NURS 1244 HESI Gerontology (GRADED A) Questions and Answers solution | Guaranteed pass

HESI GERONTOLOGY TEST BANK 1. Male resident of a nursing home requests a new room b/c he does not like the view in his present room. What action should the nurse take? Show the client the roo ms that are available. 2. The nurse is visiting an older client who is homebound. Which finding about the client’s nutritional status requires additional follow-up? Ate approximately 1200 calories daily for the past 2 weeks. 3. An elderly client with degenerative joint disease asks about using the rubber jar openers that are available. The nurse’s response should be on which information about assistive devices? They decrease the risk for joint trauma. 4. The nurse is caring for an older client who is admitted due to a change in mental status after 2 days of nausea and vomiting. The client’s home medications include subcutaneous insulin, a daily antihypertensive, and a daily diuretic. Which intervention should the nurse implement first? Obtain capillary glucose level 5. An older female who is complaining of pain in her arm and back is brought to the emergency department by her son who states she fell out of her chair. The nurse notes that the client has been in the ED five times in the last for a variety of superficial injuries. Which nursing action has the highest priority? Take mom to private room and ask if someone is hurting her 6. A nurse is caring for an older Vietnamese client who has terminal lung cancer. The family members want to stay in the room, perform cultural rituals, and serve ethnic foods until the client dies. What action should the nurse take? Provide privacy and comfort for all family members 7. A post-menopausal female client with osteopenia tells the nurse that she has increased her physical activity and hopes to participate in a charity walkathon. How should the nurse respond? Affirm the benefits of increasing her weight bearing activity. 8. The nurse is preparing to discharge an older woman to her home who was admitted last week due to malnutrition and dehydration. The nurse suspects that the client is being abused by her caregiver at home. Which intervention should the nurse implement? Notify adult protective services. 9. The clinic nurse receives a telephone call from the daughter of an older female client. The daughter reports that her mother has a cough and has become confused and short of breath, but only has a temperature of 99.4F. What action should the nurse take? a. Reassure the daughter that these are common signs of upper respiratory tract congestion. b. Advise the daughter to monitor her mother’s temperature and call if it continues to rise higher. c. Tell the daughter to keep her mother well hydrated and encourage rest for the next 48 hours. d. Explain to the daughter that she needs to bring her mother for immediate medical evaluation. 10. The unlicensed assistive personal (UAP) reports to the charge nurse that an older resident of the extended care facility, who has limited mobility, has not had a bowel movement in 5 days. Which action should the nurse take first? a. Check bowel sounds and abdominal tenderness b. Increase fiber and diet and add daily prune juice c. Perform a digital examination for a fecal impaction 11. An older male client is admitted with hypothermia with a core body temperature of 95F (35C) due to the lack of adequate heat in his home. Which findings should the nurse expect to obtain? (select all that apply) a. Hyperalert state b. Headache c. Cool skin d. Shivering e. Confusion 12. An older adult woman, who cares for her husband at home without assistance, requires minor surgery. With no family members living in the area, the wife expresses concern about her husband’s care while she recovers. Which intervention is likely to be most helpful in this situation? a. Suggest she ask social services to find a respite care facility for the husband 13. During report, an older female client, who had a right total hip replacement three days ago, is described as intolerant of pain. When assessing the client, the nurse finds that the client cannot straighten her right foot, which is pointing outward from her body. Which action should the nurse take? Call healthcare provider immediately 14. An older female sustained a right hip fracture one week ago that was surgically repaired the following day. Today she is reporting left sided leg pain, and the nurse observes edema of the left leg and a positive Homan sign. These findings should be reported to the health care provider because they are indicative of which condition? DVT 15. To help prevent drug interactions, which instruction should the nurse provide an older client who is taking many medications? A. Do not take any over the counter drugs while taking medications prescribed by a healthcare provider (could be this one?) B. Use a medication reminder system to prevent forgetting to take the right medications at the right time (could be this one?) C. Be sure a family member knows the name and use of all medications currently being taken D. Bring all medication supplement and herbs currently being taken to the next clinic appointment (could be this one?) 16. The daughter of a frail, elderly woman brings her mother to the clinic for an annual physical. Which concerns shared by the daughter should the nurse address first? a. The mother is having increasing periods of forgetfulness and mood swings. b. The daughter reports her mother’s bowel movements are hard and infrequent. c. The client lost 10 lbs last month and shows no interest in her personal hygiene. d. The family members are overwhelmed with the responsibility of caring for her mother. 17. When conducting assessments at an assisted living community, the nurse finds that an older adult client who is normally alert, oriented, and continent, is confused and incontinent of urine. Which intervention is MOST important for the nurse to implement? a. Place a protective undergarment on the client b. Obtain a clean, voided urine sample using a urinal hat c. Encourage increased fluid intake for 24 hours d. Evaluate the client’s response to bladder training efforts 18. An older female adult who lives in a nursing home is loudly demanding that the nurse call her son who has been deceased for five years. Which intervention should the nurse implement? Direct the client to a new activity 19. An older adult is admitted to an acute medical unit from a long-term care facility. When reviewing the client’s prescribed medications, which intervention should the nurse implement first? A. Determine which medications may be given in generic form rather than brand name only. B. Provide client teaching regarding the desired effects of the client’s admission prescriptions C. Reconcile prescribed medication dosages with the published recommended dosage ranges. D. Compare admission prescriptions with the list of medications previously taken by the client. 20. The nurse observes that an older client is becoming increasingly confused and measures the client’s oxygen saturation at 80%. Which assessment should the nurse perform next? Note the presence of any nail bed cyanosis. 21. Which action should the nurse implement while providing discharge instructions to the older client? Turn on overhead lights while giving instructions 22. In planning strategies to reduce an older client’s noncompliance with prescribed medication regimen, which intervention should the home health nurse implement? A. Encourage the client to dispose old drug prescriptions. B. Support the use of several pharmacies to help reduce cost. C. Observe the client’s wrist and hand grip strength bilaterally. D. Provide the client with free samples of the medication 23. An older female client states, “I’m too old to be of use to anyone anymore.” Based on Erikson’s stages of psychosocial development, what nursing intervention is best for the nurse to implement for this client? a. Enroll the client in craft classes at a community senior center. b. Arrange for a personal caregiver to assist with ADLs three times a week. c. Assist the client to arrange her room to promote a private, calm environment. d. Encourage the client to share past experiences with grandchildren. 24. An older client arrives at the clinic and tearfully reports left lower abdominal quadrant pain along with nausea without emesis for the last several days. Which information should the nurse obtain first? a. Date of last known bowel movement. b. Amount and type of daily fluid intake. c. Recent changes in eating habits. d. List of medications currently used 25. When teaching a post-menopausal client how to reduce risk for osteoporosis, the nurse should emphasize the need to increase intake of which item? a. Iron-rich meats b. Water and herbal teas c. Fresh fruits and vegetables d. Low-fat dairy products 26. When performing a functional assessment of a frail elderly male, which action should the nurse include? a. Question the client about how often he has fallen in recent months. b. Assist the client with values clarification about end of life care options. c. Encourage the client to lie as still as possible during the assessment d. Ask the client how often he experiences episodes of sundowning. 27. The nurse is preparing discharge instruction for an older female client who is going home after a hip replacement. The client tells the nurse that she can hardly wait to get home and see her cat. Which instruction regarding the cat is most critical to the client’s safety at home? a. Do not hold the cat on your lap. He is too heavy and will put pressure on your hip. b. Do not bend over and pick up the cat. Teach him to jump so you can reach him. c. Move the cat’s litterbox outside. The chemicals in cat litter may interfere with your recovery. d. Do not the cat outside. You will not be able to get out and catch him. 28. An older adult is admitted from the post-anesthesia care unit (PACU) to the medical unit following an open reduction and internal fixation (ORIF) of a fractured tibia. Which nursing intervention is most useful in preventing pulmonary complications during the immediate recovery period? Assist to a chair the day after surgery when condition is stable. 29. The nurse completes an observation of an older adult client who is experiencing a sudden onset of behavioral changes. The client frequently wanders and displays sundowning behaviors starting in the late afternoon. What action is most important for the nurse to implement? a. Observe carefully for extrapyramidal symptoms (EPS). b. Appraise light sensitivity, tiredness, and dizzy spills. c. Encourage the client to engage in social activities. d. Review medications for drug and food interactions. 30. An older female client with progressive dementia fell and broke her hip one week ago. The client is unable to communicate her level of pain. Which intervention is most important for the nurse to include in his client’s plan of care? a. Administer pain medication regularly (could be this one?) b. Explain procedures shortly before implementation. c. Provide non-pharmacological pain management (could be this one?) d. Encourage client to eat at mealtime. 31. An elderly female client grimaces and demonstrates guarding behavior but denies experiencing pain when asked by the nurse to rate her pain on a numeric scale. Which action should the nurse take next? a. Confront the client about her inconsistent behavior and response. b. Administer a prn dose of a prescribed analgesic c. Document that the client denies pain in the nurse’s notes d. Ask the client to describe how she is feeling 32. An older client with no cognitive impairment had a left hip arthroplasty 72 hours ago and is now confused and lethargic. Which action should the nurse implement? a. Auscultate for bowel sounds b. Assess mobility of the right leg c. Observe the surgical incision d. Compare pedal pulses bilaterally 33. The nurse is teaching an older male client who lives alone and has minimal memory loss about a newly prescribed medication. What actions should the nurse take? (select all that apply) a. Teach family about administration of the medication. b. Provide a quiet, calm environment when teaching. c. Assess for possible sensory deficits before beginning teaching. d. Provide printed materials about medication actions and side effects. e. Ask the client to repeat back the medication information 34. The daughter of an older woman, who has Parkinson’s disease, calls the clinic and reports that her mother has been confused for the past week. What actions should the nurse take? (select all that apply) a. Encourage increased intake of high protein foods b. Determine if the mother has recently experienced a fall c. Ask if the mother is experiencing any pain with urination d. Instruct the daughter to check her mother’s temperature e. Review the client’s current food and medication allergies 35. The nurse is preparing an older client for discharge following cataract extraction. Which instruction should the nurse include in discharge teaching? a. Have someone stay with you at all times for six weeks following surgery. b. Keep eye drops close at hand for use when vision is cloudy. c. Avoid straining at stool, stooping, or lifting heavy objects. d. Do not try to read for at least six weeks 36. When reviewing an older client’s daily laboratory findings, the nurse notes that the blood urea nitrogen (BUN) level is 23 mg/dk (8.2mmol/L). Which action should the nurse take first? a. Report the finding to the healthcare provider. b. Review prior BUN findings in the client’s record. c. Encourage client to increase fluid intake. d. Monitor the client’s daily intake and output. 37. The nurse is arranging a class that includes eight hours of content. All members of the class are over the age of 75. Which class arrangement promotes the best learning? a. Sixteen short, independent study modules. b. Two four-hour classroom seminars. c. One all-day workshop presentation d. Eight one-hour long classes 38. An older client is receiving an IV of 5% dextrose in 0.45% normal saline at 75 ml/hour. Which assessment finding indicates to the nurse that the client is developing a complication from this therapy? a. Episodes of vertigo and loss of balance b. Pulse rate 110 beat/minute and dyspnea upon exertion. c. Capillary refill measured at 3 seconds. d. Average daily urinary output of 1200 ml 39. An older male client who works as a supervisor for a construction company complains to the nurse during his annual physical exam that he is too tired to get on the roof in the afternoons to check the work of his crew. What response should the nurse offer? a. Determine if he can delegate the roof jobs to a younger employee. b. Recommend that he retire from the position c. Review his risk factors for injury and its impact on his quality of life. d. Advise him that fatigue is a common characteristic of