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. Intermittent claudication, defined as pain in the lower extremities with walking that improves with rest, is a classic symptom of moderate to severe PAD. This occurs due to inadequate blood flow to the muscles during exercise. Other choices are incorrect: A is typically associated with syncope or fainting; B is more indicative of cardiovascular or pulmonary issues; and C is more commonly seen in mesenteric ischemia.

Correct Answer: A

Rationale: The correct answer is A: Determine whether there are medication duplications. This is the first intervention the nurse should take because medication duplications can lead to potential drug interactions and adverse effects. By identifying duplicate medications, the nurse can prevent harm to the client. Choice B: Starting to educate the client on proper medication adherence may be important, but it is not the first priority in this scenario. Choice C: Monitoring the client's blood pressure closely is not directly related to the issue of multiple medications and should not be the first intervention. Choice D: Asking the client to stop taking some medications without proper assessment and consultation with a healthcare provider can be risky and may not address the issue of medication duplications.

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: C

Rationale: The correct answer is C because life expectancy is influenced by multiple factors such as gender, ethnicity, and living environment. Gender does play a role, but it is not the sole determinant. Ethnicity and living environment also significantly impact life expectancy. Genetic factors may contribute, but they are not the primary factor affecting life expectancy. Therefore, choice C is the most comprehensive and accurate statement. Choices A and B are incorrect as they oversimplify the factors that influence life expectancy, while choice D is also incorrect as it overlooks the significant impact of other factors beyond genetics.

Correct Answer: B

Rationale: The correct answer is B: Identifying goals of care through open conversations with the patient and family. This is crucial because palliative care for older adults should be person-centered and align with their preferences and values. By engaging in open conversations, healthcare providers can understand the individual's goals, values, and wishes, allowing for care to be tailored accordingly. This approach emphasizes holistic care beyond just managing pain and considers the patient's emotional, spiritual, and social needs. Incorrect choices: A: Focusing primarily on managing pain with medications overlooks the importance of addressing other aspects of care. C: Avoiding advanced medical treatments is not always appropriate as each situation should be assessed individually. D: Prescribing hospice care immediately may not be necessary or desired by the patient, as it depends on their specific needs and preferences.

Correct Answer: B

Rationale: The correct answer is B because baby boomers were exposed to unhealthy lifestyle choices and environments in their formative years, contributing to the prevalence of chronic conditions. This is supported by research showing that environmental factors, such as diet and exposure to toxins, play a significant role in the development of chronic illnesses. Additionally, unhealthy habits established in youth can have long-term effects on health. Choice A is incorrect because higher physical activity rates during youth would typically lead to better health outcomes, not increased chronic conditions. Choice C is incorrect as better access to preventive healthcare services would likely reduce chronic conditions, not increase them. Choice D is incorrect because education about nutrition and wellness would typically lead to healthier lifestyle choices and lower rates of chronic conditions.

Correct Answer: B

Rationale: The correct answer is B because regular physical activity and joint mobility exercises help improve joint flexibility, reduce pain, and increase strength. This intervention can enhance overall physical function and quality of life for older adults with arthritis. Complete bed rest (A) can lead to muscle weakness and joint stiffness, worsening arthritis symptoms. Increased use of opioid painkillers (C) can have adverse side effects and may not address the root cause of arthritis. Strictly limiting daily activities (D) can lead to decreased mobility and functional decline in older adults.

Correct Answer: B

Rationale: The correct answer is B: Difficulty standing up from a seated position. This is a key indicator of potential sarcopenia because sarcopenia is characterized by age-related loss of muscle mass and strength. Difficulty standing up from a seated position can be attributed to muscle weakness, which is a common symptom of sarcopenia. Unintentional weight loss (A) can be a sign of various health issues, not specific to sarcopenia. Loss of appetite (C) can also be caused by a range of factors, not exclusive to sarcopenia. Increased body fat percentage (D) is not a direct indicator of sarcopenia, as the condition primarily involves muscle loss rather than increased body fat.