Gerontology HESI Practice
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 - correct answerB. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate oxygenation and perfusion in this
frail elderly client. (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? - correct answerD. 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. (
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? - correct answerB. Crackles and pulse oximetry level of 88%
Rationale: With pneumonia, crackles in the lungs and low O2 saturation, can impact adequate
oxygenation, which should be reported to the Health Care Provider.
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? - correct answerA. 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.
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?
- correct answerD. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the leader and minimizes the client's
stress to remember.
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? - correct answerC. 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.
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? - correct answerA. 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).
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? - correct answerB. Small joint involvement in fingers.
Rationale: Small joint involvement (B) is common in rheumatoid arthritis.
, 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? - correct answerC. 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.
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 - correct answerC. Establish telemetry monitoring.
Rationale: The first action is to establish continuous telemetry monitoring (C) to ensure the pacemaker is
functioning properly.
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
E. Lack of exposure to technology and trends - correct answerA. Needs regretter than the caretaker's
abilities
B. Client's declining strength
Rationale: When needs are not being met due to lack of ability of the caretaker (A), stress and feelings of
failure may be expressed through neglect and abuse. Decline in strength (B) increases the older client's
vulnerability to resist or respond to elder abuse.
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 - correct answerB. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate oxygenation and perfusion in this
frail elderly client. (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? - correct answerD. 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. (
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? - correct answerB. Crackles and pulse oximetry level of 88%
Rationale: With pneumonia, crackles in the lungs and low O2 saturation, can impact adequate
oxygenation, which should be reported to the Health Care Provider.
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? - correct answerA. 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.
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?
- correct answerD. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the leader and minimizes the client's
stress to remember.
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? - correct answerC. 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.
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? - correct answerA. 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).
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? - correct answerB. Small joint involvement in fingers.
Rationale: Small joint involvement (B) is common in rheumatoid arthritis.
, 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? - correct answerC. 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.
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 - correct answerC. Establish telemetry monitoring.
Rationale: The first action is to establish continuous telemetry monitoring (C) to ensure the pacemaker is
functioning properly.
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
E. Lack of exposure to technology and trends - correct answerA. Needs regretter than the caretaker's
abilities
B. Client's declining strength
Rationale: When needs are not being met due to lack of ability of the caretaker (A), stress and feelings of
failure may be expressed through neglect and abuse. Decline in strength (B) increases the older client's
vulnerability to resist or respond to elder abuse.
