Which of the following can significantly improve the quality of life for older adults with chronic pain?

Correct Answer: C

Rationale: The correct answer is C: Cognitive-behavioral therapy (CBT) and physical therapy. CBT helps older adults manage pain through changing thought patterns and behaviors, improving coping skills. Physical therapy helps maintain mobility and reduce pain. Both approaches address the physical and psychological aspects of chronic pain, leading to better quality of life. Complete bed rest (A) can worsen pain and lead to muscle weakness. Unsupervised use of opioids (B) can be dangerous, leading to addiction and other health issues. Isolation and minimal social interaction (D) can contribute to depression and exacerbate pain.

Correct Answer: B

Rationale: The correct answer is B because tuberculosis is an infectious bacterial disease that primarily affects the lungs. Clients taking immunosuppressant medications have weakened immune systems, making them more susceptible to developing active tuberculosis. This is due to the fact that the immune system is less able to fight off the bacteria causing tuberculosis. Choices A, C, and D are incorrect because tuberculosis is not spread by persons with positive skin tests and no symptoms, it is caused by bacteria (Mycobacterium tuberculosis) not a virus related to HIV, and it typically causes weight loss and not weight gain in the early stages.

Correct Answer: A

Rationale: The correct answer is A because the TimeSlips program involves providing a picture as a creative prompt for group members to collaboratively create a story. This technique stimulates imagination and communication in cognitively impaired individuals. Choice B is incorrect as recording responses is not specific to the TimeSlips method. Choice C is incorrect as complimenting contributions is not a core component of the TimeSlips program. Choice D is incorrect as reading back the story during the session does not align with the collaborative, creative process of TimeSlips.

Correct Answer: C

Rationale: The correct answer is C because regular repositioning and the use of pressure-relieving devices are essential to prevent skin breakdown in immobile older adults. Repositioning helps redistribute pressure, maintaining blood flow to the skin and preventing tissue damage. Pressure-relieving devices such as cushions or special mattresses further reduce pressure on vulnerable areas. Choices A and B do not address the root cause of skin breakdown and may even exacerbate the issue. Choice D is incorrect as complete bed rest can lead to further complications like pressure ulcers. In summary, choice C is the most effective intervention as it directly targets the risk factors for skin breakdown in immobile older adults.

Correct Answer: D

Rationale: The correct answer is D because assisting with upper endoscopy is not a standard nursing intervention for CHF. Nursing interventions for CHF focus on managing symptoms, medication adherence, and lifestyle modifications. Choices A, B, and C are correct as they address important aspects of CHF management such as monitoring symptoms, educating on medications, and promoting a low-sodium diet. Helping with an upper endoscopy is unrelated to the management of CHF and falls outside the scope of nursing care for this condition.

Correct Answer: B

Rationale: The correct answer, B, is the primary role of the gerontological nurse when providing end-of-life care for a terminally ill older adult. This choice emphasizes the importance of pain management, comfort care, and preserving the patient's dignity. The nurse's focus should be on enhancing the quality of life and ensuring the patient's comfort rather than pursuing aggressive curative treatments (A). Administering sedatives (C) should be based on individual needs and preferences, not as a blanket approach. While family involvement is crucial, the nurse should still advocate for the patient's autonomy and preferences, rather than solely relying on family decisions (D).

Correct Answer: A

Rationale: The correct answer is A: Unsecured scattered rugs. This requires immediate nursing action as it poses a significant fall risk for the older adult. Rugs can cause tripping hazards, leading to potential injuries. The nurse should secure or remove the rugs to ensure the safety of the patient. Summary of other choices: B: Operable smoke detector - While important for safety, it does not require immediate nursing action as it is already in working condition. C: Prefilled medication cassette - This is not an immediate safety concern and can be addressed during routine medication management. D: Unsecured scattered rugs (repeated) - This choice is the same as the correct answer, so it is incorrect.

Correct Answer: D

Rationale: The correct answer is D: Confusion or cognitive decline. In older adults, dehydration can manifest differently than in younger populations. Cognitive decline is a key sign of dehydration in older adults due to the brain being more sensitive to fluid loss. Dehydration can lead to confusion, disorientation, and impaired cognitive function in older individuals. Dark-colored urine (A) is a common sign of dehydration in all age groups. Increased thirst (B) is a general sign of dehydration but may not be as prominent in older adults due to decreased thirst sensation. Dry mouth and skin (C) are also common signs of dehydration but may not be as reliable indicators in older adults compared to cognitive changes.

Correct Answer: A

Rationale: The correct answer is A: Historical. In age-stratification theory, cohort members are described in historical context to explain shared experiences. This theory emphasizes that individuals born around the same time experience similar events shaping their lives. Historical context is crucial as it considers the societal, cultural, and economic factors influencing a specific generation. Choice B, Biological, is incorrect as age-stratification theory focuses on social aspects rather than biological ones. Choice C, Sociological, is broad and doesn't specifically address the historical aspect of cohort description. Choice D, Chronological, is incorrect as it simply refers to the order of events without considering the historical backdrop of a cohort's experiences.