Which change in the skin is abnormal in an older person?

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: C

Rationale: The correct answer is C, regular exercise to improve strength and balance. This is the most effective strategy for preventing falls in older adults because it helps increase muscle strength, improve balance, and enhance coordination, reducing the risk of falls. Exercise also improves overall mobility and flexibility, which are essential for preventing falls. Installing bed alarms (A) may alert staff after a fall but does not prevent falls. Using medications to sedate the patient (B) can increase the risk of falls due to dizziness and impaired balance. Restricting movement (D) can lead to muscle weakness and loss of balance, increasing the risk of falls.

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 antibiotics are not standard therapy for congestive heart failure in the elderly. The rationale is that antibiotics are used to treat bacterial infections, not heart failure. A: ACE inhibitors are standard therapy as they help dilate blood vessels and reduce the workload on the heart. C: Diuretics help reduce fluid buildup in the body, which is beneficial for managing CHF symptoms. D: Beta blockers are used to reduce the heart's workload and help manage the stress response, making them standard therapy for CHF.

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.

Correct Answer: C

Rationale: The correct answer is C because regularly reviewing and adjusting medications can help minimize adverse effects of polypharmacy in older adults. This approach ensures that the medications are appropriate, necessary, and not causing harm. A: Encouraging herbal supplements is not a recommended approach as they can interact with prescription medications. B: Prioritizing over-the-counter medications may not address the complexities of polypharmacy and can still contribute to drug interactions. D: Limiting patient discussions about medications can lead to misunderstandings and non-adherence.

Correct Answer: B

Rationale: The correct answer is B: administer the lowest dose of 2 mg. In older adults, especially the elderly, it is essential to start with the lowest effective dose of medication to minimize the risk of adverse effects. This approach follows the principle of "start low and go slow" when administering medications to older adults due to age-related changes in drug metabolism and increased sensitivity to medications. Administering the lowest effective dose helps to reduce the risk of potential complications such as respiratory depression, sedation, and falls. Choice A (administer the highest dose of 6 mg) is incorrect because starting with the highest dose can increase the risk of adverse effects in older adults. Choice C (avoid the narcotic because of the risk of addiction) is incorrect as it is important to manage pain effectively in post-operative patients, and opioids can be safely used under proper supervision. Choice D (administer the dose only when the client asks for the medication 2 times) is incorrect as pain management should be

Correct Answer: A

Rationale: The correct answer is A because as individuals age, there is a decrease in renal function leading to reduced renal clearance of drugs. This results in a longer drug half-life and potentially increased drug accumulation in the body. Choice B is incorrect as aging often leads to a decrease in hepatic metabolism, not faster metabolism. Choice C is incorrect because aging can actually lead to reduced gastrointestinal absorption due to changes in the gastrointestinal tract. Choice D is incorrect as aging can result in decreased circulation, which may affect drug distribution negatively.

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.