Gerontology HESI test 2021/2022

The cleansing of the stomach with solution delivered through a nasogastric tube is known as what? Gavage Emesis Lavage Stomach pumping Correct answer- Lavage Gastric lavage is used to cleanse the stomach of a poison, overdose of medication, or other toxic substance. It is delivered through a nasogastric tube You are providing care to a patient who has recently begun dialysis. Her daughter, with whom she lives and who prepares many of her meals, asks what types of foods she should incorporate into her diet and which she should avoid. Which of the following is NOT a food that this patient should be advised to avoid? Avocado. Lean red meat. Dried fruit. Bananas. Correct answer- Lean red meat Dialysis patients are encouraged to eat lean meat, including red meat. High quality proteins produce less waste and help the body heal and maintain regular processes. Dialysis patients should avoid foods high in potassium, including avocado, banana, and dried fruit, and should eat other potassium-containing foods in moderation. Your 89-year-old patient presents with dyspepsia and nausea. After testing, you determine she is positive for Peptic Ulcer Disease. Of the following, which would LEAST likely be a differential diagnosis for Peptic Ulcer Disease? Cholecystitis. Migraines. Gastric carcinoma. Cardiovascular disease. Correct answer- Migraines Peptic Ulcer Disease is a gastrointestinal disorder. Other differential diagnoses of the condition are pancreatitis and biliary tract disease. There are a good many diseases affecting the elderly that are the result of smoking. Counseling regarding smoking cessation is part of the GNP's job. The components of brief intervention for treating tobacco use are: Counsel, Document, Caution, Describe, Demonstrate Advise, Confer, Describe, Document, Prescribe Advise, Counsel, Intervene, Prescribe, Follow-up Ask, Advise, Assess, Assist, Arrange Correct answer- Ask, Advise, Assess, Assist, Arrange Ask about tobacco use, Advise to quit, Assess willingness to make an attempt to quit, Assist in this quit attempt. Arrange a follow-up. Mrs. Frasier, an 50-year-old patient, presents with a mosquito bite that she is concerned about. How do you diagnose this? Cyst. Bulla. Wheal. Plaques. Correct answer- Wheal Cyst: encapsulated, fluid-filled mass that varies in size. Bulla: fluid-filled, elevated, circumscribed lesion that's larger than 5mm. Wheal: circumscribed, reddening with transient elevation lesion that's 0.5 to 10mm diameter. Plaques: usually a grouping of papules; elevated and a variety of shapes; larger than 5mm. Which of the following groups should be tested for abdominal aortic aneurysm? males aged 65-75 who have ever smoked females aged 65-75 who have hypertension males and females over 75 females over 75 Correct answer- males aged 65-75 who have ever smoked Abdominal aortic aneurysm (AAA) is more prevalent in males than in females. The American Heart Association recommends screening males once between ages 65-75 if they have ever smoked since that increases the risk of AAA. With a giardia lamblia diagnosis, the NP would MOST likely prescribe what medication? Metronidazole. Erythromycin. Ampicillin. Trimethoprim-sulfamethoxazole. Correct answer- Metronidazole. The preceding drugs are typically used in treating the following: - Campylobacter jejuni: Erythromycin - Salmonella: Ampicillin - Shigella: Trimethoprim-sulfamethoxazole - Giardia lamblia: Metronidazole A 65-year-old Caucasian male calls your office. He tells you he just came in from the woods and discovered a tick on his upper right thigh. He reports self removal of the tick and now the area is slightly red. What should you advise him to do? He should come to the office for a ceftriaxone (Rocephin) injection. He should be prescribed doxycycline. He needs no treatment. He needs a topical scrub to prevent Lyme Disease. Correct answer- He needs no treatment. To develop Lyme Disease from a tick bite, many factors must be present. The tick must belong to Ixodes species and must have been attached for at least 48 hours before the disease can spread. There is no need for prophylactic treatment in this case because the tick has not been present long enough. As part of the treatment plan for your elderly patient, you recommend he see an Ophthalmologist. What body part(s) will this doctor evaluate? Brain / nerves. Eyes. Bones / Joints / Muscles. Ears / Throat. Correct answer- Eyes Neurologist - Brain / nerves Ophthalmologist - Eyes Orthopedist - Bones / Joints / Muscles Otolaryngologist - Ears / Throat As a GNP you understand that due to physiological changes of aging, some laboratory test results will have age-related changes. Which of the following values would be the least likely to be affected? red blood cell values white blood cell counts platelet range hemoglobin values Correct answer- platelet range Due to the physiological changes of aging, red blood cell values tend to decrease, white blood cell counts tend to decrease slightly, hemoglobin values slightly decrease, but platelet range does not vary. The family of a patient with dementia has asked you to tell them more about this condition. You would tell them all of the following except: Dementia is the leading reason for institutionalization of older adults. Some persons diagnosed with dementia have reversible pseudodementia. Irreversible dementia has a gradual onset and a progressive downward course. 50% of the older adult population suffer from some form of dementia. Correct answer- 50% of the older adult population suffer from some form of dementia. This statement is not true. It is estimated that between 10 and 20% of the older adult population suffer from some form of dementia. There are 1.2 million cases in the United States in people over the age of 65. What is true regarding deep vein thrombosis (DVT)? Contrast venography is the most commonly used test to diagnose this. Because the presentation of DVT varies, making the diagnosis from clinical presentation alone is problematic. Hypocoagulation state presents a considerable risk for DVT. Therapy for patients with DVT is aimed at easing the pain. Correct answer- Because the presentation of DVT varies, making the diagnosis from clinical presentation alone is problematic. Choice B is the right answer. Contrast venography has the greatest sensitivity and specificity for the condition but due to the cost and nature of the test, ultrasound is more common as first-line diagnostic technique (choice A). A hypercoagulation state presents a considerable risk for DVT (choice C). Therapy for patients with DVT is aimed at minimizing the risk of pulmonary embolism and extension of peripheral thrombus (choice D). It has been determined that an elderly patient is suffering from long term insomnia. Which of the following is LESS likely to be considered a long term cause of the condition? Nocturia. Environmental changes. Congestive heart failure. Alcohol and substance abuse. Correct answer- Environmental changes. There are various causes of insomnia in the elderly. While some may be the cause of short term insomnia and others long term insomnia, long term insomnia is more common in the elderly than short term. In terms of the elderly which of the following is NOT true of hypothyroidism? Symptoms are often similar to normal aging changes making it difficult to detect in older adults. Symptoms usually have an insidious onset. It usually occurs before age 50. There is a greater risk for developing myxedema coma, which is life-threatening. Correct answer- It usually occurs before age 50. Hypothyroidism usually occurs after age 50. It is often diagnosed as depression. You must use caution against abruptly discontinuing medication. When treating a patient with oral Vitamin B12, which drug interaction will result in decreased absorption of vitamin B12? aminoglycosides colchicine potassium supplements all of the above Correct answer- all of the above In addition to the drugs listed in the first three choices, ascorbic acid may destroy the vitamin B12 supplement within one hour of ingestion. These drugs should not be taken concomitantly with oral vitamin B12. You are counseling a 72-year-old woman about nutrition. In the course of counseling you tell her that older adults are at increased risk of Vitamin D deficiency. Which of the following is NOT a factor that contributes to a Vitamin D deficiency? too much exposure to sunlight decreased exercise diminished renal function decreased body mass Correct answer- too much exposure to sunlight In actuality lack of sun exposure decreases synthesis of Vitamin D. An 88-year-old female patient comes into the clinic with her heart "racing and feeling funny." The ECG confirms atrial fibrillation. The GNP understands that this condition is managed by all of the following except: treating the underlying disease electrical cardioversion heparin as the drug of choice with antithrombotic therapy IV management with digoxin as first line therapy Correct answer- heparin as the drug of choice with antithrombotic therapy The antithrombotic drug of choice for atrial fibrillation is warfarin (Coumadin). 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 Correct answer- 6 to 8 weeks