GERONTOLOGY HESI PRACTICE QUESTIONS AND
CORRECT ANSWERS (VERIFIED) ALREADY GRADED A+
NEW UPDATE
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 - ANS... -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.
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 want to over-
season their food.
D. Taste buds often are dull due to atrophy so older clients should use other
seasonings instead of salt. - ANS... -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.
,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 indicating respiratory acidosis - ANS... -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.
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.
D. Reassure the client not to worry because she will meet new friends. - ANS... -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.
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 - ANS... -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.
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 - ANS... -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.
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 client's wife is young enough to get pregnant - ANS... -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.
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 - ANS... -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.
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 liquids 2 hours after meals instead of during meals - ANS... -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.
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 - ANS... -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.
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
CORRECT ANSWERS (VERIFIED) ALREADY GRADED A+
NEW UPDATE
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 - ANS... -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.
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 want to over-
season their food.
D. Taste buds often are dull due to atrophy so older clients should use other
seasonings instead of salt. - ANS... -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.
,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 indicating respiratory acidosis - ANS... -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.
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.
D. Reassure the client not to worry because she will meet new friends. - ANS... -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.
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 - ANS... -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.
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 - ANS... -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.
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 client's wife is young enough to get pregnant - ANS... -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.
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 - ANS... -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.
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 liquids 2 hours after meals instead of during meals - ANS... -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.
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 - ANS... -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.
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
