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: C

Rationale: The correct answer is C: Medications and polypharmacy. In older adults, incontinence is commonly caused by medications that affect bladder control, such as diuretics, sedatives, and anticholinergics. Polypharmacy can worsen this by increasing the likelihood of drug interactions. Chronic urinary tract infections (A) can cause incontinence but are less common in older adults. Neurological disorders (B) like dementia or stroke can also lead to incontinence but are not the most common cause. Poor hydration (D) can exacerbate incontinence but is not the primary cause.

Correct Answer: B

Rationale: The correct answer is B: Providing palliative care focused on symptom management and comfort. This is the most appropriate intervention for an older adult with advanced heart failure as it prioritizes quality of life by focusing on alleviating symptoms and ensuring comfort. High-dose diuretics (choice A) may lead to electrolyte imbalances and worsen the patient's condition. Initiating aggressive cardiac surgery (choice C) may be too risky and invasive for an older adult with advanced heart failure. Enforcing strict bed rest (choice D) can lead to deconditioning and muscle wasting, further compromising the patient's quality of life.

Correct Answer: C

Rationale: The correct answer is C: Certified gerontological nurse. This nurse has specialized knowledge and training in caring for elderly patients, aligning with the nursing home's focus on eldercare standards. Certification demonstrates expertise in gerontological nursing. A: A nurse from a certified college may not necessarily have specialized training in gerontological nursing. B: Experience is valuable, but without specific gerontological training, the nurse may lack the specialized skills required for eldercare. D: A gerontological nurse practitioner has advanced training, but for direct patient care in a nursing home setting, a certified gerontological nurse may be a better fit.

Correct Answer: B

Rationale: The correct answer is B because regular physical activity and joint mobility exercises help improve joint flexibility, reduce pain, and increase strength. This intervention can enhance overall physical function and quality of life for older adults with arthritis. Complete bed rest (A) can lead to muscle weakness and joint stiffness, worsening arthritis symptoms. Increased use of opioid painkillers (C) can have adverse side effects and may not address the root cause of arthritis. Strictly limiting daily activities (D) can lead to decreased mobility and functional decline in older adults.

Correct Answer: D

Rationale: The correct answer is D: Serum triiodothyronine (T3) and gastric pepsin. Aging typically leads to a decrease in serum T3 levels due to reduced thyroid function. Gastric pepsin production also decreases with age, impacting digestion. A: Creatinine clearance and insulin secretion typically decrease with kidney and pancreatic function decline, not necessarily solely due to aging. B: Blood CO2 levels and saliva production are not directly affected by aging but can be influenced by various health conditions. C: Left ventricle-wall thickness may increase with age due to conditions like hypertension, and skin healing time can be affected by various factors other than just aging. In summary, the correct answer stands out as age-related declines in serum T3 and gastric pepsin levels are more directly linked to the aging process compared to the other choices.

Correct Answer: B

Rationale: The correct answer is B because baby boomers were exposed to unhealthy lifestyle choices and environments in their formative years, contributing to the prevalence of chronic conditions. This is supported by research showing that environmental factors, such as diet and exposure to toxins, play a significant role in the development of chronic illnesses. Additionally, unhealthy habits established in youth can have long-term effects on health. Choice A is incorrect because higher physical activity rates during youth would typically lead to better health outcomes, not increased chronic conditions. Choice C is incorrect as better access to preventive healthcare services would likely reduce chronic conditions, not increase them. Choice D is incorrect because education about nutrition and wellness would typically lead to healthier lifestyle choices and lower rates of chronic conditions.

Correct Answer: C

Rationale: The correct answer is C because it states that the exact cause of super-centenarians' longevity and good health is not known. This acknowledges the uncertainty and complexity of the situation, highlighting the need for further research and understanding. Explanation for why the other choices are incorrect: A: Genetic makeup alone may not fully explain super-centenarians' survival, as there are likely additional factors involved. B: Living in wealthier areas does not guarantee longevity or good health, as there are many other factors at play. D: While quality medical care and improved social conditions can contribute to health, they are not the sole reasons for super-centenarians' exceptional longevity.

Correct Answer: A

Rationale: The correct answer is A: Nocturia. Nocturia, or waking up at night to urinate, is a common symptom of benign prostatic hypertrophy (BPH) due to the enlarged prostate pressing on the urethra, causing urinary frequency and urgency. Other symptoms like weak urine stream, difficulty starting urination, incomplete emptying, and dribbling may also be present. Recurrent urinary tract infections (B) are less likely to be the initial symptom of BPH, as they are more commonly associated with urinary retention or obstruction. Functional incontinence (C) is not a typical symptom of BPH, as it is more related to mobility or cognitive issues. Hematuria (D) is not a common presenting symptom of BPH, as it is more indicative of other conditions like urinary tract infections or kidney stones.