Gerontology HESI Practice Questions and
complete answers
B. 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 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
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. (A), (B), and (C) are not normal aging processes related to
taste. - ✔✔-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.
B. 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. - ✔✔-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
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. (B, C, and D) do not
provide the client with feedback that is reality based. - ✔✔-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.
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. (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. - ✔✔-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
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. (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. - ✔✔-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
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). (B), (C), and (D) are details that
the client should present, not the RN. - ✔✔-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
complete answers
B. 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 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
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. (A), (B), and (C) are not normal aging processes related to
taste. - ✔✔-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.
B. 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. - ✔✔-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
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. (B, C, and D) do not
provide the client with feedback that is reality based. - ✔✔-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.
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. (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. - ✔✔-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
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. (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. - ✔✔-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
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). (B), (C), and (D) are details that
the client should present, not the RN. - ✔✔-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
