Answer to Question 1
C
Under no circumstances should the temperature drop below 65 F because older adults are at risk for hypothermia. Furthermore, frail older adults need the temperature to be considerably higher. The issue is not one of fairness but a more fundamental issue of patient safety. Some of the resi-dents wearing blankets may represent individual temperature preferences. The purpose is to make the point that the patients are vulnerable to low temperatures, not to make veiled accusations against the administrators.
Answer to Question 2
C
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A Incorrect. The pathogen is already identified; however, some value can be ob-tained from subsequent stool cultures to determine if the infection is eradicated.
B Incorrect. Serum potassium is a reasonable parameter to check in an older adult; however, if used as a measure of renal function, the creatinine clearance is a better choice.
C Correct. Antibiotics as a group of drugs are hard on the kidneys; thus the nurse should check the creatinine clearance of this individual. Although about 30 of absorbed vancomycin is protein bound, it is cleared by the kidneys, and creati-nine clearance is the best index of renal function available. Because approx-imately 70 of vancomycin circulates in the blood stream in the active form, when the older adult has renal dysfunction, the dosage must be reduced or the dosing intervals increased to maintain the desired drug level and prevent toxici-ty.
D Incorrect. Alkaline phosphatase is a measure of hepatic function. It is a reasona-ble parameter to check when administering medications because hepatic clear-ance is important in the metabolism of many medications.