Gerontology HESI Practice Questions With Complete Solutions Graded A+

Gerontology HESI Practice Questions With Complete Solutions Graded A+ 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 B. 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? D. 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? B. 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? A. 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? D. 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? C. 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? A. 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? B. 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? C. 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 C. 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 A. 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. An older female client who has been taking hydrocodone/acetaminophen (Lortab) q4 hours for chronic back pain for the past 5 years tells the registered nurse (RN) that she cannot live without her pain pills. When asked if she is addicted, the client states that she is not an addict because the healthcare provider prescribed the pain pills. Which coping mechanism should the RN determine the client is using about her addiction? B. Rationalization to support narcotic use. Rationale: The client is using rationalization to maintain self-esteem when she is questioned by stating that she is not addicted because she is taking medication prescribed by a healthcare provider. A family member brings their aging father to the clinic because he has been alert and oriented during the day but agitated and disoriented in the evening. The registered nurse (RN) reviews the client's list of current medications with the client and family. Which action taken by the RN is most important? B. Multiple medications can contribute to sundowner like symptoms. Rationale: Older clients may see a variety of HCP which can increase the chance of polypharmacy that compounds the workload of metabolic pathways that may be less efficient due to the aging process. Multiple medication interactions may contribute to sundowner like symptoms; reviewing medication actions and interactions provides the information that may indicate polypharmacy leading to sundowner syndromes. Since his arrival in an assisted living community, an older male client is having difficulty going to sleep. Which intervention should the registered nurse (RN) implement first? A. Encourage client to take a warm bath at night B. Ask the client what has helped him in the past C. Recommend that the client not take daytime naps D. Offer the client a glass of warm milk before bedtime B. Ask the client what has helped him in the past. Rationale: Asking the client (B) about his sleeping habits involves the client in his own care and preserves his autonomy as he adapts to living in a new community. The home health registered nurse (RN) is visiting an older client with chronic hypertension. What evaluation is most important for the RN to complete with each visit? A. Effectiveness of medication B. Ability to ambulate C. Signs of dehydration D. Familial support A. Effectiveness of medication Rationale: The highest priority in the care of an older client with chronic hypertension is evaluation of the effectiveness of blood pressure medication (A) and the client's compliance in order to prevent complications related to chronic disease. An older male client with heart failure (HF) complains of chronic constipation and wants to retrain his bowel. Which information should the registered nurse (RN) offer the client for establishing regular bowel habits? (A) Add whole grain foods and fibrous vegetables to diet. Rationale: Increasing daily fiber (A) with increasing fluid intake are the best tools to use when retraining bowel habits. The registered nurse (RN) is observing the skin of an older client. Which finding should the RN document as consistent with the normal aging process? A. Decreased elasticity B. Tough and leathery texture C. Shiny and edematous D. Excessive hair growth on the head (A) Decreased elasticity Rationale: Loss of elasticity is a common finding of the normal aging process (A). The skin of elderly clients becomes thin and fragile with aging, not The home health registered nurse (RN) visits an older female client with an ideal conduit who has been experiencing chronic urinary tract infections (UTI). Which intervention should the RN recommend to the client to manage the frequency of UTIs? (C) Attach a larger drainage bag while sleeping Rationale: (C) can prevent urinary reflux if the bag fills to near capacity or greater, which can contribute to UTIs. Forcing fluids is encouraged and should exceed urinary output, which commonly should be greater than 1,000 ml The healthcare provider prescribes a new medication, atorvastatin (Lipitor), for an older client who arrives at the clinic for an annual physical examination. What common side effect should the registered nurse (RN) advise the client to observe with this medication? (B) Headaches Rationale: Headaches (B) are the most common side effect with this medication, which the RN should direct the client to report.