1. What are the four domains of geriatric nursing competencies according to the Hartford Institute for Geriatric Nursing? Provide an example of each domain in practice. - The four domains are: a) health promotion and wellness, b) complex and chronic care management, c) care coordination and transitions, and d) palliative and end-of-life care. An example of each domain in practice are: a) educating older adults on preventive measures and healthy lifestyles, b) managing multiple comorbidities and medications for older adults, c) facilitating communication and collaboration among different health care providers and settings for older adults, and d) providing comfort and symptom management for older adults with life-limiting illnesses. 2. What are some common geriatric syndromes that affect older adults? List at least five and explain how they impact the quality of life and functional status of older adults. - Some common geriatric syndromes are: a) falls, b) delirium, c) dementia, d) urinary incontinence, and e) pressure ulcers. They impact the quality of life and functional status of older adults by increasing the risk of morbidity, mortality, disability, hospitalization, institutionalization, and caregiver burden. 3. What are some evidence-based assessment tools that can be used to screen older adults for cognitive impairment, depression, pain, malnutrition, and functional decline? Name one tool for each condition and describe how to administer and interpret it. - Some evidence-based assessment tools are: a) the Mini-Mental State Examination (MMSE) for cognitive impairment, which consists of 11 questions that test orientation, memory, attention, language, and visuospatial skills. The maximum score is 30 and a score below 24 indicates cognitive impairment. b) the Geriatric Depression Scale (GDS) for depression, which consists of 15 yes/no questions that assess mood, interest, energy, appetite, sleep, and self-esteem. The maximum score is 15 and a score above 5 indicates depression. c) the Numeric Rating Scale (NRS) for pain, which asks the patient to rate their pain intensity from 0 (no pain) to 10 (worst possible pain). A score above 3 indicates moderate to severe pain. d) the Mini Nutritional Assessment (MNA) for malnutrition, which consists of 18 items that assess anthropometric measurements, dietary intake, lifestyle factors, and subjective health status. The maximum score is 30 and a score below 17 indicates malnutrition. e) the Katz Index of Independence in Activities of Daily Living (ADLs) for functional decline, which consists of six items that assess the ability to perform basic self-care tasks such as bathing, dressing, toileting, transferring, continence, and feeding. The maximum score is 6 and a score below 4 indicates functional dependence. 4. What are some pharmacological principles that should be considered when prescribing medications for older adults? List at least three and explain why they are important. - Some pharmacological principles are: a) start low and go slow, which means starting with the lowest effective dose and titrating slowly to avoid adverse effects and toxicity. This is important because older adults have altered pharmacokinetics (absorption, distribution, metabolism, and excretion) and pharmacodynamics (drug-receptor interactions) that increase their sensitivity to drugs. b) use the Beers Criteria, which is a list of potentially inappropriate medications for older adults that should be avoided or used with caution due to their high risk of adverse effects or reduced efficacy. This is important because older adults often have multiple comorbidities and polypharmacy that increase their vulnerability to drug-