HESI GERONTOLOGY RN

HESI GERONTOLOGY EXAM RN Which statement is true about rehab and restorative care for older adults? A PERSON CAN LEARN SKILLS AND GAIN ABILITIES THAT ENABLE FUNCTIONING An older adult is in the hospital because of HF and has become incontinent of urine. Which EB resource should the nurse use to guide continence care for this pt? NURSING STANDARD PRACTICE PROTOCOL The nurse understands that stress incontinence occurs? AS A RESULT OF INCEASED INTRAABDOMINAL PRESSURE A large residual urine volume characterizes what type of incontinence? OVERLFOW Which action should be included in all bladder-retraining programs? TOILETING AT BEDTIME The nurse assess a male resident in a NH for urinary incontinence and determines that he is unaware of the problem. Which recommendation should the nurse implement? PROVIDE REGULAR TOILETING The nurse wants to begin helping a resident who is overweight and has urinary incontinence with healthy bladder behavior skills. Which intervention should the nurse implement? SCHEDULE VOIDING AT 2-4 HR INTERVALS What is the most important aspect of care for the nurse to maintain when assisting an older pt with urinary incontinence? MAINTAINING AN ATTITUDE THAT IS RESPECTFUL ABOUT RESLOVING THE PROBLEM An older woman tells the NP that she fears her family will place her in a NH because she developed stress incontinence. Which recommendation should the nurse implement? RECOMMEND EXERCISES TO STRENGTHEN THE PELVIC FLOOR The nurse is caring for a pt who has recently had an indwelling catheter placed. The nurse should assess the pt for? A CHANGE IN MENTAL STATUS An older adult who is on bedrest after surgery is prescribed morphine for pain. Which of the following is the nurse’s priority for preventive care? CONSTIPATION Which of the following statements is a true about elimination in older adults? DEFACATION < 1 DAY IS NOT NECESSARILY CONSTIPATION Which option is part of the program that addresses bowel incontinence in an older adult pt? ENSURING THAT A TOILET OR COMMODE IS READILY ACCESSIBLE TO THE PT Which is an important consideration about the skin of an older adult person? THE SKIN BECOMES MORE VULNERABLE TO DAMAGE Which topical agent is safe to apply? LIGHT MINERAL OIL TO MOISTEN SKIN AFTER BATHING HESI GERONTOLOGY EXAM RN A 70 yr old woman complains of dry skin and asks for advice. Which advice should the nurse offer to this woman for improving dry skin? KEEP BATH WATER BETWEEN 90* AND 105*F The nurse monitors for which clinical indicator when the older adult complains of pruritus? COARSE SKIN Which infection control practice should the nurse implement when caring for an older adult who has active herpes zoster? COVER RUPTURED SKIN LESIONS WITH A NONABSORBENT DRESSING The nurse is conducting an admission assessment on an older adult and notes a small lesion with a multicolor appearance. Which assessment approach should the nurse use? ABCD RULE (ASYMMETRY, BORDER, COLOR, DIAMETER) The nurse cares for an older man who has a malignant melanoma. Which intervention should the nurse implement for this man to prevent a recurrence or advancement of this condition in the future? INSTRUCT HIM TO WEAR SUN-PROTECTIVE CLOTHING AND A HAT AT ALL TIMES Which of the following is a true statement about impaired skin integrity? MUSCLE AND FAT CANNOT REGENERATE An older adult is vitamin deficient. Which of the following does the nurse offer to the older adult to provide the important missing vitamin for maintaining healthy skin and enhancing tissue repair? ORANGE SLICES An older adult woman complains of foot plain from a corn. After assessing her feet, which intervention should the nurse implement to alleviate her from discomfort? CUT OUT AN OVAL CORN PAD TO MAKE A U SHAPE Which of the following statements is true about Medicare for older adults? 80% OF MEDICARE’S ANNUAL EXPENDITURES ARE FOR INDIVIDUALS WITH CHRONIC ILLNESS Acute illness is to chronic illness as to which of the following comparisons? AN ER IS TO A NH An older female pt is dx with a chronic illness. Which principle should the nurse apply when answering her questions? CHRONIC ILLNESS IS UNENDING AND COPING CAN BE INFLUENCED BY THE PERCEPTION OF UNCERTAINTY Over 50% of the population, aged 65 + yrs, suffers from which one of the following chronic health conditions? HTN AND ARTHRITIS Which older adult has the most characteristics associated with becoming frail? MALE, HISPANIC AMERICAN, WITH HYPOPROTEINEMIA HESI GERONTOLOGY EXAM RN Which of the following describes the nurse’s role for an older pt with a chronic illness? PROVIDE CARING TO HELP THE PT LIVE AT THE OPTIMAL LEVEL OF HEALTH AND WELLNESS Which of the following statements is the most suitable for establishing goals when teaching an older adult with a chronic illness about potential changes in the health maintenance regimen? MANAGEMENT OF THE PT’S CHRONIC DISEASE RESTS ON THE PT AND THE CAREGIVER; THEREFORE THE GOALS SHOULD BE COLLABORATIVELY SET Compared with acute pain, the following is true of persistent pain? IT CAN BRING ABOUT CHANGES IN LIFESTYLE The nurse admits an older male pt who had ABD surgery. On admission, VS signs are: P73, R-20, BP-136/84. He is receiving IV fluids but has not requested pain meds since surgery. 7 hrs later, his VS are: P-98, R-26, BP-164/90, and he denies pain. Which intervention should the nurse implement? ASK HIM ABOUT DISCOMFORT AT THE SURGICAL SITE. (USE OLD CART – onset, location, duration, characteristics, aggravation, relieving factors, and treatments previously used) An older female adult had hip replacement surgery 1 day ago, and the nurse thinks that the woman also has dementia. Which pt assessment does the nurse use to determine that this woman is experiencing pain? HOLDS ABD TIGHTLY An older male adult who is Hispanic states he is not having pain, but he had knee replacement surgery 2 days ago. Which is the best assessment tool as recommended by the Hartford Institute for Geriatric Nursing from “Try This” for the nurse to apply for this man? FACES PAIN SCALE-REVISED The safest opioid analgesic choice for an older pt who has severe acute pain is which of the following? MORPHINE SULFATE (MORPHINE) An older adult admitted for back surgery asks for opioid pain meds. The nurse knows the pt asked for meds 15 min before it is due. Which recommendation should the nurse implement? ADMINISTER THE PAIN MEDS AS PRESCRIBED The nurse administers an opioid analgesic to an older male postoperative pt on a surgical unit. Which is the most important intervention for the nurse to implement before leaving the pt? INSTRUCT HIM TO ASK FOR HELP BEFORE GETTING UP POSITION THE PT COMFORTABLY The nurse plans the care of an older female resident of a NH who has experienced a sudden deterioration in visual acuity. The nurse administers an opioid analgesic to an older male postoperative pt on a surgical unit. Which is the most important intervention for the nurse complete first? EXAMINE HER MOOD AND FUNCTIONAL STATUS The most detrimental illness or condition that an older adult with deafness that occurred at birth can experience is which one of the following? CATARACTS HESI GERONTOLOGY EXAM RN Which of the following diseases affects the eyesight of an older adult by damaging the central part of the retina? MACULAR DEGENERATION Which population groups are at most risk for macular degeneration? • 60 + YRS • WHITES AND ASIANS • WHITE WOMAN 80 + • GENETIC PREDISPOSITION • SMOKERS • FAMILY HX • EXCESSIVE SUNLIGHT What does the nurse teach the pt with retinopathy to slow its progression? • CONSTANT, STRICT CONTROLS OF BLOOD GLUCOSE, CHOLESTEROL, BP, AND LASER PHOTOCOAGULATION TREATMENTS CAN HALT DISEASE • LASER TREATMENT CAN REDUCE VISION LOSS IN 50% OF PTS AND RECENT EVIDENCE SUGGESTS THAT TREAMENT WITH VARIOUS DRUGS MAY BE BETTER • AVOID WIND, AND HAIR DRYERS • USE HUMIDIFIERS AT HOME • USE ARTIFICAL TEAR OINTMENT AT HS An older adult complains about experiencing dry eyes daily. Which of the following should the nurse assess to help determine the cause of the pt’s complaint? • ANTIHISAMINE PRESCRIPTION • DIURETICS • BETA BLOCKERS • SOME SLEEPING PILLS • VITAMIN A DEFICIENCY The nurse is teaching older adults maintaining health and wellness. Which recommendation should the nurse include in the teaching to maintain optimal vision? WEAR SUNGLASSES THAT BLOCK SUN RAYS How does the nurse approach the hearing impaired elder for conversation? • FACE THE PT, SIT OR STAND ON THE SAME LEVEL, DON’T TURN AWAY WHILE SPEAKING • GAIN THE ATTENTION BEFORE SPEAKING, LOOK DIRECTLY AT PT AT EYE LEVEL • CAREFULARTICULATION AND MODERATE SPEED OF SPEECH • USE NONVERBAL APPROACHES- GESTURES, DEMONSTRATIONS, VISUAL AIDS, WRITTEN MATERIALS • PAUSE BETWEEN SENTENCES OR PHRASES TO CONFIRM UNDERSTANDING HESI GERONTOLOGY EXAM RN • REDUCE BACKGROUND NOISE • VERIFY THAT INFO HAD BEEN CLEARLY UNDERSTOOD – REMEMBER PT MAY AGREE WITH EVERYTHING YOU SAY Persons with normal age related sensory changes are likely to have most difficulty distinguishing which of the following? SPOKEN PAIRS OF PHRASES LIKE “SHE’S PRAISED” AND “FEES RAISED” Which of the following is used to treat the most common cause of impairment to an older adults hearing? EAR CANAL IRRIGATION A medical illustration shows a man the blunt end of a tuning fork pressed to the center of his forehead. The man is being tested for which of the following? UNILATERAL CONDUCTIVE HEARING LOSS An older man who is non-Hispanic Caucasian has a fasting blood sugar level above 130 mg/dl. Which pt assessment does the nurse use to confirm a high risk for DM in this man? • RISK FACTORS: • 65 + YRS OLD • FASTING GLUCOSE > 126 • NO SMOKING OR SMOKING CESSATION • BP < 130/80 • CHOLESTEROL < 200 • LDL < 100 • HDL > 40 • TRIGLYCERIDES > 150 Which co-morbidity commonly associated with type 2 DM enhances the development of the microvascular complications of DM? HYPERLIPIDEMIA What concerns the nurse regarding pt with DM that confirms progression to chronic illness? • DIABETIC + TOE REMOVAL = HEALTH PROBLEMS (CHRONIC ILLNESS) • THE FOCUS OF MANAGEMENT IS GEARED MORE TOWARD LIFE EXPECTANCY AND THE REDOGNITION OF THE IMPORTANCE OF CARDIOVACULAR HEALTH PROMOTING STRATEGIES • SELF MANAGEMENT SKILLS: • NUTRITION • EXERCISE PLAN • MED USE • BLOOD GLUCOSE • FEET CARE HESI GERONTOLOGY EXAM RN The nurse assists an older man who has DM type 2 to improve his glucose control. Which of the following instructions does the nurse give to this individual when he plans to walk more than usual in one day? SUPPLEMENT CALORIC INTAKE • MEN – 60+ NEED • WOMEN 60+ NEED • LIMIT SATURATED FATS FROM DIET • BALANCE EXERCISE AND DIET Which is a true statement about osteoporosis? A HIGH RISK OF DEATH FOLLOWS AN OSTEOPOROSIS-RELATED RX • NEEDS: Vitamin D, Ca, NO SMOKING An older female pt seeks advice from the nurse about preventing further bone loss after being dx with osteopenia. To achieve the woman’s goal, which teaching should the nurse provide to enhance activity of osteoblasts? EXERCISE WITH WEIGHTS (brisk walking with weights) Which are characteristics of RA that are unlike OA? IT IS SYSEMIC AND SYMMETRICAL • RA – degenerative joint disorder • OA – systemic and symmetrical Which statement is true about joints in older adults? SURGICAL JOINT REPLACEMENT CAN CURE OA (cannot be “cured” without joint replacement – arthroplasty) An osteoporosis related fall necessitated hip replacement surgery for an older female adult who is entering a rehab facility. Which id the nurse’s priority goal during this woman’s rehab? RECAPTURE PREOPERATIVE MOBILITY STATUS Which of the following statements is true about RA? CAN AFFECT BODY SYSTEMS RATHER THAN JOINTS Which of the following nursing interventions are suitable for a pt who has gout? • COLCHICINE (COLSALIDE) BY MOUTH • ALLOPURINOL • PROBENECID • ENCOURAGE 2L/DAY FLUIDS TO FLUSH URIC ACID FROM KIDNEYS Which of the following is a true statement about heart disease in men and women? WOMEN GENERALLY RECEIVE LESS AGFRESSIVE TREAMENT THAN MEN DO • MEN > 55 are dx with ANGINA & ICS • WOMEN > 55 are dx with VAGUE chest pain only – receive fewer meds – same as BLACKS Which assessment is typical for a pt with OA? NARROW JOINT SPACES WITH CREPITUS HESI GERONTOLOGY EXAM RN The nurse prepares an older male adult who has OA for discharge. Which instruction does the nurse include in pt teaching to maintain safety for this man? REPORT JOINT INSTABILITY TO THE HEALTH CARE PROVIDER An older male adult who has OA tells the nurse that he has experienced fatigue for the past 2 weeks. Which nursing intervention should the nurse implement to help him manage fatigue? HELP HIM PLAN EXERCISE AND REST Which classic sign of an AMI can be absent in an older man with an AMI? CRUSHING CHEST PAIN An African-American 58 yr old man in good health has a BP at 120/73 at his annual physical exam. Which of the following is the best goal for the nurse to assist him in maintaining his health and wellness into older age? PREVENT CARDIOVASCULAR DISEASE An older woman has severe ischemic heart disease, HTN, and low cardiac output. Which medication does the nurse administer to counteract the neurohormonal activation of this pt’s cardiovascular status? BETA-ADRENERGIC BLOCKER Which of the following is the most important plan of care to decrease the frequency of hospitalizations for acute exacerbations of HF in older adults who have HF? CONTROL FLUID BALANCE An older man in a cardiac rehab exercise class refuses to participate in the cool- down phase of the activity; consequently, 2 minutes later, he passes out but quickly regains consciousness. Which instruction does the nurse include in pt teaching to reinforce the importance of cooling down after exercising to this man? BARORECEPTOR FUNCTION DIMINISHES WITH AGE Which condition is a COPD? BRONCHITIS, ASTHMA, EMPHYSEMA An older woman who has COPD wants to perform self-care activities. Which instruction should the nurse include in pt teaching to help her achieve this goal? BATHE AND EAT SLOWLY WITH PERIODIC REST Which of the following statements is true about cardiopulmonary disease in older adults? MOUTH HYGIENE IS ESSENTIAL TO PREVENT AND TREAT PNEUMONIA Which of the following is a true statement about TB in older adults? OLDER PERSONS, PARTICULARLY THOSE IN NH, ARE AT RISK FOR TB (Homeless too) An older man who is right-handed works as a carpenter, but he has been left with a flaccid right arm after a thrombus occluded a cerebral artery. Which is the most important goal for the POC to help this man achieve his optimal state of health and wellness? COLLABORATE WITH OT Which is the fundamental difference between Medicare part A and Medicare part B? HEALTH CARE SETTING HESI GERONTOLOGY EXAM RN Which of the following statements is true about health care costs for older adults in the US? HMOs CAN OBTAIN AN EXEMPTION FROM MEDICARE’S PERCAPITA SPENDING LIMIT Managed care systems are most effective for an older adult who does which of the following? SEEKS REGULAR PRIMARY CARE AND PREVENTIVE STRATEGIES TO MAINTAIN HEALTH The older adult wants to appoint an attorney-in-fact with DPA for a specific period around a forthcoming surgery. Which should the nurse implement? HELP THE PT FIND A QUALIFIED ATTORNEY Which of the following qualities does the nurse need to provide caring? ABILITY TO CREATE A TRUSTING ENVIRONMENT Which of the following statements describes one of the following standards of case management during hospitalization? BEGIN DISCHARGE PLANNING ON THE FIRST DAY OF HOSPITALIZATION