HESI Gerontology Exam Edge (Answered)
With Rationale
Good communication is a necessity for healthcare providers for interviewing and
teaching patients. The GNP understands that which of the following is true
regarding communication?
a. Not all communication is privileged and confidential.
b. Triage is a form of communication that involves a system of controlled
oversight and authorization of services.
c. Case management is a form of communication that involves the privatization
and sorting of patients according to a preexisting standard.
d. Communication involves the written and oral transfer of information regarding
the structure, process, and outcome of healthcare encounters.
d. Communication involves the written and oral transfer of information regarding the
structure, process, and outcome of healthcare encounters.
All communication is privileged and confidential. Case management is a form of
communication that involves a system of controlled oversight and authorization of
services. Triage is a form of communication that involves the prioritization and sorting of
patients according to a preexisting standard.
You are seeing a 72-year old man with an abdominal aortic aneurysm (AAA).
Besides hypertension, what risk factor contributes the most to the development
of an AAA?
a. cigarette smoking
b. alcohol consumption
c. eating red meat
d. obesity
a. cigarette smoking
Choice A is the right answer. Smoking clearly increases the risk for AAA. The
prevalence in women is far lower than in men and the benefits associated with
screening women do not justify the costs. It is recommended a one-time screening be
done for males aged 65 to 75 who have ever smoked.
There has been a recent shift of the health care delivery toward the provision of
nonacute care from the hospital setting to the ambulatory care setting and the
home. Nursing research that was previously conducted in hospitals:
a. is now applicable to all in-hospital providers of care.
b. is now relevant in the new settings, as patient care is unchanged.
c. is no longer applicable to the delivery of patient care.
d. is needed to be applied directly to patient care that is provided in the new
settings.
c. is no longer applicable to the delivery of patient care.
The restructuring of the health care delivery system and the changes that have occurred
make previous studies no longer applicable to nursing care. The other choices are
incorrect because the nonacute care is not provided in-hospital; because of the phrase
"as patient care is unchanged" in that the delivery of nursing care has changed settings;
,and previous studies were about care delivered in-hospital and it cannot be applied to
care provided in the new settings.
A 67-year-old male comes to the clinic telling you that he was bitten on the hand
by a raccoon. The GNP cleanses the wound. What would the next action be?
a. contact local animal control authorities
b. administer rabies immune globulin (RIG) and human diploid cell vaccine
(HDCV)
c. administer tetanus antitoxin
d. teach the patient how to do hourly soaks to the hand using normal saline and
peroxide
b. administer rabies immune globulin (RIG) and human diploid cell vaccine (HDCV)
Any bite associated with an animal that may harbor rabies (skunks, bats, raccoons,
foxes, coyotes, rats) should be treated with both active and passive rabies
immunization. The tetanus antitoxin would also be indicated if patient was not currently
up to date.
You are treating a patient with a recent TIA. The GNP must consider that:
a. There is no need to educate the person on signs and symptoms of stroke or
stroke prevention.
b. Women present with this disorder more often than men.
c. Long-term antiplatelet therapy is likely indicated.
d. It will be necessary to schedule rehabilitation therapy.
c. Long-term antiplatelet therapy is likely indicated.
Intervention includes minimizing risk factors through lifestyle modification, aggressive
treatment of dyslipidemia, hypertension, and diabetes mellitus, and long-term platelet
therapy. The person should be educated on stroke and stroke prevention, men present
more often than women with TIAs, and rehabilitation therapy is not warranted after a
TIA.
When seeing a 68-year-old man in the clinic with acute cocaine intoxication, you
inquire about:
a. chest pain
b. feelings of anxiety
c. abdominal pain
d. difficulty maintaining sleep
a. chest pain
Cocaine is a potent sympathomimetic and can increase heart rate and myocardial
contractility. This causes coronary vessel constiction that could lead to myocardial
ischemia. Inquiring about chest pain is prudent in caring for a patient with cocaine
abuse.
A 65-year-old Caucasian presents with a long history of chronic airflow
obstructive disease and has noticed a change in sputum color over the past few
days, with increased amounts of thick yellow-green mucus. The GNP
understands that the appropriate therapy would be:
a. Augmentin 500 mg PO tid for 10 days
, b. Tylenol with codeine
c. Vancenase MDI 2 puffs prn
d. Hismanal 10 mg PO qd
a. Augmentin 500 mg PO tid for 10 days
Antibiotic therapy is indicated if there has been a change in sputum color, consistency,
and amount. Cough suppressants and antihistamines should be avoided.
In assessing a patient who has a lower extremity ulcer, the nurse assesses the
temperature and skin. The nurse checks the shape of the patient's leg. Chronic
venous stasis gives the leg:
a. An apple shape.
b. A round shape.
c. A sausage shape.
d. A bowling pin shape.
d. A bowling pin shape.
Lower extremity ulcers can be a symptom of other conditions. A leg with chronic venous
stasis has a bowling pin or champagne bottle shape.
When treating the patient with heartburn symptoms, the GNP understand that the
drug that is most likely to produce rapid relief for a patient is:
a. H2 blockers
b. proton pump inhibitors
c. sucralfate
d. antacids
d. antacids
These medications produce the most rapid change in gastric pH and the most rapid
relief of symptoms. H2 blockers and proton pump inhibitors may take many hours
before relief is realized and so these are not adequate for immediate relief. Sucralfate
does not affect gastric pH.
You prescribe a short-acting anticholinergic medication that can be used alone or
in combination with a short-acting beta agonist that the patient has already. What
disease are you trying to manage?
a. benign prostatic hyperplasia
b. glaucoma
c. chronic obstructive pulmonary disease
d. tachyarrhythmias
c. chronic obstructive pulmonary disease
Patients with chronic obstructive pulmonary disease who have intermittent symptoms
need a first line treatment for shortness of breath which is an anticholinergic alone or in
combination with a beta agonist. Both these medications will improve lung function.
Your 87-year-old patient presents with bright red blood from the rectum and
abdominal pain. After testing, you determine he is positive for Colorectal Cancer.
Which of the following would LEAST likely be a differential diagnosis for
Colorectal Cancer?
With Rationale
Good communication is a necessity for healthcare providers for interviewing and
teaching patients. The GNP understands that which of the following is true
regarding communication?
a. Not all communication is privileged and confidential.
b. Triage is a form of communication that involves a system of controlled
oversight and authorization of services.
c. Case management is a form of communication that involves the privatization
and sorting of patients according to a preexisting standard.
d. Communication involves the written and oral transfer of information regarding
the structure, process, and outcome of healthcare encounters.
d. Communication involves the written and oral transfer of information regarding the
structure, process, and outcome of healthcare encounters.
All communication is privileged and confidential. Case management is a form of
communication that involves a system of controlled oversight and authorization of
services. Triage is a form of communication that involves the prioritization and sorting of
patients according to a preexisting standard.
You are seeing a 72-year old man with an abdominal aortic aneurysm (AAA).
Besides hypertension, what risk factor contributes the most to the development
of an AAA?
a. cigarette smoking
b. alcohol consumption
c. eating red meat
d. obesity
a. cigarette smoking
Choice A is the right answer. Smoking clearly increases the risk for AAA. The
prevalence in women is far lower than in men and the benefits associated with
screening women do not justify the costs. It is recommended a one-time screening be
done for males aged 65 to 75 who have ever smoked.
There has been a recent shift of the health care delivery toward the provision of
nonacute care from the hospital setting to the ambulatory care setting and the
home. Nursing research that was previously conducted in hospitals:
a. is now applicable to all in-hospital providers of care.
b. is now relevant in the new settings, as patient care is unchanged.
c. is no longer applicable to the delivery of patient care.
d. is needed to be applied directly to patient care that is provided in the new
settings.
c. is no longer applicable to the delivery of patient care.
The restructuring of the health care delivery system and the changes that have occurred
make previous studies no longer applicable to nursing care. The other choices are
incorrect because the nonacute care is not provided in-hospital; because of the phrase
"as patient care is unchanged" in that the delivery of nursing care has changed settings;
,and previous studies were about care delivered in-hospital and it cannot be applied to
care provided in the new settings.
A 67-year-old male comes to the clinic telling you that he was bitten on the hand
by a raccoon. The GNP cleanses the wound. What would the next action be?
a. contact local animal control authorities
b. administer rabies immune globulin (RIG) and human diploid cell vaccine
(HDCV)
c. administer tetanus antitoxin
d. teach the patient how to do hourly soaks to the hand using normal saline and
peroxide
b. administer rabies immune globulin (RIG) and human diploid cell vaccine (HDCV)
Any bite associated with an animal that may harbor rabies (skunks, bats, raccoons,
foxes, coyotes, rats) should be treated with both active and passive rabies
immunization. The tetanus antitoxin would also be indicated if patient was not currently
up to date.
You are treating a patient with a recent TIA. The GNP must consider that:
a. There is no need to educate the person on signs and symptoms of stroke or
stroke prevention.
b. Women present with this disorder more often than men.
c. Long-term antiplatelet therapy is likely indicated.
d. It will be necessary to schedule rehabilitation therapy.
c. Long-term antiplatelet therapy is likely indicated.
Intervention includes minimizing risk factors through lifestyle modification, aggressive
treatment of dyslipidemia, hypertension, and diabetes mellitus, and long-term platelet
therapy. The person should be educated on stroke and stroke prevention, men present
more often than women with TIAs, and rehabilitation therapy is not warranted after a
TIA.
When seeing a 68-year-old man in the clinic with acute cocaine intoxication, you
inquire about:
a. chest pain
b. feelings of anxiety
c. abdominal pain
d. difficulty maintaining sleep
a. chest pain
Cocaine is a potent sympathomimetic and can increase heart rate and myocardial
contractility. This causes coronary vessel constiction that could lead to myocardial
ischemia. Inquiring about chest pain is prudent in caring for a patient with cocaine
abuse.
A 65-year-old Caucasian presents with a long history of chronic airflow
obstructive disease and has noticed a change in sputum color over the past few
days, with increased amounts of thick yellow-green mucus. The GNP
understands that the appropriate therapy would be:
a. Augmentin 500 mg PO tid for 10 days
, b. Tylenol with codeine
c. Vancenase MDI 2 puffs prn
d. Hismanal 10 mg PO qd
a. Augmentin 500 mg PO tid for 10 days
Antibiotic therapy is indicated if there has been a change in sputum color, consistency,
and amount. Cough suppressants and antihistamines should be avoided.
In assessing a patient who has a lower extremity ulcer, the nurse assesses the
temperature and skin. The nurse checks the shape of the patient's leg. Chronic
venous stasis gives the leg:
a. An apple shape.
b. A round shape.
c. A sausage shape.
d. A bowling pin shape.
d. A bowling pin shape.
Lower extremity ulcers can be a symptom of other conditions. A leg with chronic venous
stasis has a bowling pin or champagne bottle shape.
When treating the patient with heartburn symptoms, the GNP understand that the
drug that is most likely to produce rapid relief for a patient is:
a. H2 blockers
b. proton pump inhibitors
c. sucralfate
d. antacids
d. antacids
These medications produce the most rapid change in gastric pH and the most rapid
relief of symptoms. H2 blockers and proton pump inhibitors may take many hours
before relief is realized and so these are not adequate for immediate relief. Sucralfate
does not affect gastric pH.
You prescribe a short-acting anticholinergic medication that can be used alone or
in combination with a short-acting beta agonist that the patient has already. What
disease are you trying to manage?
a. benign prostatic hyperplasia
b. glaucoma
c. chronic obstructive pulmonary disease
d. tachyarrhythmias
c. chronic obstructive pulmonary disease
Patients with chronic obstructive pulmonary disease who have intermittent symptoms
need a first line treatment for shortness of breath which is an anticholinergic alone or in
combination with a beta agonist. Both these medications will improve lung function.
Your 87-year-old patient presents with bright red blood from the rectum and
abdominal pain. After testing, you determine he is positive for Colorectal Cancer.
Which of the following would LEAST likely be a differential diagnosis for
Colorectal Cancer?
