The nurse is performing an assessment on an older client who is having difficulty sleeping at night. What statement by the client indicates education is needed on improving sleep?

Correct Answer: C

Rationale: The correct answer is C because drinking hot chocolate before bed contains caffeine which can disrupt sleep. A is correct as exercise can promote better sleep. B is correct as smoking can affect sleep quality. D is correct as reading before bed can help relax the mind.

Correct Answer: D

Rationale: The correct answer is D: For patients 65 years and older to be given sensitive and exemplary care. NICHE aims to provide specialized, high-quality care for older adults through evidence-based practices. This answer aligns with NICHE's goal of improving care quality for elderly patients. Choice A is too restrictive and does not encompass the holistic approach of NICHE. Choice B focuses on cost rather than quality of care. Choice C is vague and does not capture the essence of NICHE's mission to enhance care for older adults.

Correct Answer: A

Rationale: Holistic nursing is the correct answer because it considers the physical, emotional, social, and spiritual aspects of an individual's life in the care plan. It emphasizes treating the whole person rather than just the symptoms. Healthy People 2020 focuses on improving the overall health of the population. Maslow's hierarchy of needs prioritizes basic human needs. Orem's self-care requirements focus on the individual's ability to care for themselves. Holistic nursing is the only approach that integrates and balances all aspects of an individual's life into the care plan, making it the most comprehensive and patient-centered approach.

Correct Answer: B

Rationale: The correct answer is B: Difficulty standing up from a seated position. This is a key indicator of potential sarcopenia because sarcopenia is characterized by age-related loss of muscle mass and strength. Difficulty standing up from a seated position can be attributed to muscle weakness, which is a common symptom of sarcopenia. Unintentional weight loss (A) can be a sign of various health issues, not specific to sarcopenia. Loss of appetite (C) can also be caused by a range of factors, not exclusive to sarcopenia. Increased body fat percentage (D) is not a direct indicator of sarcopenia, as the condition primarily involves muscle loss rather than increased body fat.

Correct Answer: A

Rationale: The correct answer is A because it accurately reflects the multifactorial nature of diabetes in older adults. Age-related changes, coupled with lifestyle factors like poor diet and lack of exercise, contribute to the high incidence of diabetes in this population. This statement acknowledges the complexity of diabetes in older adults. B is incorrect because while nurses should have knowledge about diabetes in older adults, the statement does not specifically address the multifactorial nature of the disease in this population. C is incorrect because ethnicity can indeed play a role in diabetes risk and should not be dismissed outright. D is incorrect because the development of diabetes is not considered a normal age-related change; it is a medical condition that can be influenced by various factors.

Correct Answer: B

Rationale: The correct answer is B because normal age-related immune changes can result in a lower fever response to illness in older adults. As people age, their immune system may not respond as vigorously to infections, leading to a muted fever response. This explains why the older woman with a UTI experienced only mild symptoms and a low-grade fever. Choice A is incorrect because the seriousness of a UTI does not necessarily correlate with the presence or absence of a fever. Choice C is incorrect as older adults can still develop fevers in response to infections. Choice D is incorrect as it is too broad and does not specifically address the age-related immune changes that impact fever response in older adults.

Correct Answer: B

Rationale: The correct answer is B: Magicoreligious. This belief involves attributing illness to supernatural forces or divine punishment. In this scenario, the patient's statement implies a belief that her illness is a result of angering God, indicating a magical or religious explanation. Choice A (Biomedical) focuses on scientific and physical causes of illness, which is not reflected in the patient's statement. Choice C (Naturalistic) involves viewing illness as a part of the natural world, without supernatural elements. Choice D (Ayurvedic) is a traditional Indian system of medicine and does not relate to the patient's belief in supernatural punishment.

Correct Answer: B

Rationale: The correct answer is B: Low calcium intake. Osteoporosis is a condition characterized by weakened bones, making them more susceptible to fractures. Calcium is essential for bone health, and a low intake can lead to decreased bone density and increased risk of osteoporosis. Physical activity, while beneficial for overall health, is not a significant risk factor for osteoporosis. High alcohol consumption can contribute to bone loss but is not as significant as low calcium intake. Genetics play a role in predisposing individuals to osteoporosis, but it is not a modifiable risk factor like low calcium intake. Thus, B is the correct answer.

Correct Answer: A

Rationale: The correct answer is A: Determine whether there are medication duplications. This is the first intervention the nurse should take because medication duplications can lead to potential drug interactions and adverse effects. By identifying duplicate medications, the nurse can prevent harm to the client. Choice B: Starting to educate the client on proper medication adherence may be important, but it is not the first priority in this scenario. Choice C: Monitoring the client's blood pressure closely is not directly related to the issue of multiple medications and should not be the first intervention. Choice D: Asking the client to stop taking some medications without proper assessment and consultation with a healthcare provider can be risky and may not address the issue of medication duplications.