What is the most effective intervention to prevent skin breakdown in immobile older adults?

Correct Answer: C

Rationale: The correct answer is C because regular repositioning and the use of pressure-relieving devices are essential to prevent skin breakdown in immobile older adults. Repositioning helps redistribute pressure, maintaining blood flow to the skin and preventing tissue damage. Pressure-relieving devices such as cushions or special mattresses further reduce pressure on vulnerable areas. Choices A and B do not address the root cause of skin breakdown and may even exacerbate the issue. Choice D is incorrect as complete bed rest can lead to further complications like pressure ulcers. In summary, choice C is the most effective intervention as it directly targets the risk factors for skin breakdown in immobile older adults.

Correct Answer: D

Rationale: The correct answer is D because reluctance of older adults to report pain is a significant barrier to effective pain management. Older adults may underreport pain due to various factors such as fear of being seen as a burden, denial of aging-related changes, or belief that pain is a natural part of aging. This can lead to under-treatment of pain and decreased quality of life. Choices A, B, and C are not the most common barriers in this context. Fear of addiction to opioids, insufficient knowledge among healthcare providers, and inadequate access to specialists are important factors but are not as prevalent as older adults' reluctance to report pain.

Correct Answer: B

Rationale: The correct answer is B, cognitive-behavioral therapy (CBT) combined with antidepressant medications, for treating depression in older adults. CBT helps address negative thought patterns and behaviors associated with depression, while antidepressant medications provide physiological support. Combining both approaches has been shown to be more effective than either treatment alone in older adults. A: Long-term pharmacological therapy with SSRIs may have side effects and limited effectiveness in older adults. C: Antidepressant medications alone may not address the underlying psychological factors contributing to depression. D: Psychodynamic therapy may not be as effective in older adults as it focuses on unresolved issues from early life rather than targeting current depressive symptoms.

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: B

Rationale: The correct answer is B: high likelihood of orthostatic hypotension upon rising quickly. Orthostatic hypotension is a common issue in the elderly, causing a sudden drop in blood pressure when standing up quickly, leading to dizziness and falls. This factor directly contributes to the high incidence of falls in the elderly. Increased muscle mass and tone (A) actually reduce the risk of falls, while improving eyesight in dim light (C) would decrease the risk. Constipation (D) is not directly related to falls in the elderly.