Which of the following is a strong predictor of functional decline in older adults?

Correct Answer: D

Rationale: The correct answer is D: Depression. Depression is a strong predictor of functional decline in older adults because it can lead to decreased motivation, social withdrawal, and physical symptoms that affect daily activities. Depression is also associated with cognitive impairment, which can further impact functioning. Being physically active (A) and high socioeconomic status (B) are generally positive factors for maintaining function. Advanced age (C) alone is not a strong predictor of functional decline compared to depression.

Correct Answer: D

Rationale: The correct answer is D: Serum triiodothyronine (T3) and gastric pepsin. Aging typically leads to a decrease in serum T3 levels due to reduced thyroid function. Gastric pepsin production also decreases with age, impacting digestion. A: Creatinine clearance and insulin secretion typically decrease with kidney and pancreatic function decline, not necessarily solely due to aging. B: Blood CO2 levels and saliva production are not directly affected by aging but can be influenced by various health conditions. C: Left ventricle-wall thickness may increase with age due to conditions like hypertension, and skin healing time can be affected by various factors other than just aging. In summary, the correct answer stands out as age-related declines in serum T3 and gastric pepsin levels are more directly linked to the aging process compared to the other choices.

Correct Answer: C

Rationale: The correct answer is C: Certified gerontological nurse. This nurse has specialized knowledge and training in caring for elderly patients, aligning with the nursing home's focus on eldercare standards. Certification demonstrates expertise in gerontological nursing. A: A nurse from a certified college may not necessarily have specialized training in gerontological nursing. B: Experience is valuable, but without specific gerontological training, the nurse may lack the specialized skills required for eldercare. D: A gerontological nurse practitioner has advanced training, but for direct patient care in a nursing home setting, a certified gerontological nurse may be a better fit.

Correct Answer: B

Rationale: Postural hypotension is a drop in blood pressure when standing up. Increased cholesterol levels do not directly affect blood pressure regulation or lead to postural hypotension. Medications, decreased baroreceptor sensitivity, and arterial stiffness can all contribute to postural hypotension by affecting blood pressure regulation mechanisms. Therefore, choice B, increased cholesterol level, is the correct answer as it does not directly cause postural hypotension.

Correct Answer: B

Rationale: The correct answer is B: Cognitive decline or dementia. Elder abuse risk assessment in gerontological nursing involves considering cognitive decline or dementia as the most important factor. This is because individuals with cognitive impairments are more vulnerable and may have difficulty recognizing and reporting abuse. Family history of violence (A), history of physical ailments (C), and medication regimen (D) are important factors to consider but do not directly impact the elder abuse risk assessment as significantly as cognitive decline or dementia.

Correct Answer: B

Rationale: The correct answer is B because using large size fonts on written material is important for elderly individuals in assisted living facilities who may have visual impairments. This accommodation ensures that the residents can easily read and understand the information being presented. This is crucial for effective communication and engagement in the educational program. A: While using simple language is generally beneficial, the primary concern for this specific population is visual accessibility rather than language complexity. C: Providing the program in a quiet area is important for minimizing distractions, but it is not as critical as ensuring the residents can read the material. D: While building on prior knowledge is a good practice in teaching, it is secondary to ensuring that the information is visually accessible to the residents.

Correct Answer: C

Rationale: The correct answer is C: Coordinating care among healthcare providers. This is the most important consideration for providing care to older adults with multiple chronic conditions because it ensures that all aspects of their health are managed comprehensively and efficiently. Coordinating care among healthcare providers helps prevent medication interactions, duplicate tests, and conflicting treatment plans. It also promotes better communication and collaboration among the healthcare team, leading to improved outcomes for the patient. A: Treating each condition independently is not ideal as it may result in conflicting treatment plans and overlook the holistic nature of managing multiple chronic conditions. B: Using a single medication for all conditions is not appropriate as different conditions may require specific medications tailored to each individual's needs. D: Limiting social interactions to reduce stress is not directly related to managing multiple chronic conditions and may have negative effects on the overall well-being of the older adults.

Correct Answer: A

Rationale: Holistic nursing is the correct answer because it considers the physical, emotional, social, and spiritual aspects of an individual's life in the care plan. It emphasizes treating the whole person rather than just the symptoms. Healthy People 2020 focuses on improving the overall health of the population. Maslow's hierarchy of needs prioritizes basic human needs. Orem's self-care requirements focus on the individual's ability to care for themselves. Holistic nursing is the only approach that integrates and balances all aspects of an individual's life into the care plan, making it the most comprehensive and patient-centered approach.

Correct Answer: B

Rationale: The correct answer is B: Providing palliative care focused on symptom management and comfort. This is the most appropriate intervention for an older adult with advanced heart failure as it prioritizes quality of life by focusing on alleviating symptoms and ensuring comfort. High-dose diuretics (choice A) may lead to electrolyte imbalances and worsen the patient's condition. Initiating aggressive cardiac surgery (choice C) may be too risky and invasive for an older adult with advanced heart failure. Enforcing strict bed rest (choice D) can lead to deconditioning and muscle wasting, further compromising the patient's quality of life.