A male elder living in an adult community becomes a widower 1 month after retirement. Two months ...

Answer to #1

C

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A Incorrect. The nurse avoids confronting the elder even if done so in a gentle manner. Why questions can be interpreted as confrontational, and the elder can be unable or unwilling to articulate a reason.
B Incorrect. The nurse avoids asking club members to visit him because it removes the elder from the decision making. Although this effort can be well-meaning, it can be misinterpreted as an invasion of privacy.
C Correct. The nurse meets with the elder to determine how and when to establish new relationships and social activities in light of his wife's death. Even though the elder engaged in fishing beforehand, the nurse respects the elder's wishes and needs as he transitions to a different life.
D Incorrect. The elder is much more likely to participate in an activity in which he has input. In addition, the nurse's action can be misinterpreted as disrespectful because an adult has the right to control his own life.

Answer to #2

A, C, E
Eliminating the conditions that created the problem will decrease the occurrences. The skin should be cleaned with a mild soap or cleansing agent daily, and the skin should be thoroughly dried. Lotion should not be used because it traps moisture. Antifungal medications should be used 7 to 14 days or until the fungal infection is completely cleared.

Answer to #3

A, D, E
Prevention is prioritized for persons who are obese, bedridden, incontinent, or diaphoretic. Pa-tients with multiple sclerosis may develop skin infections but are not at high risk. Patients with an impaired mental status can often be incontinent, but this condition, in itself, does not predispose the patient to fungal infections.

Answer to #4

C

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A Incorrect. This question sounds like a challenge to the client's personal qualities. In addition, the nurse is leading the client to the answer. The client is likely to respond simply, Oh, yes.
B Incorrect. Although this question is meant to elicit the reason for nonadherence, it has an accusatory tone that is likely to make the client defensive.
C Correct. This question is worded to put the client at ease and elicit information in a matter-of-fact way.
D Incorrect. This question can be interpreted as judgmental.

Answer to #5

A, B, D
Skin must be strong enough to withstand forces that can impair its integrity. If skin is not supple, then it is unable to withstand directional forces and will tear. Skin must be sturdy enough to act as an effective protective mechanism. All skin must be able to absorb, cushion, and withstand forces. Skin in a moist environment is subject to bacterial and fungal overgrowth. Skin pigmen-tation is unrelated to its ability to cushion, absorb, and withstand potentially harmful substances and forces.

Answer to #6

B

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A Incorrect. Stimulants such as methyphenidate (Ritalin) should be given in very low doses in cases of chronic depression; to prevent insomnia, extended-release forms should be administered early in the morning and shorter-acting forms at the latest in the early afternoon.
B Correct. Buspirone (BuSpar) is safer for older adults than benzodiazepines for anxiety. Because it can take up to 5 to 7 days for the therapeutic benefit to be felt, it should be used only for chronic anxiety.
C Incorrect. Tricyclic antidepressants such as amitryptaline (Elavil) are contrain-dicated for use with older adults because of the risk for anticholinergic and sed-ative effects. Tricyclic antidepressants have been replaced with selective seroto-nin reuptake inhibitors (SSRIs), which are more effective at lower doses with fewer side effects.
D Incorrect. Antipsychotic agents such as haloperidol (Haldol) can cause extrapy-ramidal effects, especially in older adults. For long-term administration, they should be used only after a thorough psychiatric evaluation.

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