Comprehensive Gero Hesi Review/106 Questions And
Answers Graded (A+)
Quiz :A frail, elderly client is admitted to the unit with a diagnosis of
pneumonia. Which finding is most important for the registered nurse (RN) to
report to the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting - Answer :B. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate
oxygenation and perfusion in this frail elderly client. (A), (C) and (D) are all
common with pneumonia, but the most important finding is confusion and
evidence of dehydration, which require treatment for this frail elderly client.
Quiz :A frail elderly couple asks the registered nurse (RN) if they have to watch
their salt intake because food does not taste as good as it used to so they have
to season most foods. What information should the RN offer the couple?
A. Boredom may influence how the taste of food is perceived, and different
seasonings can stimulate taste.
B. With age, an increase in sodium intake is needed to compensate for a
decrease in renal function.
C. Short-term memory loss and confusion may be the reason they w -
Answer :D. Taste buds are often dull due to atrophy so older clients should use
other seasonings instead of salt.
Rationale: Taste buds atrophy with normal aging, which influences an older
client's sensitivity to taste and is often compensated for the use of stronger
tasting seasonings. (A), (B), and (C) are not normal aging processes related to
taste.
Quiz :After taking a 10-day course of an antibiotic that was ineffective, a frail,
elderly client with chronic obstructive pulmonary disease (COPD) is admitted
for pneumonia. The client has a long history of smoking and still smokes a pack
of cigarettes a day. Which finding should the registered nurse (RN) report to
the healthcare provider?
A. Barrel chest with increased chest diameter
,B. Crackles and pulse oximetry level of 88%
C. Low hemoglobin and hematocrit levels
D. Arterial blood gases indicatin - Answer :B. Crackles and pulse oximetry level
of 88%
Rationale: With pneumonia, crackles in the lungs and low O2 saturation (B) can
impact adequate oxygenation, which should be reported to the HCP. (A) occurs
due to chronic hyperinflation of the lungs and is common in clients with COPD.
Anemia (C) is frequently identified in clients with COPD, and respiratory
acidosis (D) due to CO2 retention contributes to a lower blood pH.
Quiz :An older female client recently moved to an assisted living facility. The
family explains to the registered nurse (RN) that the client is unmanageable
and always confused, disoriented and depressed. The client asks the RN
repeatedly, "Where am I?". How should the RN respond?
A. Explain that she is in a new home called an assisted living community
B. Question the client about her perception of where she might be now.
C. Distract the client with a scenario that she is on an outing with her family. -
Answer :A. Explain that she is in a new home called an assisted living
community.
Rationale: Reality re-orientation (A) is the best response for a client who is
confused because the response is consistent and true. (B, C, and D) do not
provide the client with feedback that is reality based.
Quiz :A new resident in an assisted living facility is an older client who is
experiencing short-term memory loss and confusion. Which activity should the
registered nurse (RN) schedule the client to do during the day?
A. Arts and crafts
B. Current events discussion group
C. Group sing-along
D. Daily exercise group - Answer :D. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the leader and
minimizes the client's stress to remember. (A), (C), and a current events
discussion group (B) are thought-provoking activities that require attention to
detail and short-term memory to participate in the group activity which may
be stressful and frustrating to the resident who has difficulty remembering
sequence of the details.
, Quiz :The hospice nurse is completing a focused assessment of an older
female client with end stage Alzheimer's disease, who recently fractured her
hip. What technique should the registered nurse (RN) use to determine the
client's pain?
A. Use the FACE pain scale
B. Ask the client to rate pain on a scale of 1 to 10
C. Observe for facial grimacing
D. Review documentation of recent eating habits - Answer :C. Observe for
facial grimacing
Rationale: Observing for facial grimacing (C) is the best method for evaluating
pain for a client who cannot communicate due to Alzheimer disease. (A) and
(B) may not be understood by a client with end-stage Alzheimer's disease. (D)
is not a helpful tool for pain assessment.
Quiz :An older male client arrives at the clinic for an annual physical
examination. While the nurse assesses the client, the client states that he is
having intimacy problems with his wife. Which information should the nurse
provide to elicit more information from the client?
A. Query client to clarify the client's idea of an intimacy problem.
B. Discuss benign prostatic hypertrophy (BPH) and ejaculation.
C. Explore the frequency that he experiences erectile dysfunction (ED)
D. Determine if the clie - Answer :A. Query client to clarify the client's idea of
an intimacy problem.
Rationale: Clarification of the client's concern is needed to appropriately
address the specific concern about intimacy issues (A). (B), (C), and (D) are
details that the client should present, not the RN.
Quiz :The registered nurse (RN) is caring for an older female client with a 20
year history of rheumatoid arthritis (RA), who is admitted for carpel tunnel
release. Which finding associated with RA should the RN document?
A. Asymmetrical joint deformity
B. Small joint involvement in fingers
C. Crepitation or grating sensation in joints
D. Weight bearing joint involvement - Answer :B. Small joint involvement in
fingers.
Rationale: Small joint involvement (B) is common in rheumatoid arthritis. (A),
(C) and (D) are findings that different OA from RA.
, Quiz :The registered nurse (RN) is re-enforcing discharge instructions with the
family of an older client who was recently admitted for an intestinal
obstruction. Which statement indicates that the family understands the
instructions?
A. Increase protein and carbohydrates in the daily diet
B. Limit activity to bed rest for the first week and increase mobility
incrementally each week
C. Report abdominal distention, constipation or any other nausea and vomiting
to the healthcare provider
D. Drink liquid - Answer :C. Report abdominal distention, constipation, or any
nausea and vomiting to the healthcare provider.
Rationale: (C) are symptoms that occur with intestinal obstruction and should
be addressed immediately. (A, B, and D) are not indicated for a client who has
been discharged for intestinal obstruction.
Quiz :An older client is transferred to a telemetry unit after placement of a
pacemaker. What action should the registered nurse (RN) take first?
A. View incision site
B. Obtain a blood pressure
C. Establish telemetry monitoring
D. Evaluate client for pain - Answer :C. Establish telemetry monitoring.
Rationale: The first action is to establish continuous telemetry monitoring (C)
to ensure the pacemaker is functioning properly. (A, B and D) should be
implemented after the client's heart rate and rhythm are successfully being
monitored.
Quiz :Older clients are at highest risk for abuse and neglect due to which
factors? (Select all that apply.)
A. Needs are greater than the caretaker's abilities
B. Client's declining strength
C. Fixed income
D. Longer life expectancy
E. Lack of exposure to technology and trends - Answer :A. Needs regretter
than the caretaker's abilities
B. Client's declining strength
Answers Graded (A+)
Quiz :A frail, elderly client is admitted to the unit with a diagnosis of
pneumonia. Which finding is most important for the registered nurse (RN) to
report to the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting - Answer :B. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate
oxygenation and perfusion in this frail elderly client. (A), (C) and (D) are all
common with pneumonia, but the most important finding is confusion and
evidence of dehydration, which require treatment for this frail elderly client.
Quiz :A frail elderly couple asks the registered nurse (RN) if they have to watch
their salt intake because food does not taste as good as it used to so they have
to season most foods. What information should the RN offer the couple?
A. Boredom may influence how the taste of food is perceived, and different
seasonings can stimulate taste.
B. With age, an increase in sodium intake is needed to compensate for a
decrease in renal function.
C. Short-term memory loss and confusion may be the reason they w -
Answer :D. Taste buds are often dull due to atrophy so older clients should use
other seasonings instead of salt.
Rationale: Taste buds atrophy with normal aging, which influences an older
client's sensitivity to taste and is often compensated for the use of stronger
tasting seasonings. (A), (B), and (C) are not normal aging processes related to
taste.
Quiz :After taking a 10-day course of an antibiotic that was ineffective, a frail,
elderly client with chronic obstructive pulmonary disease (COPD) is admitted
for pneumonia. The client has a long history of smoking and still smokes a pack
of cigarettes a day. Which finding should the registered nurse (RN) report to
the healthcare provider?
A. Barrel chest with increased chest diameter
,B. Crackles and pulse oximetry level of 88%
C. Low hemoglobin and hematocrit levels
D. Arterial blood gases indicatin - Answer :B. Crackles and pulse oximetry level
of 88%
Rationale: With pneumonia, crackles in the lungs and low O2 saturation (B) can
impact adequate oxygenation, which should be reported to the HCP. (A) occurs
due to chronic hyperinflation of the lungs and is common in clients with COPD.
Anemia (C) is frequently identified in clients with COPD, and respiratory
acidosis (D) due to CO2 retention contributes to a lower blood pH.
Quiz :An older female client recently moved to an assisted living facility. The
family explains to the registered nurse (RN) that the client is unmanageable
and always confused, disoriented and depressed. The client asks the RN
repeatedly, "Where am I?". How should the RN respond?
A. Explain that she is in a new home called an assisted living community
B. Question the client about her perception of where she might be now.
C. Distract the client with a scenario that she is on an outing with her family. -
Answer :A. Explain that she is in a new home called an assisted living
community.
Rationale: Reality re-orientation (A) is the best response for a client who is
confused because the response is consistent and true. (B, C, and D) do not
provide the client with feedback that is reality based.
Quiz :A new resident in an assisted living facility is an older client who is
experiencing short-term memory loss and confusion. Which activity should the
registered nurse (RN) schedule the client to do during the day?
A. Arts and crafts
B. Current events discussion group
C. Group sing-along
D. Daily exercise group - Answer :D. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the leader and
minimizes the client's stress to remember. (A), (C), and a current events
discussion group (B) are thought-provoking activities that require attention to
detail and short-term memory to participate in the group activity which may
be stressful and frustrating to the resident who has difficulty remembering
sequence of the details.
, Quiz :The hospice nurse is completing a focused assessment of an older
female client with end stage Alzheimer's disease, who recently fractured her
hip. What technique should the registered nurse (RN) use to determine the
client's pain?
A. Use the FACE pain scale
B. Ask the client to rate pain on a scale of 1 to 10
C. Observe for facial grimacing
D. Review documentation of recent eating habits - Answer :C. Observe for
facial grimacing
Rationale: Observing for facial grimacing (C) is the best method for evaluating
pain for a client who cannot communicate due to Alzheimer disease. (A) and
(B) may not be understood by a client with end-stage Alzheimer's disease. (D)
is not a helpful tool for pain assessment.
Quiz :An older male client arrives at the clinic for an annual physical
examination. While the nurse assesses the client, the client states that he is
having intimacy problems with his wife. Which information should the nurse
provide to elicit more information from the client?
A. Query client to clarify the client's idea of an intimacy problem.
B. Discuss benign prostatic hypertrophy (BPH) and ejaculation.
C. Explore the frequency that he experiences erectile dysfunction (ED)
D. Determine if the clie - Answer :A. Query client to clarify the client's idea of
an intimacy problem.
Rationale: Clarification of the client's concern is needed to appropriately
address the specific concern about intimacy issues (A). (B), (C), and (D) are
details that the client should present, not the RN.
Quiz :The registered nurse (RN) is caring for an older female client with a 20
year history of rheumatoid arthritis (RA), who is admitted for carpel tunnel
release. Which finding associated with RA should the RN document?
A. Asymmetrical joint deformity
B. Small joint involvement in fingers
C. Crepitation or grating sensation in joints
D. Weight bearing joint involvement - Answer :B. Small joint involvement in
fingers.
Rationale: Small joint involvement (B) is common in rheumatoid arthritis. (A),
(C) and (D) are findings that different OA from RA.
, Quiz :The registered nurse (RN) is re-enforcing discharge instructions with the
family of an older client who was recently admitted for an intestinal
obstruction. Which statement indicates that the family understands the
instructions?
A. Increase protein and carbohydrates in the daily diet
B. Limit activity to bed rest for the first week and increase mobility
incrementally each week
C. Report abdominal distention, constipation or any other nausea and vomiting
to the healthcare provider
D. Drink liquid - Answer :C. Report abdominal distention, constipation, or any
nausea and vomiting to the healthcare provider.
Rationale: (C) are symptoms that occur with intestinal obstruction and should
be addressed immediately. (A, B, and D) are not indicated for a client who has
been discharged for intestinal obstruction.
Quiz :An older client is transferred to a telemetry unit after placement of a
pacemaker. What action should the registered nurse (RN) take first?
A. View incision site
B. Obtain a blood pressure
C. Establish telemetry monitoring
D. Evaluate client for pain - Answer :C. Establish telemetry monitoring.
Rationale: The first action is to establish continuous telemetry monitoring (C)
to ensure the pacemaker is functioning properly. (A, B and D) should be
implemented after the client's heart rate and rhythm are successfully being
monitored.
Quiz :Older clients are at highest risk for abuse and neglect due to which
factors? (Select all that apply.)
A. Needs are greater than the caretaker's abilities
B. Client's declining strength
C. Fixed income
D. Longer life expectancy
E. Lack of exposure to technology and trends - Answer :A. Needs regretter
than the caretaker's abilities
B. Client's declining strength
