What is the primary consideration when managing an older adult with advanced chronic kidney disease (CKD)?

Correct Answer: C

Rationale: The correct answer is C: Monitoring for electrolyte imbalances and adjusting medications accordingly. In advanced CKD, electrolyte imbalances can worsen kidney function and lead to complications. Monitoring electrolytes like potassium and adjusting medications such as diuretics is crucial. A: Initiating early dialysis is not always necessary and should be based on individual patient factors. B: Avoiding all medications is not feasible as some medications are essential and can be adjusted based on kidney function. D: Limiting fluid intake to less than 500 mL per day is too restrictive and can lead to dehydration.

Correct Answer: D

Rationale: The correct answer is D because allowing the client to choose activities promotes autonomy by giving him control over his daily routine and decision-making. This empowers the client to maintain a sense of independence and self-determination, which is crucial in long-term care settings. Planning meals (A) and scheduling appointments (B) are important tasks but do not directly contribute to the client's autonomy. Decorating his room (C) is a thoughtful gesture but does not actively involve the client in decision-making or daily choices.

Correct Answer: D

Rationale: The correct answer is D, Standards of gerontological nursing practice, as the ANA Scope and Standards of Gerontological Nursing (2010) specifically outlines the accepted standards and guidelines for gerontological nursing practice. This document does not focus on skills and knowledge (Choice A), levels of practice (Choice B), or certification requirements (Choice C), but rather on setting the standards and expectations for gerontological nursing care. It is essential for nurses to adhere to these standards to provide high-quality care to older adults.

Correct Answer: B

Rationale: The correct answer is B because a red, swollen 3-day-old wound in an older person indicates delayed wound healing, which is abnormal. The skin's ability to heal slows down with age due to decreased collagen production and compromised immune response. Thinner and more fragile skin (choice A) are typical changes in older individuals but not necessarily abnormal. Greater number of freckles (choice C) is a common age-related change due to accumulated sun exposure. Loss of hair on the extremities (choice D) can occur with aging but is not necessarily abnormal unless it is sudden and widespread.

Correct Answer: B

Rationale: The correct answer is B because health disparities refer to variations in health outcomes between different groups, often linked to social, economic, or environmental factors. This definition accurately captures the essence of health disparities by emphasizing the differences in health outcomes among various populations. Choice A is incorrect because it describes cultural elimination rather than health disparities. Choice C is incorrect as it focuses on statistical comparison rather than the health outcomes themselves. Choice D is incorrect as it discusses differing values and perspectives, which are not directly related to health disparities. In summary, choice B is the correct answer as it aligns with the definition and concept of health disparities.

Correct Answer: A

Rationale: The correct answer is A: Primarily in the last 30 years. This is because advancements in research methodologies, technology, and increased awareness of aging population's health needs have led to a significant increase in research rigor and scope in the past few decades. Choice B is too broad and vague. Choice C is incorrect as research on older adults' health outcomes predates the establishment of Medicare. Choice D is too limited in scope, as research on older adults' health outcomes has been ongoing for more than just the last decade.

Correct Answer: C

Rationale: The correct answer is C: Monitoring for electrolyte imbalances and adjusting medications accordingly. In advanced CKD, electrolyte imbalances can worsen kidney function and lead to complications. Monitoring electrolytes like potassium and adjusting medications such as diuretics is crucial. A: Initiating early dialysis is not always necessary and should be based on individual patient factors. B: Avoiding all medications is not feasible as some medications are essential and can be adjusted based on kidney function. D: Limiting fluid intake to less than 500 mL per day is too restrictive and can lead to dehydration.

Correct Answer: B

Rationale: Step 1: Conducting regular reviews allows nurses to assess the necessity and appropriateness of each medication, addressing potential drug interactions, duplications, and side effects in elderly patients. Step 2: This proactive approach helps prevent polypharmacy-related complications and ensures optimal medication management. Step 3: Ensuring medications are taken exactly as directed (A) may not address the root cause of polypharmacy. Recommending over-the-counter medications (C) without proper evaluation can worsen the issue. Administering medications only during hospital stays (D) is not a comprehensive solution outside of the hospital setting.

Correct Answer: C

Rationale: The correct answer is C because maintaining good eye contact and a relaxed, smiling approach can help establish a sense of trust and connection with persons with dementia. This approach can help reduce feelings of confusion and anxiety in individuals with dementia, improving communication and fostering a positive interaction. A: Asking open-ended questions may overwhelm individuals with dementia and make it difficult for them to process information. B: Talking to persons with dementia as you would a child is inappropriate and disrespectful, as it disregards their dignity and autonomy. D: Reminding individuals with dementia not to forget something can be frustrating and may lead to feelings of failure or inadequacy.