HESI GERONTOLOGY TEST 540
COMPREHENSIVE EXAM SCRIPT 2026 SOLVED
QUESTIONS FULL SOLUTION
◉ A patient you diagnosed with hypothyroidism was started on
levothyroixine. At what interval should the GNP reassess her TSH?
1 to 2 weeks
2 to 4 weeks
4 to 6 weeks
6 to 8 weeks. Answer: 6 to 8 weeks
In the treatment of hypothyroidism, T4 replacement is needed in the
form of levothyroixine (Synthroid or Levoxyl). The initial dosages for
an adult is 75 to 125 mcg. For an elderly person, the dose is 75% less
than the adult dosage. Because of the long half-life of levothyroxine,
the effects of a dosage adjustment or initiation would not cause a
change in TSH for approximately five to six drug half-lives, or about
6 to 8 weeks.
◉ A 67-year-old diabetic has been taking oral anti-hypoglycemics
and is still having poor glycemic control. You make the decision to
,start insulin therapy. He weighs 60 kg. What should you order as an
initial starting dose?
6 units short-acting insulin at breakfast, continue oral medication
6 units intermediate insulin at bedtime, stop oral medication
6 units long-acting before breakfast, stop oral medication
6 units long-acting insulin at bedtime, continue oral medication.
Answer: 6 units long-acting insulin at bedtime, continue oral
medication
The American Diabetic Association algorithm for initiation and
adjustment of therapy (2006) suggests an intermediate or long-
acting insulin to be started at bedtime or morning as a once daily
dose. The starting dose is either 10 units or 0.2 units per kilogram.
Oral medication should be continued except for discontinuing
sulfonylureas or meglitinides.
◉ A 65 year patient has sub-occipital and posterior cranial head
pain following a fall. The GNP conducts a musculoskeletal
assessment by:
Palpating the acromioclavicular joint.
Assessing the gleno-humeral range of motion.
Palpating the cervical vertebrae.
,Palpating anterior the thoracic muscles.. Answer: Palpating the
cervical vertebrae.
The patient who is complaining of sub-occipital, posterior head pain
should have the cervical vertebrae assessed. Additionally, the GNP
will palpate the posterior neck muscles and assess the neck for
range of motion.
◉ A 67-year-old female is in the office with cataracts. She is asking
what she needs to do about this. The GNP understands that all of the
following are management for this except:
Surgery may be necessary if the cataract markedly decreases visual
acuity.
No drugs are available that will halt the progression of the aging
process of the eye.
Vision correction with corrective lenses are available if the cataracts
are in the early stages.
Ophthalmic steroids that decrease the severity are available by
prescription from an ophthalmologist.. Answer: Ophthalmic steroids
that decrease the severity are available by prescription from an
ophthalmologist.
No topical or oral medications exists that will cure or treat this
condition. However, there are surgical options.
, ◉ You are providing patient education to a patient who has recently
been diagnosed with shingles. Which of the following is NOT true of
the way this patient should care for his rash?
He should leave the rash uncovered to speed healing.
He should keep the rash covered.
He should keep the rash clean and dry.
He should use only nonadhesive bandages on the rash.. Answer: He
should leave the rash uncovered to speed healing.
Patients with herpes zoster - shingles - should keep their rashes
clean, dry, and covered. The adhesive in bandages can irritate the
shingles, so only nonadhesive bandages should be used.
◉ You are providing care for a patient who has been admitted to the
hospital after a fall. Which of the following is NOT appropriate when
providing patient education for when the patient returns home?
The patient should resume regular activities as soon as possible.
The patient should avoid returning to full activity until he is fully
recovered.
The patient should take extra care of his feet.
COMPREHENSIVE EXAM SCRIPT 2026 SOLVED
QUESTIONS FULL SOLUTION
◉ A patient you diagnosed with hypothyroidism was started on
levothyroixine. At what interval should the GNP reassess her TSH?
1 to 2 weeks
2 to 4 weeks
4 to 6 weeks
6 to 8 weeks. Answer: 6 to 8 weeks
In the treatment of hypothyroidism, T4 replacement is needed in the
form of levothyroixine (Synthroid or Levoxyl). The initial dosages for
an adult is 75 to 125 mcg. For an elderly person, the dose is 75% less
than the adult dosage. Because of the long half-life of levothyroxine,
the effects of a dosage adjustment or initiation would not cause a
change in TSH for approximately five to six drug half-lives, or about
6 to 8 weeks.
◉ A 67-year-old diabetic has been taking oral anti-hypoglycemics
and is still having poor glycemic control. You make the decision to
,start insulin therapy. He weighs 60 kg. What should you order as an
initial starting dose?
6 units short-acting insulin at breakfast, continue oral medication
6 units intermediate insulin at bedtime, stop oral medication
6 units long-acting before breakfast, stop oral medication
6 units long-acting insulin at bedtime, continue oral medication.
Answer: 6 units long-acting insulin at bedtime, continue oral
medication
The American Diabetic Association algorithm for initiation and
adjustment of therapy (2006) suggests an intermediate or long-
acting insulin to be started at bedtime or morning as a once daily
dose. The starting dose is either 10 units or 0.2 units per kilogram.
Oral medication should be continued except for discontinuing
sulfonylureas or meglitinides.
◉ A 65 year patient has sub-occipital and posterior cranial head
pain following a fall. The GNP conducts a musculoskeletal
assessment by:
Palpating the acromioclavicular joint.
Assessing the gleno-humeral range of motion.
Palpating the cervical vertebrae.
,Palpating anterior the thoracic muscles.. Answer: Palpating the
cervical vertebrae.
The patient who is complaining of sub-occipital, posterior head pain
should have the cervical vertebrae assessed. Additionally, the GNP
will palpate the posterior neck muscles and assess the neck for
range of motion.
◉ A 67-year-old female is in the office with cataracts. She is asking
what she needs to do about this. The GNP understands that all of the
following are management for this except:
Surgery may be necessary if the cataract markedly decreases visual
acuity.
No drugs are available that will halt the progression of the aging
process of the eye.
Vision correction with corrective lenses are available if the cataracts
are in the early stages.
Ophthalmic steroids that decrease the severity are available by
prescription from an ophthalmologist.. Answer: Ophthalmic steroids
that decrease the severity are available by prescription from an
ophthalmologist.
No topical or oral medications exists that will cure or treat this
condition. However, there are surgical options.
, ◉ You are providing patient education to a patient who has recently
been diagnosed with shingles. Which of the following is NOT true of
the way this patient should care for his rash?
He should leave the rash uncovered to speed healing.
He should keep the rash covered.
He should keep the rash clean and dry.
He should use only nonadhesive bandages on the rash.. Answer: He
should leave the rash uncovered to speed healing.
Patients with herpes zoster - shingles - should keep their rashes
clean, dry, and covered. The adhesive in bandages can irritate the
shingles, so only nonadhesive bandages should be used.
◉ You are providing care for a patient who has been admitted to the
hospital after a fall. Which of the following is NOT appropriate when
providing patient education for when the patient returns home?
The patient should resume regular activities as soon as possible.
The patient should avoid returning to full activity until he is fully
recovered.
The patient should take extra care of his feet.
