GERONTOLOGY HESI RN PRACTICE EXAM COMPLETE
QUESTIONS AND ACCURATE DETAILED ANSWERS LATEST
UPDATED A+ SCORE SOLUTION REVIEW
Rationale: The highest priority in the care of an older client
with chronic hypertension is evaluation of the effectiveness of
blood pressure medication (A) and the client's compliance in
order to prevent complications related to chronic disease. (B,
C and D) are issues common in the older population, but the
effectiveness of the blood pressure management is most
important.
An older male client with heart failure (HF) complains of
chronic constipation and wants to retrain his bowel. Which
information should the registered nurse (RN) offer the client
for establishing regular bowel habits?
A. Add whole grain foods and fibrous vegetables to diet
B. Drink water and fluids up to 3,000 ml daily
C. Use a stool softener or glycerin suppository PRN
D. Plan daily exercise based on fatigue level
(A) Add whole grain foods and fibrous vegetables to diet.
Rationale: Increasing daily fiber (A) with increasing fluid intake
are the best tools to use when retraining bowel habits. (B) may
cause fluid overload for this older client and potentially
exacerbate HF. (C) should not be advised without the
healthcare provider's recommendation. The client's fatigue
Page 1 of 35
,level may curtail how much daily exercise (D) the client can
tolerate.
The registered nurse (RN) is observing the skin of an older
client. Which finding should the RN document as consistent
with the normal aging process?
A. Decreased elasticity
B. Tough and leathery texture
C. Shiny and edematous
D. Excessive hair growth on the head
(A) Decreased elasticity
Rationale: Loss of elasticity is a common finding of the normal
aging process (A). The skin of elderly clients becomes thin and
fragile with aging, not (B). When a client has peripheral edema,
the skin can be shiny and edematous (C), which is not
consistent with normal aging changes. Hair thinning and hair
loss are common, not excessive hair growth (D).
The home health registered nurse (RN) visits an older female
client with an ideal conduit who has been experiencing chronic
urinary tract infections (UTI). Which intervention should the RN
recommend to the client to manage the frequency of utis?
A. Force fluid intake to 1,000 ml daily
B. Change appliance every 4 hours
C. Attach a larger drainage bag while sleeping
Page 2 of 35
,D. Allow bag to fill completely before emptying
(C) Attach a larger drainage bag while sleeping
Rationale: (C) can prevent urinary reflux if the bag fills to near
capacity or greater, which can contribute to utis. Forcing fluids
is encouraged and should exceed urinary output, which
commonly should be greater than 1,000 ml (A). (B) can
increase skin irritation and increase risk for infection by
exposing the portal of entry frequently. Allowing the bag to fill
completely before emptying (D) increases risk of urinary
reflux and utis.
The healthcare provider prescribes a new medication,
atorvastatin (Lipitor), for an older client who arrives at the
clinic for an annual physical examination. What common side
effect should the registered nurse (RN) advise the client to
observe with this medication?
A. Constipation
B. Headaches
C. Muscle weakness
D. Nausea and vomiting
(B) Headaches
Rationale: Headaches (B) are the most common side effect
with this medication, which the RN should direct the client to
report. (A and C) are rare occurrences with this medication.
(D) is not considered a side effect of this medication.
Page 3 of 35
, After a transurethral resection of the prostate (TURP), an older
man returns to the medical surgical floor with a 3-way
indwelling urinary catheter. The registered nurse (RN)
observes the catheter's tubing for drainage when the client
states that he needs to void. What should the RN implement
based on this finding?
A. Irrigate the bladder through the catheter port
B. Remove the indwelling catheter
C. Explain that urgency is expected
D. Notify the healthcare provider of the symptom
(A) Irrigate the bladder through the catheter port
Rationale: The feeling of urgency can be caused by blood clots
that can occlude drainage of the catheter, which is a common
occurrence in the first 72 hours after a TURP. The urgency is
an indication that the client's bladder is not emptying, and the
RN should irrigate catheter (A) to relieve symptoms caused by
a clot. (B) and (C) should not be implemented. (D) should be
implemented after determining if the irrigation was effective in
relieving the client's complaint.
An older client with chronic kidney disease (CKD) has an
arteriovenous fistula (AV) in the left forearm for for
hemodialysis. After palpating the AV fistula, which finding is an
indication that the AV fistula is functioning properly?
A. Enlarged veins
B. Redness around the site
Page 4 of 35
QUESTIONS AND ACCURATE DETAILED ANSWERS LATEST
UPDATED A+ SCORE SOLUTION REVIEW
Rationale: The highest priority in the care of an older client
with chronic hypertension is evaluation of the effectiveness of
blood pressure medication (A) and the client's compliance in
order to prevent complications related to chronic disease. (B,
C and D) are issues common in the older population, but the
effectiveness of the blood pressure management is most
important.
An older male client with heart failure (HF) complains of
chronic constipation and wants to retrain his bowel. Which
information should the registered nurse (RN) offer the client
for establishing regular bowel habits?
A. Add whole grain foods and fibrous vegetables to diet
B. Drink water and fluids up to 3,000 ml daily
C. Use a stool softener or glycerin suppository PRN
D. Plan daily exercise based on fatigue level
(A) Add whole grain foods and fibrous vegetables to diet.
Rationale: Increasing daily fiber (A) with increasing fluid intake
are the best tools to use when retraining bowel habits. (B) may
cause fluid overload for this older client and potentially
exacerbate HF. (C) should not be advised without the
healthcare provider's recommendation. The client's fatigue
Page 1 of 35
,level may curtail how much daily exercise (D) the client can
tolerate.
The registered nurse (RN) is observing the skin of an older
client. Which finding should the RN document as consistent
with the normal aging process?
A. Decreased elasticity
B. Tough and leathery texture
C. Shiny and edematous
D. Excessive hair growth on the head
(A) Decreased elasticity
Rationale: Loss of elasticity is a common finding of the normal
aging process (A). The skin of elderly clients becomes thin and
fragile with aging, not (B). When a client has peripheral edema,
the skin can be shiny and edematous (C), which is not
consistent with normal aging changes. Hair thinning and hair
loss are common, not excessive hair growth (D).
The home health registered nurse (RN) visits an older female
client with an ideal conduit who has been experiencing chronic
urinary tract infections (UTI). Which intervention should the RN
recommend to the client to manage the frequency of utis?
A. Force fluid intake to 1,000 ml daily
B. Change appliance every 4 hours
C. Attach a larger drainage bag while sleeping
Page 2 of 35
,D. Allow bag to fill completely before emptying
(C) Attach a larger drainage bag while sleeping
Rationale: (C) can prevent urinary reflux if the bag fills to near
capacity or greater, which can contribute to utis. Forcing fluids
is encouraged and should exceed urinary output, which
commonly should be greater than 1,000 ml (A). (B) can
increase skin irritation and increase risk for infection by
exposing the portal of entry frequently. Allowing the bag to fill
completely before emptying (D) increases risk of urinary
reflux and utis.
The healthcare provider prescribes a new medication,
atorvastatin (Lipitor), for an older client who arrives at the
clinic for an annual physical examination. What common side
effect should the registered nurse (RN) advise the client to
observe with this medication?
A. Constipation
B. Headaches
C. Muscle weakness
D. Nausea and vomiting
(B) Headaches
Rationale: Headaches (B) are the most common side effect
with this medication, which the RN should direct the client to
report. (A and C) are rare occurrences with this medication.
(D) is not considered a side effect of this medication.
Page 3 of 35
, After a transurethral resection of the prostate (TURP), an older
man returns to the medical surgical floor with a 3-way
indwelling urinary catheter. The registered nurse (RN)
observes the catheter's tubing for drainage when the client
states that he needs to void. What should the RN implement
based on this finding?
A. Irrigate the bladder through the catheter port
B. Remove the indwelling catheter
C. Explain that urgency is expected
D. Notify the healthcare provider of the symptom
(A) Irrigate the bladder through the catheter port
Rationale: The feeling of urgency can be caused by blood clots
that can occlude drainage of the catheter, which is a common
occurrence in the first 72 hours after a TURP. The urgency is
an indication that the client's bladder is not emptying, and the
RN should irrigate catheter (A) to relieve symptoms caused by
a clot. (B) and (C) should not be implemented. (D) should be
implemented after determining if the irrigation was effective in
relieving the client's complaint.
An older client with chronic kidney disease (CKD) has an
arteriovenous fistula (AV) in the left forearm for for
hemodialysis. After palpating the AV fistula, which finding is an
indication that the AV fistula is functioning properly?
A. Enlarged veins
B. Redness around the site
Page 4 of 35
