HESI GERIATRICS (UPDATED CORRECT ANSWERS)

Document Content and Description Below

HESI GERIATRICS 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 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? A. Boredom may influence how the taste of food is perceived, and different seasonings can stimulate taste. B. With age, an increase in sodium intake is needed to compensate for a decrease in renal function. C. Short-term memory loss and confusion may be the reason they want to over-season their food. D. Taste buds often are dull due to atrophy so older clients should use other seasonings instead of salt. - D. Taste buds are often dull due to atrophy so older clients should use other seasonings instead of salt. 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? A. Barrel chest with increased chest diameter B. Crackles and pulse oximetry level of 88% C. Low hemoglobin and hematocrit levels D. Arterial blood gases indicating respiratory acidosis - B. Crackles and pulse oximetry level of 88% 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 B. Question the client about her perception of where she might be now. C. Distract the client with a scenario that she is on an outing with her family. D. Reassure the client not to worry because she will meet new friends. - A. Explain that she is in a new home called an assisted living community. 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? A. Arts and crafts B. Current events discussion group C. Group sing-along D. Daily exercise group - D. Daily exercise group 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? A. Use the FACE pain scale B. Ask the client to rate pain on a scale of 1 to 10 C. Observe for facial grimacing D. Review documentation of recent eating habits - C. Observe for facial grimacing 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. B. Discuss benign prostatic hypertrophy (BPH) and ejaculation. C. Explore the frequency that he experiences erectile dysfunction (ED) D. Determine if the client's wife is young enough to get pregnant - A. Query client to clarify the client's idea of an intimacy problem. 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? A. Asymmetrical joint deformity B. Small joint involvement in fingers C. Crepitation or grating sensation in joints D. Weight bearing joint involvement - B. Small joint involvement in fingers. 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? A. Increase protein and carbohydrates in the daily diet B. Limit activity to bed rest for the first week and increase mobility incrementally each week C. Report abdominal distention, constipation or any other nausea and vomiting to the healthcare provider D. Drink liquids 2 hours after meals instead of during meals - C. Report abdominal distention, constipation, or any nausea and vomiting to the healthcare provider. 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. 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 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? A. Lack of knowledge about narcotic medications B. Rationalization to support narcotic use C. Transfer of blame to healthcare provider D. Justification of narcotic use due to chronic pain - B. Rationalization to support narcotic use. 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? A. Medication review with family caregivers is the RN's responsibility B. Multiple medications can contribute to sundowner-like symptoms C. Medication recall is the best way to evaluate the client's memory D. Reviewing medication actions is a component of effective client care - B. Multiple medications can contribute to sundowner like symptoms. 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. 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 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 B. Drink water and fluids up to 3,000 ml daily C. Use a stool softener or glycerin suppository PRN D. Plan daily exercise based on fatigue level - (A) Add whole grain foods and fibrous vegetables to diet. 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 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? A. Force fluid intake to 1,000 ml daily B. Change appliance every 4 hours C. Attach a larger drainage bag while sleeping D. Allow bag to fill completely before emptying - (C) Attach a larger drainage bag while sleeping 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? A. Constipation B. Headaches C. Muscle weakness D. Nausea and vomiting - (B) Headaches After a transurethral resection of the prostate (TURP), an older man returns to the medical surgical floor with a 3-way indwelling urinary catheter. The registered nurse (RN) observes the catheter's tubing for drainage when the client states that he needs to void. What should the RN implement based on this finding? A. Irrigate the bladder through the catheter port B. Remove the indwelling catheter C. Explain that urgency is expected D. Notify the healthcare provider of the symptom - (A) Irrigate the bladder through the catheter port An older client with chronic kidney disease (CKD) has an arteriovenous fistula (AV) in the left forearm for for hemodialysis. After palpating the AV fistula, which finding is an indication that the AV fistula is functioning properly? A. Enlarged veins B. Redness around the site C. Decreased pulses below fistula D. Marked ecchymotic areas - (A) Enlarged veins During the quarterly evaluations of the clients in the assisted living community, the registered nurse (RN) assesses for findings of failure to thrive in the older population. What findings should the RN document and report as manifestations related to failure to thrive? (Select all that apply.) A. Unintentional weight loss B. Increased weakness C. Increased amounts of sleep D. Irritation and agitation E. Seeking constant attention from caregiver - (A) Unintentional weight loss (B) Increased weakness (C) Increased amounts of sleep The registered nurse (RN) is reinforcing discharge instructions to the family of an older client with failure to thrive. What information should the RN include to promote nutritional intake for the client? (Select all that apply.) A. Minimize stress levels by providing the client with a quiet environment during meals B. Provide food variations that the client can manage without assistance C. Assist the client with eating meals in bed in a semi-Fowler's position D. Encourage fluid intake before meals to decrease dehydration E. Offer any type of food to the client as long as calories are consumed - (A) Minimize stress level by providing the client with a quiet environment during meals (B) Provide food variations that the client can manage without assistance The registered nurse (RN) is assigned the care of an older client who returns to the unit after surgery for closed angle glaucoma. What intervention in the plan of care should the RN bring to the attention of the healthcare team? A. Assist with ambulating to commode B. Monitor intake and output q8 hours C. Administer morphine 4 mg IM q2 hour PRN pain D. Place an eye patch on operative eye during sleep - (C) Administer morphine 4 mg IM q2 hour PRN pain After a recent total hip replacement, an older female client, who transferred to a rehabilitation facility placement, asks the registered nurse (RN) if she broke her hip because she is old. How should the RN best respond? A. Hip fractures can occur in any age group and require strength conditioning B. With aging, everything tends to break down more easily the older one gets C. Older people tend to look down instead of ahead, increasing the risk of falls D. Older women commonly lose bone calcium, which increases the risk of fracture - (D) Older women commonly lose bone calcium which increases the risk of fracture. B and C) offer other responses but are not client centered in response to her expressed self-concern. An older male client is admitted for emergency treatment of acute closed-angle glaucoma. The registered nurse (RN) begins administering the prescribed miotic medications and glycerin (Glycol) therapy. Which intervention is most important for the RN to maintain during the client's therapy? A. Maintain lighting control in the room during therapy B. Monitor intake and output q2 hours for 24 hours C. Place an eye patch over the affected eye during sleep D. Administer the eye drops at the scheduled intervals - (B) Monitor intake and output q2 hours for 24 hours The home health registered nurse (RN) visits an older woman with heart failure (HF) who is on complete bed rest. Which intervention is most important for the RN to suggest to the client to prevent complications related to immobility? A. Get as much sleep as possible B. Perform leg exercises while in bed C. increase protein intake to combat fatigue D. Invite friends to visit to decrease risk for depression - (B) Perform leg exercises while in bed. An older client is admitted with a preliminary diagnosis of Addison's disease. Which skin finding should the registered nurse (RN) document that is typical with Addison's disease? A. Moon face B. Hyperpigmentation C. Excessive acne D. Multiple skin tags - (B) Hyperpigmentation Osteoporosis increases the risk for a hip fracture in older adults, and women are more likely to have osteoporosis than men. Women of which ethnic group have the highest risk for a hip fracture? (Arrange with the highest risk first and the lowest risk last.) A. African American B. Caucasian C. Asian D. Hispanic - (B) Caucasian (C) Asian (D) Hispanic (A) African American An older male client returns to the hospital after discharge 4 days ago for a TURP. The registered nurse (RN) evaluates the function of the 3-way indwelling urinary catheter and the continuous bladder irrigation system. Which finding should the RN report to the healthcare provider? A. Irrigation bag of normal saline is hanging at the level of the client's head B. The urinary output is greater than the amount of irrigation fluid instilled C. The irrigation tubing is attached to the irrigation port on the 3-way catheter D. The tubing that drains the urinary bladder has bright red urine with clots. - (D) The tubing that drains the urinary bladder has bright red urine with clots. An older client who recently moved into an assisted living community refuses to eat or join any activities. When evaluating the client further, what should the registered nurse (RN) focus on during the next examination? A. Anxiety B. Depression C. Exhaustion D. Confusion - (B) Depression An older client who is a resident in a long-term care facility is receiving medications through a gastric tube (GT). After interrupting the continuous GT feeding in which sequence should the nurse implement these actions for administration of crushed medications? (Arrange in order from first to last step.) A. Flush the feeding tube of feeding solution B. Crush the medication into a powder or fine granules C. Administer each medication separately D. Dissolve each crushed medication in a medicine cup E. Flush GT to clear the medication from the tubing F. Reconnect the gastric feeding tube - B - D - A - C - E - F The registered nurse (RN) is caring for an elderly client with functional incontinence who lives in an assisted living community. The client is alert and mildly confused and can self-ambulate. Which nursing intervention should the RN implement? A. Offer assistance with toileting q2 hours B. Use protective disposal undergarment instead of underwear C. Ask if the client has attempted to void q2 hours D. Obtain a prescription for intermittent catheterization - (A) Offer assistance with toileting q2 hours The home health registered nurse (RN) is reinforcing instructions to the family about how to prevent pressure ulcers for their older family member who is bedridden. Which measure should the RN discuss? A. Lift the client when turning instead of sliding B. Massage directly over reddened sites C. Change client's position every 4 hours D. Place pillows under both the knees - (A) Lift the client when turning instead of sliding An older male client is admitted to the hospital with left-sided heart failure (HF). Which finding should the registered nurse (RN) document that is consistent with HF? A. Ascites B. Pitting edema C. Jugular distention D. Coarse and fine crackles - (D) Coarse and fine crackles An older woman asks the registered nurse (RN) how she can decrease her chances of getting cystitis. What information should the RN provide? A. Void and empty the bladder completely every 2 to 3 hours B. Take warm sits baths with bubble bath to cleanse the vulva C. Decrease fluid volume intake to reduce urgency D. Test urine pH daily using over-the-counter (OTC) dipsticks - (A) Void and empty the bladder completely every 2 to 3 hours An older female client who is a new resident at an assisted living facility cannot remember how to get to her room. What action should the registered nurse (RN) implement? A. Schedule therapy and social activities in her room B. Ask another resident to help the client C. Show client how to follow hallway signs to her room D. Move client to a room close to nurses station - (C) Show client how to follow hallway signs to her room An older female client arrives for an annual visit by the urologist due to a history of changes in serum values related to renal function. What changes should the registered nurse (RN) expect for an older client due to normal aging? A. Decrease in glomerular filtration rate (GFR) B. Hematuria during urinalysis C. Chronic bladder infections D. Urinary incontinence - (A) Decrease in glomerular filtration rate (GFR) The nursing assessment of an older female elicits information that the client is diagnosed with Raynaud's phenomenon. Which exposure should the nurse instruct the client to avoid? A. Alcohol consumption B. Warm climates C. Cold climates D. Active exercise - (C) Cold climates An older resident is newly admitted to an assisted living community. Which actions should the registered nurse (RN) implement to provide the resident ways to maintain safe medication administration? (Select all that apply.) A. Locked medication storage in the client's room B. Medication administration record (MAR) C. Payment forms for prescribed medications D. Delivery of adequate supply of medication E. List of findings indicating medication effectiveness - (A), (B), (D), (E) An older male client is seeking counseling about his recent sexual issues with his partner. What issue should the registered nurse (RN) explore in this discussion? A. Certain mediations may impact sexual function B. Normal aging affects sexual function in male clients C. Safe sex is not necessary with older sexually active elders D. Sexual interest usually declines with aging in male clients - (A) Certain medications may impact sexual function male clients. Some men may experience a decline in testosterone and sperm production, but sexual dysfunction is not a part of normal aging in the male client. The incidence of STIs has increased and may be related to a lack of education for this age group about preventative measures (C). Older clients continue to have interest in sex (C) as long as there is not a direct influence of medication side effects that cause sexual dysfunction An older male client with Parkinson's disease (PD) is discharged home with levodopa- carbidopa (Sinemet) and instructions to his wife for his care. What statement best indicates to the registered nurse (RN) that the wife understands her husband's needs? A. "It is important to keep my husband in a chair or in bed as much as possible and prevent him from falling." B. "I will notify the healthcare provider if my husband has increasing involuntary movements of his extremities." C. "Since it is difficult for my husband to eat, we should stay in the house instead of going out to dine." D. "I should expect that my husband will be incontinent of bowel and bladder as his disease advances." - (B) "I will notify the healthcare provider if my husband has increasing involuntary movements of his extremities." A frail elderly woman visits the healthcare provider because she has been getting out of breath easily when walking long distances. Which pulmonary function change should the registered nurse (RN) expect to commonly occur with aging? A. Decreased residual volume B. Mild respiratory acidosis C. Reduced vital capacity D. Increased alveoli function - (C) Reduced vital capacity The registered nurse (RN) is assigned to the care of an older client with venous stasis ulcers. A primary goal in the client's plan of care is to decrease swelling in the extremities. What action should the RN take to meet this goal? A. Elevate the legs on pillows B. Decrease fluid intake C. Decrease salt intake in diet D. Increase protein intake in diet - (A) Elevate the legs on pillows n older male client asks the registered nurse (RN) how he can reduce his incidents of hemorrhoidal flare ups. What information should the RN offer the client about how to prevent rectal discomfort? (Select all that apply.) A. Increase fiber and liquids in the diet to help prevent constipation and straining B. Change exercise program to reflect less cardio-exercise and more weight training C. Use a therapeutic cushion or frequent repositioning for periods of prolonged sitting D. Take frequent warm sits baths and do not use abrasive paper that can traumatize tissues E. Establish bowel habits by scheduling daily time to defecate when the client is not rushed - (A), (C), (D) and (E) When assessing an older client, which age-related changes in the cardiovascular system should the registered nurse (RN) document? (Select all that apply.) A. Dyspnea B. Chest pain C. Cardiac murmurs D. Widening pulse pressure E. Irregular heart rate - (C), (D) he home health registered nurse (RN) is changing an older client's wet to dry dressing. Which observation should the RN evaluate as a therapeutic response with the removal of the dry dressing? A. Debridement and removal of slough and eschar B. Drainage of purulent exudate from the wound C. Moist skin edges around the wound field D. Presence of capillary growth in the wound - (A) Debridement and removal of slough and eschar The home health registered nurse (RN) is assessing an older client for a pressure ulcer. Which finding should the RN observe the area for a Stage I pressure ulcer? A. Superficial skin breakdown and flaking B. Deep pink, red or mottle skin C. Subcutaneous damage or necrosis D. Skin that blanches pink when pressed - (B) Deep pink, red or mottled skin An older client who is unconscious is admitted after experiencing a head injury from a fall. Glasgow Coma Scale (GCS) is prescribed to evaluate the client. Which focused assessments should the registered nurse (RN) use to determine the client's GCS score? (Select all that apply.) A. Verbal response B. Motor response C. Eye opening D. Pupillary reaction E. Hearing - (A), (B), (C) A 64-year-old client is admitted to the hospital with a fractured right hip. One of the concerns following surgical repair is to promote dorsiflexion. Which intervention would a nurse implement? A. Begin early ambulation B. Monitor pain level C. Provide PCA instructions D. Provide a foot board - (D) Provide a foot board [Show More]

Last updated: 3 years ago

Preview 1 out of 23 pages