Analyzed Gerontology HESI test Exam
Questions With 100% Verified
Solutions
A patient you diagnosed with hypothyroidism was started on levothyroixine. At
what interval should the GNP reassess her TSH?
1 to 2 weeks
2 to 4 weeks
4 to 6 weeks
6 to 8 weeks - ANSWER -6 to 8 weeks
In the treatment of hypothyroidism, T4 replacement is needed in the form of
levothyroixine (Synthroid or Levoxyl). The initial dosages for an adult is 75 to 125
mcg. For an elderly person, the dose is 75% less than the adult dosage. Because of
the long half-life of levothyroxine, the effects of a dosage adjustment or initiation
would not cause a change in TSH for approximately five to six drug half-lives, or
about 6 to 8 weeks.
A 67-year-old diabetic has been taking oral anti-hypoglycemics and is still having
poor glycemic control. You make the decision to start insulin therapy. He weighs
60 kg. What should you order as an initial starting dose?
6 units short-acting insulin at breakfast, continue oral medication
6 units intermediate insulin at bedtime, stop oral medication
6 units long-acting before breakfast, stop oral medication
6 units long-acting insulin at bedtime, continue oral medication - ANSWER -6
units long-acting insulin at bedtime, continue oral medication
The American Diabetic Association algorithm for initiation and adjustment of
therapy (2006) suggests an intermediate or long-acting insulin to be started at
bedtime or morning as a once daily dose. The starting dose is either 10 units or 0.2
,units per kilogram. Oral medication should be continued except for discontinuing
sulfonylureas or meglitinides.
A 65 year patient has sub-occipital and posterior cranial head pain following a fall.
The GNP conducts a musculoskeletal assessment by:
Palpating the acromioclavicular joint.
Assessing the gleno-humeral range of motion.
Palpating the cervical vertebrae.
Palpating anterior the thoracic muscles. - ANSWER -Palpating the cervical
vertebrae.
The patient who is complaining of sub-occipital, posterior head pain should have
the cervical vertebrae assessed. Additionally, the GNP will palpate the posterior
neck muscles and assess the neck for range of motion.
A 67-year-old female is in the office with cataracts. She is asking what she needs
to do about this. The GNP understands that all of the following are management
for this except:
Surgery may be necessary if the cataract markedly decreases visual acuity.
No drugs are available that will halt the progression of the aging process of the
eye.
Vision correction with corrective lenses are available if the cataracts are in the
early stages.
Ophthalmic steroids that decrease the severity are available by prescription from
an ophthalmologist. - ANSWER -Ophthalmic steroids that decrease the severity are
available by prescription from an ophthalmologist.
No topical or oral medications exists that will cure or treat this condition.
However, there are surgical options.
You are providing patient education to a patient who has recently been diagnosed
with shingles. Which of the following is NOT true of the way this patient should
care for his rash?
, He should leave the rash uncovered to speed healing.
He should keep the rash covered.
He should keep the rash clean and dry.
He should use only nonadhesive bandages on the rash. - ANSWER -He should
leave the rash uncovered to speed healing.
Patients with herpes zoster - shingles - should keep their rashes clean, dry, and
covered. The adhesive in bandages can irritate the shingles, so only nonadhesive
bandages should be used.
You are providing care for a patient who has been admitted to the hospital after a
fall. Which of the following is NOT appropriate when providing patient education
for when the patient returns home?
The patient should resume regular activities as soon as possible.
The patient should avoid returning to full activity until he is fully recovered.
The patient should take extra care of his feet.
The patient should engage in some type of regular exercise. - ANSWER -The
patient should avoid returning to full activity until he is fully recovered.
Patients who have suffered a fall should return to normal activity as soon as
possible. Avoiding routine activities may increase fear of falling and actually
increase the risk of falling. Regular exercise and foot care can also help reduce the
risk of falls.
Which of the following is true when performing a functional assessment with a
geriatric patient?
It may be necessary to allow more time for the assessment if the patient has
impaired mobility.
It is not necessary to perform the assessment if the patient uses a wheelchair.
It may be necessary to bring in someone to assist the patient with the assessment.
, It is only necessary when the patient returns for follow-up after treatment. -
ANSWER -It may be necessary to allow more time for the assessment if the patient
has impaired mobility.
Functional assessments may take longer with geriatric patients due to impaired
mobility. Allow for extra time to conduct the functional assessment if you are
working with a geriatric patient whose mobility is limited.
You are managing a patient who has irritable bowel syndrome (IBS). Altering the
gut pain threshold in IBS is a possible therapeutic outcome with the use of:
amitriptyline (Elavil)
loperamide (Immodium)
dicyclomine (Bentyl)
metrodionazole (Flagyl) - ANSWER -amitriptyline (Elavil)
Low dose tricyclic antidepressant or selective serotonin reuptake inhibitor use can
be helpful in altering the gut pain threshold, resulting in less abdominal pain.
Imodium and Bentyl are prescribed to treat diarrhea. Flagyl is not used in IBS, but
is used to treat certain types of infectious colitis.
Which of the following is NOT a sign of depression in an older adult?
She neglects personal grooming.
She has difficulty concentrating.
She often becomes lost even in familiar places.
She worries about lapses in memory. - ANSWER -She often becomes lost even in
familiar places.
Older adults who are depressed may have trouble concentrating or may have
memory lapses. They often express concern about these lapses. Depression may
lead to neglect of personal grooming as well. Depression does not lead to patients
being disoriented or becoming easily lost. These symptoms are more often
associated with dementia.
Questions With 100% Verified
Solutions
A patient you diagnosed with hypothyroidism was started on levothyroixine. At
what interval should the GNP reassess her TSH?
1 to 2 weeks
2 to 4 weeks
4 to 6 weeks
6 to 8 weeks - ANSWER -6 to 8 weeks
In the treatment of hypothyroidism, T4 replacement is needed in the form of
levothyroixine (Synthroid or Levoxyl). The initial dosages for an adult is 75 to 125
mcg. For an elderly person, the dose is 75% less than the adult dosage. Because of
the long half-life of levothyroxine, the effects of a dosage adjustment or initiation
would not cause a change in TSH for approximately five to six drug half-lives, or
about 6 to 8 weeks.
A 67-year-old diabetic has been taking oral anti-hypoglycemics and is still having
poor glycemic control. You make the decision to start insulin therapy. He weighs
60 kg. What should you order as an initial starting dose?
6 units short-acting insulin at breakfast, continue oral medication
6 units intermediate insulin at bedtime, stop oral medication
6 units long-acting before breakfast, stop oral medication
6 units long-acting insulin at bedtime, continue oral medication - ANSWER -6
units long-acting insulin at bedtime, continue oral medication
The American Diabetic Association algorithm for initiation and adjustment of
therapy (2006) suggests an intermediate or long-acting insulin to be started at
bedtime or morning as a once daily dose. The starting dose is either 10 units or 0.2
,units per kilogram. Oral medication should be continued except for discontinuing
sulfonylureas or meglitinides.
A 65 year patient has sub-occipital and posterior cranial head pain following a fall.
The GNP conducts a musculoskeletal assessment by:
Palpating the acromioclavicular joint.
Assessing the gleno-humeral range of motion.
Palpating the cervical vertebrae.
Palpating anterior the thoracic muscles. - ANSWER -Palpating the cervical
vertebrae.
The patient who is complaining of sub-occipital, posterior head pain should have
the cervical vertebrae assessed. Additionally, the GNP will palpate the posterior
neck muscles and assess the neck for range of motion.
A 67-year-old female is in the office with cataracts. She is asking what she needs
to do about this. The GNP understands that all of the following are management
for this except:
Surgery may be necessary if the cataract markedly decreases visual acuity.
No drugs are available that will halt the progression of the aging process of the
eye.
Vision correction with corrective lenses are available if the cataracts are in the
early stages.
Ophthalmic steroids that decrease the severity are available by prescription from
an ophthalmologist. - ANSWER -Ophthalmic steroids that decrease the severity are
available by prescription from an ophthalmologist.
No topical or oral medications exists that will cure or treat this condition.
However, there are surgical options.
You are providing patient education to a patient who has recently been diagnosed
with shingles. Which of the following is NOT true of the way this patient should
care for his rash?
, He should leave the rash uncovered to speed healing.
He should keep the rash covered.
He should keep the rash clean and dry.
He should use only nonadhesive bandages on the rash. - ANSWER -He should
leave the rash uncovered to speed healing.
Patients with herpes zoster - shingles - should keep their rashes clean, dry, and
covered. The adhesive in bandages can irritate the shingles, so only nonadhesive
bandages should be used.
You are providing care for a patient who has been admitted to the hospital after a
fall. Which of the following is NOT appropriate when providing patient education
for when the patient returns home?
The patient should resume regular activities as soon as possible.
The patient should avoid returning to full activity until he is fully recovered.
The patient should take extra care of his feet.
The patient should engage in some type of regular exercise. - ANSWER -The
patient should avoid returning to full activity until he is fully recovered.
Patients who have suffered a fall should return to normal activity as soon as
possible. Avoiding routine activities may increase fear of falling and actually
increase the risk of falling. Regular exercise and foot care can also help reduce the
risk of falls.
Which of the following is true when performing a functional assessment with a
geriatric patient?
It may be necessary to allow more time for the assessment if the patient has
impaired mobility.
It is not necessary to perform the assessment if the patient uses a wheelchair.
It may be necessary to bring in someone to assist the patient with the assessment.
, It is only necessary when the patient returns for follow-up after treatment. -
ANSWER -It may be necessary to allow more time for the assessment if the patient
has impaired mobility.
Functional assessments may take longer with geriatric patients due to impaired
mobility. Allow for extra time to conduct the functional assessment if you are
working with a geriatric patient whose mobility is limited.
You are managing a patient who has irritable bowel syndrome (IBS). Altering the
gut pain threshold in IBS is a possible therapeutic outcome with the use of:
amitriptyline (Elavil)
loperamide (Immodium)
dicyclomine (Bentyl)
metrodionazole (Flagyl) - ANSWER -amitriptyline (Elavil)
Low dose tricyclic antidepressant or selective serotonin reuptake inhibitor use can
be helpful in altering the gut pain threshold, resulting in less abdominal pain.
Imodium and Bentyl are prescribed to treat diarrhea. Flagyl is not used in IBS, but
is used to treat certain types of infectious colitis.
Which of the following is NOT a sign of depression in an older adult?
She neglects personal grooming.
She has difficulty concentrating.
She often becomes lost even in familiar places.
She worries about lapses in memory. - ANSWER -She often becomes lost even in
familiar places.
Older adults who are depressed may have trouble concentrating or may have
memory lapses. They often express concern about these lapses. Depression may
lead to neglect of personal grooming as well. Depression does not lead to patients
being disoriented or becoming easily lost. These symptoms are more often
associated with dementia.
