Gerontology HESI Test Questions And Answers Solved 100% Correct!!

Gerontology HESI Test Questions And Answers Solved 100% Correct!! The cleansing of the stomach with solution delivered through a nasogastric tube is known as what? Gavage Emesis Lavage Stomach pumping 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. 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. 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 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. 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 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. 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. 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. 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 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. 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. 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. 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. 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 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 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 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 6 to 8 weeks In the treatment of hypothyroidism, T4 replacement is needed in the form of levothyroixine (Synthroid or Levoxyl). The initial dosages for an adult is 75 to 125 mcg. For an elderly person, the dose is 75% less than the adult dosage. Because of the long half-life of levothyroxine, the effects of a dosage adjustment or initiation would not cause a change in TSH for approximately five to six drug half-lives, or about 6 to 8 weeks. A 67-year-old diabetic has been taking oral anti-hypoglycemics and is still having poor glycemic control. You make the decision to start insulin therapy. He weighs 60 kg. What should you order as an initial starting dose? 6 units short-acting insulin at breakfast, continue oral medication 6 units intermediate insulin at bedtime, stop oral medication 6 units long-acting before breakfast, stop oral medication 6 units long-acting insulin at bedtime, continue oral medication 6 units long-acting insulin at bedtime, continue oral medication The American Diabetic Association algorithm for initiation and adjustment of therapy (2006) suggests an intermediate or long-acting insulin to be started at bedtime or morning as a once daily dose. The starting dose is either 10 units or 0.2 units per kilogram. Oral medication should be continued except for discontinuing sulfonylureas or meglitinides. A 65 year patient has sub-occipital and posterior cranial head pain following a fall. The GNP conducts a musculoskeletal assessment by: Palpating the acromioclavicular joint. Assessing the gleno-humeral range of motion. Palpating the cervical vertebrae. Palpating anterior the thoracic muscles. Palpating the cervical vertebrae. The patient who is complaining of sub-occipital, posterior head pain should have the cervical vertebrae assessed. Additionally, the GNP will palpate the posterior neck muscles and assess the neck for range of motion. A 67-year-old female is in the office with cataracts. She is asking what she needs to do about this. The GNP understands that all of the following are management for this except: Surgery may be necessary if the cataract markedly decreases visual acuity. No drugs are available that will halt the progression of the aging process of the eye. Vision correction with corrective lenses are available if the cataracts are in the early stages. Ophthalmic steroids that decrease the severity are available by prescription from an ophthalmologist. Ophthalmic steroids that decrease the severity are available by prescription from an ophthalmologist. No topical or oral medications exists that will cure or treat this condition. However, there are surgical options. You are providing patient education to a patient who has recently been diagnosed with shingles. Which of the following is NOT true of the way this patient should care for his rash?