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: B

Rationale: The correct answer is B: Biomedical. Biomedical health belief system focuses on treating diseases and conditions by repairing or replacing specific body parts through medical interventions such as surgeries, medications, and therapies. This approach is based on scientific evidence and aims to address the physical aspects of health. Incorrect choices: A: Holistic - Holistic health belief system emphasizes treating the whole person, including physical, emotional, and spiritual aspects, rather than focusing solely on repairing specific body parts. C: Personalistic - Personalistic health belief system attributes illnesses to external factors such as curses or supernatural forces, rather than treating specific body parts. D: Magicoreligious - Magicoreligious health belief system relies on magical or religious rituals to heal illnesses, rather than repairing body parts through medical interventions.

Correct Answer: A

Rationale: The correct answer is A because social aging refers to changes in a person's roles and relationships as they age. Retiring from a job is a significant social change that typically accompanies aging. This indicates a shift in the man's social status and activities, which aligns with the concept of social aging. B, C, and D are incorrect because taking multiple medications, using a walker, and celebrating a 65th birthday are not direct indicators of social aging. While these factors may be related to aging, they do not specifically address the social aspects of aging, which is the focus of the question.

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: 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: 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: Step 1: Conducting regular reviews allows nurses to assess the necessity and appropriateness of each medication, addressing potential drug interactions, duplications, and side effects in elderly patients. Step 2: This proactive approach helps prevent polypharmacy-related complications and ensures optimal medication management. Step 3: Ensuring medications are taken exactly as directed (A) may not address the root cause of polypharmacy. Recommending over-the-counter medications (C) without proper evaluation can worsen the issue. Administering medications only during hospital stays (D) is not a comprehensive solution outside of the hospital setting.

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.