Which of the following cases seen by a nurse working in the ED identifies a situation that suggests a case of elder mistreatment?

Correct Answer: B

Rationale: Step-by-step rationale: 1. Choice B is the correct answer because dime-sized burned areas on the upper inner thigh can be indicative of elder mistreatment, such as neglect or abuse. 2. Burns in unusual areas like the inner thigh raise suspicion as they are not commonly accidental. 3. Elderly individuals may be unable to defend themselves or report abuse, making it crucial for healthcare providers to recognize potential signs. 4. Choices A, C, and D do not directly suggest elder mistreatment but may indicate other health issues or accidents. Summary: Choice B is correct as it presents a specific sign of potential elder mistreatment, while the other choices do not exhibit clear indicators of abuse or neglect.

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 because Mezey and Fulmer (2002) justify gerontological nursing research by emphasizing that it positively influences outcomes from nursing care. This is supported by evidence showing how research in gerontological nursing can lead to improved quality of care for older adults. Other choices are incorrect: A is not directly supported by the justification provided by Mezey and Fulmer (2002), C is too specific and not the main focus of their justification, and D is not mentioned in the justification and does not address the impact of research on nursing care outcomes.

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: A

Rationale: The correct answer is A because storytelling allows older clients to recall and share past experiences, promoting reminiscence. Storytelling evokes memories and encourages clients to reflect on their lives. Playing cards, painting, and watching movies do not necessarily prompt reminiscence as effectively as storytelling does. Playing cards and painting are activities that may not directly stimulate reminiscence, and watching movies may not engage clients in personal reflection as much as storytelling does.

Correct Answer: C

Rationale: The correct answer is C: Regular review and adjustment of medications by healthcare providers. This approach is the best because it involves healthcare professionals regularly assessing the appropriateness of each medication, adjusting dosages, and eliminating unnecessary drugs to minimize potential adverse effects and drug interactions in older adults. This proactive management strategy ensures that the patient's medication regimen is optimized for their specific health needs, reducing the risks associated with polypharmacy. Choice A (Regular use of over-the-counter medications) is incorrect as it does not address the issue of polypharmacy and may actually contribute to it. Choice B (Reducing the number of medications based on patient preferences) is not the best approach as patient preferences alone may not always align with the most effective and safe medication regimen. Choice D (Relying solely on herbal supplements) is also incorrect as herbal supplements can interact with prescribed medications, leading to potential complications.

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: 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: Correct Answer: B Rationale: The thymus gland is responsible for producing T-cells, crucial for immune responses. As individuals age, the thymus gland shrinks and becomes less efficient, reducing the production of new T-cells. This decline in T-cell production weakens the immune response in older adults, making them more susceptible to infections. Therefore, choice B is correct. Summary of Incorrect Choices: A: Aging does not increase the production of white blood cells. In fact, the immune system may weaken with age due to a decline in key immune cells. C: Aging does not improve the body's ability to recognize and fight off pathogens. Instead, it often leads to a decline in immune function. D: While some inflammatory responses may increase with age, excessive inflammation can actually be harmful and contribute to age-related diseases, rather than providing protection.