Gerontology HESI Practice Exam Study Guide
Questions And Answers Verified 100% Correct
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. - 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. - 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
lifethreatening. - 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 - 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 - 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 - 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 - ANSWER 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 - ANSWER
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.
Questions And Answers Verified 100% Correct
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. - 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. - 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
lifethreatening. - 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 - 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 - 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 - 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 - ANSWER 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 - ANSWER
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.
