Gerontology HESI Practice Exam 2022/2023 with latest Questions And Answers Graded A+

An older male client with Parkinson's disease (PD) is discharged home with levodopacarbidopa (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." Correct answer- (B) "I will notify the healthcare provider if my husband has increasing involuntary movements of his extremities." Rationale: Increasing involuntary movements (B) should be reported during the use of levodopa; it is an indicator that the body is failing to readjust to the changes in the level of the intracerebral neurotransmitter dopamine. The client should be encouraged to engage in exercise and regular daily activities (A). Socialization and activities as tolerated help to prevent the client from becoming depressed, so (C) is not indicated. Clients with PD usually are constipated due to muscle weakness, lack of exercise, and decreased fluid intake, but incontinence should not be an expectation related to PD. 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 Correct answer- (C) Reduced vital capacity Rationale: With aging, a frail elder is likely to have a reduced vital capacity (C) due to the loss of elasticity of the lung tissue. With reduced elasticity, residual volume increases (A). Arterial pH should not change with normal aging (B). A decrease, rather than an increase, in alveoli function (D) can occur due to a thinning of the alveolar walls with age. 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 Correct answer- (A) Elevate the legs on pillows Rationale: Venous insufficiency is causing intravenous fluids to move into the interstitial spaces, causing edema. To promote gravity drainage, the extremities should be elevated (A). (B) may not decrease the edema, which is due to the inability to mobilize stagnated venous blood. Dietary changes, such as (C and D) may be recommended if prescribed dietary changes are in place, but the underlying etiology is venous insufficiency. An 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 Correct answer- (A), (C), (D) and (E) Rationale: (A, C, D and E) are correct. Fluids, comfort measures, and establishment of a regular bowel pattern help reduce incidents of hemorrhoid inflammation. Weight training can aggravate hemorrhoids and is not effective in reducing hemorrhoid irritation. 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 Correct answer- (C), (D) Rationale: For older clients, the expected age-related changes in the cardiovascular system include murmurs (C) and widening pulse pressure (D). (A, B and E) are not normal findings and require further evaluation. The 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 Correct answer- (A) Debridement and removal of slough and eschar