Which of the following is a key sign of dehydration in older adults that differs from younger populations?

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: B

Rationale: The correct answer is B: Consistent mental and physical activity. Engaging in mental and physical activities can help improve cognitive function, increase brain plasticity, and reduce the risk of cognitive decline. Regular stimulation of the brain through activities like puzzles, reading, and learning new skills can help delay the onset of dementia. Physical activity also promotes overall brain health by improving circulation and reducing inflammation. Choices A, C, and D are incorrect: A: Strict dietary restrictions may have some benefits for overall health, but there is limited evidence to suggest that it directly delays the onset of dementia. C: Regular social isolation can actually increase the risk of cognitive decline and dementia, as social interaction is important for brain health. D: Pharmacologic interventions to control hypertension may be important for overall health, but they are not specifically shown to delay the onset of dementia in older adults.

Correct Answer: D

Rationale: The correct answer is D because reluctance of older adults to report pain is a significant barrier to effective pain management. Older adults may underreport pain due to various factors such as fear of being seen as a burden, denial of aging-related changes, or belief that pain is a natural part of aging. This can lead to under-treatment of pain and decreased quality of life. Choices A, B, and C are not the most common barriers in this context. Fear of addiction to opioids, insufficient knowledge among healthcare providers, and inadequate access to specialists are important factors but are not as prevalent as older adults' reluctance to report pain.

Correct Answer: B

Rationale: The correct answer is B, cognitive-behavioral therapy (CBT) combined with antidepressant medications, for treating depression in older adults. CBT helps address negative thought patterns and behaviors associated with depression, while antidepressant medications provide physiological support. Combining both approaches has been shown to be more effective than either treatment alone in older adults. A: Long-term pharmacological therapy with SSRIs may have side effects and limited effectiveness in older adults. C: Antidepressant medications alone may not address the underlying psychological factors contributing to depression. D: Psychodynamic therapy may not be as effective in older adults as it focuses on unresolved issues from early life rather than targeting current depressive symptoms.

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).