What is the primary consideration when initiating care for older adults with palliative care needs?

Correct Answer: B

Rationale: The correct answer is B: Identifying goals of care through open conversations with the patient and family. This is crucial because palliative care for older adults should be person-centered and align with their preferences and values. By engaging in open conversations, healthcare providers can understand the individual's goals, values, and wishes, allowing for care to be tailored accordingly. This approach emphasizes holistic care beyond just managing pain and considers the patient's emotional, spiritual, and social needs. Incorrect choices: A: Focusing primarily on managing pain with medications overlooks the importance of addressing other aspects of care. C: Avoiding advanced medical treatments is not always appropriate as each situation should be assessed individually. D: Prescribing hospice care immediately may not be necessary or desired by the patient, as it depends on their specific needs and preferences.

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 because it provides inaccurate information. Osteoarthritis commonly affects weight-bearing joints like the knees and hips, not the hands, elbows, and shoulders as stated. The other choices are incorrect due to the following reasons: A: Correct - describes osteoarthritis B: Incorrect - describes rheumatoid arthritis D: Incorrect - describes risk factors for osteoarthritis, not rheumatoid arthritis.

Correct Answer: C

Rationale: The correct answer is C: sleep apnea. Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep, which does not directly cause pneumonia. Aspiration from a poor swallow (A), community acquired pneumonia (B), and compromised immune function (D) are all known risk factors for pneumonia in older adults. Aspiration can lead to the entry of bacteria into the lungs, community-acquired pneumonia is a common cause of infection in the elderly, and compromised immune function makes older adults more susceptible to infections. Thus, sleep apnea is the only option that does not directly contribute to the development of pneumonia in older clients.

Correct Answer: B

Rationale: The correct answer is B because straining to void can lead to increased vagal stimulation, resulting in decreased blood pressure upon standing (orthostatic hypotension). A: age and walker use don't directly increase risk. C: a leg cast may not directly affect blood pressure. D: Premarin use is not a common cause of orthostatic hypotension.