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Gerontology HESI Practice 2024/2025 already graded A+
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Gerontology HESI Practice 2024/2025 already graded A+
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Gerontology HESI PracticeA 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 - ANSB. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate oxygenation and perfusion
in this frail elderly client. (A), (C) and (D) 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?
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. - ANSD. 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. (A), (B), and (C) are
not normal aging processes related to taste.
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 - ANSB. Crackles and pulse oximetry level
of 88%
,Rationale: With pneumonia, crackles in the lungs and low O2 saturation (B) can impact
adequate oxygenation, which should be reported to the HCP. (A) occurs due to chronic
hyperinflation of the lungs and is common in clients with COPD. Anemia (C) is frequently
identified in clients with COPD, and respiratory acidosis (D) due to CO2 retention contributes to
a lower blood pH.
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. - ANSA. 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. (B, C, and D) do not provide the client with feedback that is
reality based.
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 - ANSD. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the leader and minimizes the
client's stress to remember. (A), (C), and a current events discussion group (B) are
thought-provoking activities that require attention to detail and short-term memory to participate
in the group activity which may be stressful and frustrating to the resident who has difficulty
remembering sequence of the details.
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 - ANSC. 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. (A) and (B) may not be understood by a
client with end-stage Alzheimer's disease. (D) is not a helpful tool for pain assessment.
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 - ANSA. 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). (B), (C), and (D) are details that the client should present,
not the RN.
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 - ANSB. Small joint involvement in fingers.
Rationale: Small joint involvement (B) is common in rheumatoid arthritis. (A), (C) and (D) are
findings that different OA from RA.
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 - ANSC. 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. (A, B, and D) are not indicated for a client who has been discharged for intestinal
obstruction.
An older client is transferred to a telemetry unit after placement of a pacemaker. What action
should the registered nurse (RN) take first?
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