During a routine assessment, a nurse caring for a postoperative patient observes that the patient is increasingly confused and has produced 15 mL of urine over the past hour. Which nursing action best represents the Noticing phase of Tanner’s Clinical Judgment Model?

A nurse administers IV fluids to a patient with suspected fluid volume deficit and notes improvement in blood pressure and urine output. Which nurse action best represents the Reflecting phase of Tanner’s Clinical Judgment Model?

An older adult tells the nurse, “I’m trying to be heart-healthy, so I’ve been cutting out fat from my meals.” Which nurse response best demonstrates accurate nutrition teaching and clinical judgment?

A 79-year-old woman is admitted with new-onset anxiety, restlessness, and insomnia. Her history includes hypertension, atrial fibrillation, and type 2 diabetes. The nurse notes tremors, palpitations, and diaphoresis. What is the most appropriate nursing action?

A hospitalized older adult screened positive for suicidal ideation but denies having a specific plan. Family states they will “watch him closely” at home. What is the priority nursing intervention?

A 84-year-old male, is brought to the clinic by his daughter, who is concerned about his poor appetite, frequent complaints of fullness after small meals, and recent 8-pound weight loss over the last month. He denies nausea, vomiting, or abdominal pain, but says he feels “stuffed” quickly and doesn’t enjoy food like he used to. His bowel habits are unchanged. Vital signs: BP: 128/76 HR: 78 Temp: 97.8°F Weight: 132 lbs (previously 140 lbs two months ago) Physical exam reveals a soft, non-distended abdomen with normal bowel sounds. He takes a proton pump inhibitor (PPI) daily for GERD. The nurse recognizes the need to assess for digestive system changes associated with aging. Which of the following age-related digestive changes is most likely contributing to his symptoms? 

Clinical Scenario:Your patient is a 72-year-old male with ventilator associated pneumonia and sepsis. The provider orders Vancomycin 15 mg/kg IV every 12 hours. The patient weighs 176 pounds. The pharmacy sends up Vancomycin 1000 mg in 250 mL of NS to be infused over 90 minutes via an IV pump. Vancomycin safe dose range: 15–20 mg/kg/dose IV q12 Is the ordered dose within the safe range for this patient? What infusion rate (in mL/hr) will you program into the IV pump?

A patient recovering from an acute diverticulitis episode asks about diet. Which teaching shows best clinical judgment?

A 78‑year‑old woman weighs 70 kg and is recovering from a recent hospitalization. The nurse notes she has decreased muscle mass and low protein intake. According to recommended guidelines for older adults, how much protein should this patient consume per day?

82‑year‑old male: dribbling, hesitancy, weak stream, “still feels full,” PVR 400 mL, ambulates independently.Priority action?