When caring for an older adult with advanced heart failure, which intervention is most likely to improve the patient's quality of life?

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: 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: 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: 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: 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: 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: C

Rationale: The correct answer is C because life expectancy is influenced by multiple factors such as gender, ethnicity, and living environment. Gender does play a role, but it is not the sole determinant. Ethnicity and living environment also significantly impact life expectancy. Genetic factors may contribute, but they are not the primary factor affecting life expectancy. Therefore, choice C is the most comprehensive and accurate statement. Choices A and B are incorrect as they oversimplify the factors that influence life expectancy, while choice D is also incorrect as it overlooks the significant impact of other factors beyond genetics.

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: 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.