1. A 75-year-old woman with a history of hypertension, diabetes and osteoarthritis visits the

primary care clinic for a routine check-up. She reports feeling tired, depressed and lonely

since her husband passed away six months ago. She lives alone and has limited social

support. What is the most appropriate nursing intervention for this patient?

a) Refer her to a psychiatrist for antidepressant medication.

b) Encourage her to join a bereavement support group or a senior center.

c) Advise her to exercise regularly and eat a balanced diet.

d) Assess her for signs of cognitive impairment or dementia.

*Answer: b) Encourage her to join a bereavement support group or a senior center.*

Rationale: Older adults who experience loss of a spouse are at risk of social isolation,

depression and poor quality of life. Nursing interventions should focus on promoting their

psychosocial well-being and enhancing their coping skills. Referring the patient to a support

group or a senior center can help her connect with others who share similar experiences and

provide emotional and practical support. While exercise, nutrition and cognitive assessment

are also important aspects of care, they are not the priority in this case.

2. A 68-year-old man with a history of chronic obstructive pulmonary disease (COPD) and

smoking presents to the primary care clinic with worsening dyspnea, cough and sputum

production. He has been using his rescue inhaler more frequently and has difficulty

performing his daily activities. His oxygen saturation is 88% on room air. What is the most

appropriate nursing intervention for this patient?

a) Administer supplemental oxygen via nasal cannula.

b) Teach him how to use a peak flow meter to monitor his lung function.

c) Educate him on the benefits of smoking cessation and refer him to a smoking cessation

program.

d) Perform chest physiotherapy and suctioning to clear his airway secretions.

*Answer: a) Administer supplemental oxygen via nasal cannula.*

Rationale: Older adults with COPD are at risk of hypoxemia, which can lead to

complications such as pulmonary hypertension, cor pulmonale and respiratory failure.

Nursing interventions should focus on improving their oxygenation and preventing further

deterioration. Administering supplemental oxygen is the first-line treatment for hypoxemic

patients with COPD, as it can reduce dyspnea, improve exercise tolerance and prevent organ

damage. While teaching, education and chest physiotherapy are also important aspects of

care, they are not the priority in this case.

3. A 72-year-old woman with a history of osteoporosis and falls visits the primary care clinic

for a follow-up after sustaining a hip fracture. She underwent surgical repair of the fracture

and completed a course of physical therapy. She reports pain in her hip, difficulty walking

and fear of falling again. She lives alone and has no family nearby. What is the most

appropriate nursing intervention for this patient?

a) Prescribe her analgesics for pain relief and advise her to rest.

b) Refer her to an occupational therapist for home safety evaluation and modification.

c) Recommend her to take calcium and vitamin D supplements to prevent further bone loss.