Which of the following interventions is most effective in managing chronic pain in older adults?

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: 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: 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: 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.