Which of the following issues in the care of older adults are identified in Healthy People 2020?

Correct Answer: C

Rationale: Step 1: Healthy People 2020 focuses on improving the health and well-being of all individuals, including older adults. Step 2: Identifying minimum levels of training for people who care for older adults is crucial to ensure quality care. Step 3: This issue aligns with the goal of promoting quality of care and safety for older adults. Step 4: Other choices are not directly addressed in Healthy People 2020 goals. Summary: Choice C is correct as it directly relates to improving the care of older adults, while the other choices focus on specific issues not highlighted in Healthy People 2020.

Correct Answer: A

Rationale: Step 1: Gerontological nursing certification focuses on advanced knowledge and skills for caring for older adults. Step 2: This certification is not a requirement for all nurses in long-term care or limited to rehabilitation centers. Step 3: Nurses with various levels of education, not just a master's degree, can obtain gerontological certification. Therefore, option A is correct as it accurately states that gerontological nursing certification signifies advanced knowledge and skills specific to older adult care. Options B, C, and D are incorrect as they provide inaccurate information about the certification requirements and scope.

Correct Answer: B

Rationale: The correct answer is B: Benzodiazepines. Benzodiazepines are central nervous system depressants that can cause drowsiness, dizziness, and confusion, increasing the risk of falls in older adults. They can also impair balance and coordination. Older adults are more sensitive to these effects due to age-related changes in metabolism and increased risk of cognitive impairment. Beta-blockers (A), statins (C), and antihypertensives (D) are generally safe in older adults and do not directly increase the risk of falls. Beta-blockers can sometimes cause dizziness but are more commonly associated with bradycardia. Statins are used to lower cholesterol levels and do not affect fall risk. Antihypertensives help lower blood pressure and can actually reduce the risk of falls by preventing conditions like orthostatic hypotension.

Correct Answer: B

Rationale: The correct answer is B: dehydration. Mr. J's symptoms of flu-like illness, diarrhea, vomiting, confusion, lethargy, dry skin, brown tongue, sunken cheeks, and concentrated urine are indicative of severe dehydration. Dehydration can lead to electrolyte imbalances, decreased blood volume, and impaired organ function, resulting in confusion and lethargy. Skin changes, dry mucous membranes, and concentrated urine are also classic signs of dehydration. The other choices (A, C, D) do not align with the constellation of symptoms presented by Mr. J and are less likely based on the information provided.

Correct Answer: C, D, E

Rationale: The correct answers are C, D, and E. C is crucial as it allows for effective communication, D involves observing nonverbal cues, and E emphasizes the need for clear and concise language. A is incorrect as the nurse should address the client directly, not just the interpreter. B is incorrect as using technical terms may hinder understanding.

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 because demographic data shows an increasing aging population, leading to a higher demand for healthcare services for individuals over 85. This trend indicates a greater need for nursing services to cater to the specific health care needs of this age group. Option A is incorrect as the aging population will require more care. Option C is also incorrect as fewer nurses will not be sufficient to meet the increasing demand. Option D is irrelevant to the predictive trend of healthcare needs based on demographics.

Correct Answer: C

Rationale: The correct answer is C because regular repositioning and the use of pressure-relieving devices are essential to prevent skin breakdown in immobile older adults. Repositioning helps redistribute pressure, maintaining blood flow to the skin and preventing tissue damage. Pressure-relieving devices such as cushions or special mattresses further reduce pressure on vulnerable areas. Choices A and B do not address the root cause of skin breakdown and may even exacerbate the issue. Choice D is incorrect as complete bed rest can lead to further complications like pressure ulcers. In summary, choice C is the most effective intervention as it directly targets the risk factors for skin breakdown in immobile older adults.

Correct Answer: C

Rationale: The correct answer is C because a room with hardwood floor and large windows overlooking a garden area offers a safe, non-slip surface for exercise and natural light for a pleasant environment. Hardwood floors are ideal for exercise to prevent slipping, and the large windows provide a view of the garden area, which can enhance motivation and mood. The other choices are incorrect because A has throw rugs, which can cause tripping hazards, B lacks natural light and ventilation, and D has a linoleum floor which may not be as safe for exercise compared to hardwood.