HESI PN GERONTOLOGY EXAM 2020

1. The clinic nurse receives a telephone call from the daughter of an older female client. The daughter reports that her mother has a cough and has become confused and short of breath, but only has a temperature of 99.4F. What action should the nurse take? a. Reassure the daughter that these are common signs of upper respiratory tract congestion. b. Advise the daughter to monitor her mother’s temperature and call if it continues to rise higher. c. Tell the daughter to keep her mother well hydrated and encourage rest for the next 48 hours. d. Explain to the daughter that she needs to bring her mother for immediate medical evaluation. 2. The unlicensed assistive personal (UAP) reports to the charge nurse that an older resident of the extended care facility, who has limited mobility, has not had a bowel movement in 5 days. Which action should the nurse take first? a. Check bowel sounds and abdominal tenderness b. Increase fiber and diet and add daily prune juice c. Perform a digital examination for a fecal impaction 3. An older male client is admitted with hypothermia with a core body temperature of 95F (35C) due to the lack of adequate heat in his home. Which findings should the nurse expect to obtain? (select all that apply) a. Hyperalert state b. Headache c. Cool skin d. Shivering e. Confusion 4. An older adult woman, who cares for her husband at home without assistance, requires minor surgery. With no family members living in the area, the wife expresses concern about her husband’s care while she recovers. Which intervention is likely to be most helpful in this situation? a. Suggest she ask social services to find a respite care facility for the husband 5. During report, an older female client, who had a right total hip replacement three days ago, is described as intolerant of pain. When assessing the client, the nurse finds that the client cannot straighten her right foot, which is pointing outward from her body. Which action should the nurse take? Call healthcare provider immediately 6. An older female sustained a right hip fracture one week ago that was surgically repaired the following day. Today she is reporting left sided leg pain, and the nurse observes edema of the left leg and a positive Homan sign. These findings should be reported to the health care provider because they are indicative of which condition? DVT 7. To help prevent drug interactions, which instruction should the nurse provide an older client who is taking many medications? A. Do not take any over the counter drugs while taking medications prescribed by a healthcare provider (could be this one?) B. Use a medication reminder system to prevent forgetting to take the right medications at the right time (could be this one?) C. Be sure a family member knows the name and use of all medications currently being taken D. Bring all medication supplement and herbs currently being taken to the next clinic appointment (could be this one?) 8. The daughter of a frail, elderly woman brings her mother to the clinic for an annual physical. Which concerns shared by the daughter should the nurse address first? a. The mother is having increasing periods of forgetfulness and mood swings. b. The daughter reports her mother’s bowel movements are hard and infrequent. c. The client lost 10 lbs last month and shows no interest in her personal hygiene. d. The family members are overwhelmed with the responsibility of caring for her mother. 9. When conducting assessments at an assisted living community, the nurse finds that an older adult client who is normally alert, oriented, and continent, is confused and incontinent of urine. Which intervention is MOST important for the nurse to implement? a. Place a protective undergarment on the client b. Obtain a clean, voided urine sample using a urinal hat c. Encourage increased fluid intake for 24 hours d. Evaluate the client’s response to bladder training efforts 10. An older female adult who lives in a nursing home is loudly demanding that the nurse call her son who has been deceased for five years. Which intervention should the nurse implement? Direct the client to a new activity 11. An older adult is admitted to an acute medical unit from a long-term care facility. When reviewing the client’s prescribed medications, which intervention should the nurse implement first? A. Determine which medications may be given in generic form rather than brand name only. B. Provide client teaching regarding the desired effects of the client’s admission prescriptions C. Reconcile prescribed medication dosages with the published recommended dosage ranges. D. Compare admission prescriptions with the list of medications previously taken by the client. 12. The nurse observes that an older client is becoming increasingly confused and measures the client’s oxygen saturation at 80%. Which assessment should the nurse perform next? Note the presence of any nail bed cyanosis. 13. Which action should the nurse implement while providing discharge instructions to the older client? Turn on overhead lights while giving instructions 14. The nurse is visiting an older client who is homebound. Which finding about the client’s nutritional status requires additional follow-up? Ate approximately 1200 calories daily for the past 2 weeks. 15. An elderly client with degenerative joint disease asks about using the rubber jar openers that are available. The nurse’s response should be on which information about assistive devices? They decrease the risk for joint trauma. 16. The nurse is caring for an older client who is admitted due to a change in mental status after 2 days of nausea and vomiting. The client’s home medications include subcutaneous insulin, a daily antihypertensive, and a daily diuretic. Which intervention should the nurse implement first? Obtain capillary glucose level 17. An older female who is complaining of pain in her arm and back is brought to the emergency department by her son who states she fell out of her chair. The nurse notes that the client has been in the ED five times in the last for a variety of superficial injuries. Which nursing action has the highest priority? Take mom to private room and ask if someone is hurting her 18. A nurse is caring for an older Vietnamese client who has terminal lung cancer. The family members want to stay in the room, perform cultural rituals, and serve ethnic foods until the client dies. What action should the nurse take? Provide privacy and comfort for all family members 19. A post-menopausal female client with osteopenia tells the nurse that she has increased her physical activity and hopes to participate in a charity walkathon. How should the nurse respond? Affirm the benefits of increasing her weight bearing activity.