When considering end-of-life care, which of the following is most crucial for the gerontological nurse to evaluate?

Correct Answer: C

Rationale: The correct answer is C: The patient's advanced directives and wishes. This is crucial in end-of-life care as it ensures that the patient's preferences and values are respected. By evaluating the advanced directives and wishes, the nurse can provide care that aligns with the patient's goals and desires. This promotes autonomy and dignity in the patient's end-of-life experience. Choice A (Patient's financial situation) is not as crucial as the patient's wishes in end-of-life care, as financial considerations should not dictate the quality of care provided. Choice B (The family’s expectations) is important, but the patient's wishes should take precedence as it is their care and preferences that should be the primary focus. Choice D (The patient's history of medication use) is relevant for overall care but not as crucial in end-of-life care as honoring the patient's wishes and directives.

Correct Answer: B

Rationale: The correct answer is B because older adults with chronic conditions are often prescribed multiple medications to manage their various health issues, leading to polypharmacy and increased risk of adverse drug reactions. This challenge can result in medication mismanagement, drug interactions, and medication non-adherence. The other choices are incorrect because comorbidities are common in older adults, medical intervention is generally accepted, and older adults often experience declines in physical and cognitive health with age.

Correct Answer: B

Rationale: The correct answer is B, Cognitive Behavioral Therapy (CBT) combined with physical therapy. This intervention is effective in managing chronic pain in older adults because it addresses both the psychological and physical aspects of pain. CBT helps individuals change negative thought patterns and behaviors related to pain, leading to improved pain management. Physical therapy can help improve physical function and reduce pain through exercises and techniques. A: Increased use of narcotic medications may provide short-term relief but can lead to dependence and other negative side effects in older adults. C: Isolation can worsen mental health and exacerbate pain symptoms due to lack of social support and interaction. D: Surgery is not suitable for all types of chronic pain in older adults and should only be considered as a last resort after conservative interventions have been tried. In summary, B is the most effective intervention as it addresses both psychological and physical aspects of chronic pain in older adults, unlike the other options which may have limitations or negative consequences.

Correct Answer: B

Rationale: The correct answer is B: Increasing protein intake. Protein is crucial for maintaining muscle mass and strength in older adults, aiding in the prevention and management of malnutrition. Protein also supports immune function and wound healing. Reducing calorie intake (A) can exacerbate malnutrition, as older adults need adequate nutrition. Avoiding all fats (C) is not recommended as healthy fats are essential for brain health and nutrient absorption. Limiting hydration (D) can lead to dehydration and worsen malnutrition. In summary, increasing protein intake is the most important factor in managing malnutrition in older adults due to its vital role in maintaining overall health and preventing muscle loss.

Correct Answer: D

Rationale: The correct answer is D: Age-related changes in liver function. As people age, there are changes in liver metabolism and blood flow, affecting the processing of anesthetic agents. Liver function declines with age, leading to slower drug metabolism and clearance, increasing the risk of adverse reactions. Decreased muscle mass (A) may affect drug distribution but not metabolism. Decreased renal function (B) can impact drug excretion but is not the primary reason for adverse reactions. Increased body fat (C) can alter drug distribution but is not the main factor in anesthesia reactions for older adults.