnesium 1.8 mg/dL, and D: serum phosphorus 4.0 mg/dL are within normal ranges and do not specifically indicate the need for hemodialysis in chronic kidney disease.

Correct Answer: D

Rationale: The correct answer is D: Substance use disorder. Ramelteon is the preferred hypnotic for patients with substance use disorder as it lacks abuse potential and does not affect the GABA system, reducing the risk of dependence. Patients with substance use disorder are at higher risk of developing addiction to traditional hypnotics like benzodiazepines. Ramelteon's unique mechanism of action targeting melatonin receptors makes it a safer option for this patient population. Incorrect Choices: A: Obsessive-compulsive disorder - Ramelteon is not specifically indicated for OCD. B: Generalized anxiety disorder - While ramelteon may help with sleep in patients with anxiety, it is not the preferred choice for this condition. C: Persistent depressive disorder - Ramelteon is not typically used as a first-line treatment for depression-related insomnia.

Correct Answer: D

Rationale: The correct answer is D because Larry's long history of aggressive and manipulative behavior suggests deep-rooted issues that are unlikely to change dramatically. Small incremental changes indicate a more realistic expectation for progress in his treatment. Choice A is incorrect as transforming Larry into a model prisoner is overly optimistic given his history. Choice B is incorrect as it assumes no improvement in coping skills, which may occur to some extent through therapy. Choice C is incorrect as reaffirming high-risk behaviors would be detrimental to Larry's rehabilitation.

Correct Answer: D

Rationale: The correct answer is D: Electric wheelchair. This is because anxiety related to falling can impact an older adult's mobility and independence. Providing an electric wheelchair can help the patient move around safely and independently, reducing the fear of falling and promoting personal freedom. Choice A: Yoga and tai-chi may help with relaxation and balance, but they may not address the immediate mobility concerns of the patient with mild dementia and anxiety related to falling. Choice B: Xanax is a medication commonly used to treat anxiety, but it may not address the underlying mobility issues and could potentially cause side effects in older adults. Choice C: Relaxation techniques can be beneficial for managing anxiety, but in this case, addressing the patient's mobility concerns with an electric wheelchair would be more appropriate and effective.