Which of the following is the most important intervention to prevent pressure ulcers in older adults?

Correct Answer: A

Rationale: The correct answer is A: Regular repositioning every 2 hours. Repositioning helps to relieve pressure on vulnerable areas, improving blood flow and preventing tissue damage. This intervention is evidence-based and recommended in pressure ulcer prevention guidelines. Administering pain medications before repositioning (B) does not address the root cause of pressure ulcers. Encouraging excessive hydration (C) may have other health benefits but does not directly prevent pressure ulcers. Using restrictive bandages (D) can actually increase pressure and worsen the risk of pressure ulcers.

Correct Answer: A

Rationale: The correct answer is A: peripheral arterial disease. Altered level of consciousness in an 81-year-old female is unlikely to be directly caused by peripheral arterial disease. Instead, hypoglycemia, pneumonia, and hypotension from dehydration are common causes of altered mental status in the elderly. Hypoglycemia can lead to brain dysfunction, pneumonia can cause low oxygen levels affecting brain function, and dehydration-induced hypotension can reduce blood flow to the brain. Therefore, peripheral arterial disease is not typically a direct cause of altered consciousness in this scenario.

Correct Answer: B

Rationale: The correct answer is B because the Nurse Competence in Aging (NCA) initiative focuses on developing resources for nurses to access evidence-based information on topics related to the care of older adults. This is evident in the initiative's goal to enhance the knowledge and skills of nurses caring for older adults. The other choices are incorrect because A is not specific to the NCA initiative, C pertains to scholarships rather than resources for accessing information, and D is incorrect as the NCA initiative did not develop the first certification in gerontological nursing.

Correct Answer: D

Rationale: The correct answer is D: Asian and Pacific Island Americans. This group has the highest life expectancy in the US due to various factors such as healthy dietary habits, lower rates of smoking and alcohol consumption, access to quality healthcare, and strong social support systems. They also tend to engage in regular physical activity and have lower rates of obesity and chronic diseases compared to other racial or ethnic groups. In contrast, choices A, B, and C have lower life expectancies due to factors such as higher rates of poverty, inadequate healthcare access, systemic racism, and higher prevalence of chronic health conditions like diabetes and heart disease.

Correct Answer: B

Rationale: The most effective approach to improve quality of life in older adults with Alzheimer's disease is non-pharmacological interventions like music therapy and structured routines. This is because these interventions have been shown to reduce behavioral symptoms, enhance cognitive function, and promote overall well-being without the potential side effects of pharmacological treatments. Music therapy can help calm and stimulate memory recall, while structured routines provide predictability and familiarity, reducing confusion and agitation. Pharmacological management of behavioral symptoms alone may not address the root causes of the behaviors and can lead to adverse effects. Physical immobilization is harmful and can worsen cognitive decline. Sedatives can have detrimental effects on cognition and may increase the risk of falls and other complications. Therefore, non-pharmacological interventions are the most effective and holistic approach to enhancing the quality of life for older adults with Alzheimer's disease.

Correct Answer: D

Rationale: The correct answer is D because reviewing a menu with the older man allows for personalized food selection, taking into account his preferences and dietary restrictions. This approach promotes adherence to a healthy eating plan, leading to better cholesterol management and overall wellness. Choice A is not the best option as simply instructing him to increase dietary fiber may not address his specific dietary needs. Choice B suggests asking the health care provider for a low-fat diet, which may not consider the individual's food preferences or cultural background. Choice C of scheduling a consultation with a dietitian is a good option, but it may not be as immediately accessible or practical as reviewing a menu together with the individual.

Correct Answer: D

Rationale: The correct answer is D. Ingesting excessive acetaminophen can lead to liver damage, not renal failure. Diabetes mellitus, prostate hypertrophy causing urinary obstruction, and heart failure are known to cause renal failure due to their effects on kidney function. Diabetic nephropathy can damage the kidneys over time, prostate hypertrophy can obstruct urine flow and lead to kidney damage, and heart failure can result in decreased blood flow to the kidneys, causing renal failure. Thus, D is the correct answer as it does not directly cause renal failure, unlike the other choices.

Correct Answer: B

Rationale: The correct answer is B because it directly addresses the older woman's emotional response to the instructions, showing empathy and understanding. By asking how she feels, the nurse can uncover any concerns or fears she may have, leading to effective communication and tailored support. Moving on to medication (A) ignores the woman's distress, potentially worsening the situation. Instructing the interpreter to repeat instructions (C) may not address the underlying issue. Having the woman repeat instructions (D) does not acknowledge her emotional state and may not resolve her tension.

Correct Answer: A

Rationale: The correct answer is A because walking is a physical activity that promotes cardiovascular health, strength, and overall well-being. Regular exercise like walking 3-5 times per week for 30 minutes can help improve circulation, maintain healthy weight, and reduce the risk of chronic diseases. Cooking healthy meals (choice B) is important for nutrition but may not directly promote physical activity. Reading and knitting (choice C) are mentally stimulating but do not provide the physical benefits of exercise. Taking vitamins daily (choice D) is important for overall health but does not substitute for physical activity.