Mrs. Ford, a 78-year-old retired teacher, presents with increasing restlessness, muscle tension, insomnia, and persistent worry following her husband's recent cancer diagnosis. She lives alone and reports that her thoughts "won't shut off at night." Her history includes hypertension, osteoporosis, and mild cognitive impairment (MCI). Medications include lisinopril and calcium/vitamin D. A primary care provider diagnoses late-onset generalized anxiety disorder (GAD). As the nurse collaborates on her care plan, which intervention is most appropriate based on safety, effectiveness, and age-related considerations?

A nurse is reviewing recent assessments for four older adult clients in a primary care clinic. Based on the data provided, for which client would administering the Alcohol Use Disorders Identification Test (AUDIT) be the most clinically appropriate and evidence-based next step?

A 72-year-old man visits the eye clinic reporting that things look distorted in the center of his vision, straight lines appear wavy. colors seem dull, and he has difficulty recognizing faces. These symptoms have developed gradually over several months. He denies any trauma or previous eye surgery. Based on these symptoms, which nursing action is most appropriate?

A 50-year-old woman presents to the clinic with a persistent cough and sputum production for the past three months. She reports a history of smoking for 15 years. On examination, there are coarse crackles heard on auscultation, particularly in the lower lung fields. The patient denies any history of wheezing or shortness of breath.

Sarah, a 55-year-old woman, visits her primary care clinic for a routine check-up. She has a past medical history of hypertension. During the visit, her blood pressure is measured, and the nurse notes it as 200/79 mmHg. Sarah reports occasional headaches but denies any chest pain, shortness of breath, or dizziness. She mentions that she has been under stress lately due to work and family responsibilities. Based on her blood pressure readings and symptoms, the nurse suspects that Sarah's hypertension may be progressing. Which stage of hypertension is Sarah likely experiencing based on her blood pressure reading and symptoms, and what is the most important action for the nurse to take?

David, a 69-year-old man, visits his primary care clinic for a routine check- up. He has no significant medical history. During the visit, his blood pressure is measured, and the nurse notes it as 140/88 mmHg. David denies any symptoms such as headaches, chest pain, shortness of breath, or dizziness. Based on his blood pressure reading and absence of symptoms, what is the most appropriate action for the nurse to take regarding David's hypertension status?

Mr. Alvarez, a 78-year-old man with a history of hypertension, is being discharged from the hospital after experiencing a hypertensive crisis. He has been prescribed lisinopril 10 mg daily and is receiving stroke prevention education from the nurse. The nurse reviews lifestyle changes, blood pressure monitoring, and medication safety. Which of the following statements made by Mr. Alvarez requires follow-up education?

A 55-year-old male presents to the emergency department with complaints of fever, productive cough with yellowish-green sputum, chest pain, and shortness of breath for the past three days. He reports a history of smoking for 30 years. On examination, his temperature is 39°C (102.2°F), respiratory rate is 28 breaths per minute, blood pressure is 140/90 mmHg, and oxygen saturation is 92% on room air. Auscultation reveals crackles in the right lower lung field. Laboratory tests show elevated white blood cell count.

Mrs. Nguyen, a 79-year-old woman, presents to the clinic accompanied by her daughter, who reports that her mother is "not herself lately." Over the past several weeks, Mrs. Nguyen has stopped attending her church group, has expressed feelings of hopelessness, and has unintentionally lost 8 pounds. She denies sadness but admits to feeling "tired all the time." Her past medical history includes hypertension and osteoarthritis. Which nursing action is most appropriate based on this presentation?

During a wound assessment of an older adult in a skilled nursing facility, the nurse notes that a skin tear on the forearm shows no remaining skin flap to approximate over the wound bed. The wound bed is fully exposed with complete tissue loss. Which action best reflects appropriate clinical judgment regarding classification and documentation of this wound?

A 65-year-old patient, Mrs. Smith, presents to the emergency department with complaints of severe pain in her lower back. She reports that the pain started suddenly while she was lifting a heavy box at home. Mrs. Smith describes the pain as sharp and stabbing, radiating down her left leg. She rates the pain as 8 out of 10 on the pain scale. Upon further assessment, Mrs. Smith reports a history of intermittent lower back pain for the past few years, which usually resolves with rest and over-the- counter pain medications. Based on Mrs. Smith's presentation, which of the following findings would support a diagnosis of acute pain rather than chronic pain?

The nurse is assessing four hospitalized older adults on a medical- surgical unit. Each client has distinct factors that could contribute to acute cognitive changes.

Which case is more suspicious for malignant melanoma, and which case should the nurse prioritize for further assessment?

What is the primary treatment for hydrocephalus?

A nurse is caring for an 86-year-old client with moderate Alzheimer's disease who has become increasingly agitated and verbally aggressive in the evenings. The provider considers initiating an antipsychotic medication.

Mrs. Thompson, an 82-year-old woman, resides in a long-term care facility due to advanced dementia. She has a history of osteoarthritis and frequently experiences pain in her joints. Mrs. Thompson has limited verbal communication abilities and often relies on non-verbal cues to express discomfort. When using the PAINAID scale to assess Mrs. Thompson's pain level, which of the following non-verbal cues should the nurse primarily focus on?

While providing discharge education to an older adult recently diagnosed with shingles, the nurse compares the condition to chickenpox for clarification. Which statement by the nurse best explains the clinical difference in presentation between chickenpox and shingles?

Mr. Anderson, a 76-year-old widower, presents for a follow-up visit 8 months after his wife's death. He lives alone, appears disheveled, and has unintentionally lost 10 pounds. He reports poor sleep and increasing reliance on wine to "take the edge off." His daughter reports he is more forgetful and has had two recent falls. He admits to drinking 3-4 glasses of wine per night, often more, and says it helps him feel less alone. The nurse administers the Alcohol Use Disorders Identification Test (AUDIT) and records a score of 18, with positive responses for: •Drinking 4+ times/week Consuming 3-4 drinks/day • Inability to stop drinking once started • Guilt/remorse after drinking • Alcohol-related injury Which nursing action is most appropriate in response to these findings?

Mr. Jenkins is a 79-year-old man seen for a routine primary care visit. His medical history includes hypertension, type 2 diabetes mellitus, hyperlipidemia, and a 30-pack-year smoking history (quit 5 years ago). He reports missing doses of lisinopril, atorvastatin, and metformin and admits to a sedentary lifestyle and high-sodium diet. His father died of a stroke at age 67. The nurse is developing an individualized education plan focused on stroke prevention.

A 79-year-old woman is admitted for pneumonia. On day 3 of hospitalization, she becomes disoriented to place, demonstrates fluctuating levels of alertness, and shows difficulty sustaining attention. Her daughter states that although her mother has mild memory problems at home, she has never experienced this type of confusion. The nurse suspects delirium, but notes the presence of pre-existing mild Cognitive impairment. Which screening tool should the nurse prioritize to most accurately identify acute delirium in this client?

Which of the following are recommended lifestyle modifications for managing hypertension (HTN)? (Select All that Apply.)

COPD, or Chronic Obstructive Pulmonary Disease, is best defined as:

During a routine skin examination in the dermatology clinic, Sarah, a seasoned nurse, encounters Mr. Rodriguez, a 55-year-old man with a history of excessive sun exposure. Mr. Rodriguez presents with a suspicious skin lesion on his back, which he noticed has changed in size and appearance over the past few months. Concerned about the possibility of skin cancer, Sarah decides to use the ABCDE rule to assess the lesion. Sarah, a gerontological nurse, is evaluating a newly identified skin lesion on Mr. Rodriguez, an 82-year-old man. Using the ABCDE rule, which finding should Sarah recognize as the strongest indicator of potential melanoma in this population?