HESI GERIATRICS LATEST EXAM 2024/2025 WITH
QUESTIONS AND VERIFIED CORRECT ANSWERS/ ALREADY
GRADED A++
The nurse is caring for a 60-year-old client who is diagnosed with
dementia. Which antipsychotic drugs would be contraindicated for the
client? -ANSWER First-generation antipsychotic drugs such as haloperidol
and chlorpromazine are contraindicated because they may increase the
risk of mortality when used to treat dementia-related psychosis in elderly
clients. Quetiapine, aripiprazole, and risperidone are second-generation
antipsychotic drugs that are not contraindicated in elderly adults suffering
from dementia-related psychosis.
When a nurse is admitting an older client to the mental health unit, it is
important to identify any signs of dementia. What signs and symptoms
denote the presence of dementia of the Alzheimer type? -ANSWER Older
clients who have dementia[1][2] often have short-term memory loss. Clients
in whom dementia is developing often have difficulty expressing
themselves (expressive aphasia) or understanding the spoken word
(receptive aphasia). Clients with the diagnosis of schizophrenia or
depression are often indecisive and ambivalent. A client who is
experiencing a manic episode of bipolar disorder experiences flight of
ideas. Loose associations between thoughts are related to schizophrenia,
not dementia.
An older adult client with dementia of the Alzheimer type frequently
switches from being pleasant and happy to being hostile and unhappy
without apparent external cause. How can the nurse best care for this
client? -ANSWER Because these clients experience lability of mood, it is
best to attempt to establish a relationship and give care when they are
feeling receptive. Although the mood swings may be pointed out to the
client, the client may still have limited contact with reality. Also, repeated
attempts to reorient the client may elicit agitated behavior. Encouraging the
client to talk about personal feelings may be of limited help; the client may
be unable to do this. Avoiding caring for the hostile client rejects the client
when the client needs the nurse most.
What age-related changes are associated with the female genitalia? -
ANSWER An elderly female client may have dry, smooth, and thin vaginal
,walls due to atrophy of the vaginal tissue and secretory glands on the
vaginal walls. Graying and thinning pubic hair and decreased size of the
labia majora and clitoris are also normal signs of aging. The client may
have increased flabbiness and fibrosis of the breasts, which hang lower on
the chest wall, along with decreased erection of the nipples.
Which age-related effects on the immune system are seen in the older
client? -ANSWER The effects of aging on the immune system include
increased autoantibodies. Expression of IL-2 receptors, delayed
hypersensitivity reaction, and primary and secondary antibody responses
decrease in older adults because of the effects of aging on the immune
system.
A 70-year-old client is diagnosed with cartilaginous degeneration. Which
action should the nurse take? -ANSWER Clients with cartilaginous
degeneration are advised to take moist heat showers because they
increase blood flow to the region. Isometric exercises are indicated for
clients with muscular atrophy. Sitting in a supportive armchair provides
support to bony structures and prevents further deformities in a client with
kyphosis. Weight-bearing exercises are indicated in clients with decreased
bone density.
The nurse is caring for an older client who is scheduled for a
bronchoscopy. Midazolam has been prescribed for the procedure. What
administration guidelines will the nurse follow? -ANSWER In an older client,
peak effect may be delayed; increments should be smaller and rate of
injection slower. When used for sedation/anxiolysis/amnesia for a
procedure, the dosage must be individualized and titrated. Midazolam
should always be titrated slowly; administer over at least 2 minutes and
allow an additional 2 or more minutes to fully evaluate the sedative effect.
Titration to effect with multiple small doses is essential for safe
administration. Central nervous system depression is the most serious side
effect. A sudden rise in blood pressure shortly after administration has not
been evidenced. Midazolam is given for sedation/anxiolysis/amnesia for a
procedure.
A married couple in their 80s is living independently. They have three adult
children. The husband, who is alert but forgetful, has an enlarged prostate
and at times is incontinent of urine. The wife has diabetes and rheumatoid
arthritis and walks with difficulty. Both need assistance with bathing,
,dressing, and meal preparation. What does the nurse suggest as the most
suitable plan for this couple? -ANSWER Care provided in the home is more
efficient and cost-effective; this couple can manage with assistance from
community resources. There is nothing in the history to demonstrate that
skilled nursing care provided by a nursing home is necessary. Because the
couple appears able to function with assistance at home, it is not necessary
to move them to another setting at this time.
A nurse is caring for an older adult with a hearing loss secondary to aging.
What can the nurse expect to identify when assessing this client? -
ANSWER Cerumen (ear wax) becomes drier and harder as a person ages.
Generally, female voices have a higher pitch than male voices; older adults
with presbycusis (hearing loss caused by the aging process) have more
difficulty hearing higher pitched sounds. There is no greater incidence of
tympanic tears caused by the aging process. The hair in the auditory canal
increases, not decreases. The epithelium of the lining of the ear becomes
thinner and drier.
The biggest problem for an older female client immediately after the
sudden death of her husband will probably be her inability to cope with
what? -ANSWER Anger at her husband for leaving her may make the client
feel guilty for having these feelings. Financial security may or may not be a
problem for this client. Loneliness is something she will have to cope with
later, depending on her support system; it is not an immediate problem.
Estrangement may be something that she will have to cope with later; it is
not an immediate problem.
What can the nurse do to help an older adult successfully complete
Erikson's major task of this stage? -ANSWER Feeling a sense of
satisfaction when considering past achievements allows the client to accept
what life is or was and helps prevent feelings of despair. Investing creative
energies in promoting social welfare is the major task of middle adulthood
(30 to 65 years). Developing deep, lasting relationships with other people
or institutions is the major task of the young adult (20 to 30 years). Feeling
a need to make up for past failings is a negative resolution of the major
task of the older adult.
The nurse is caring for an older client admitted to the hospital with type 2
diabetes. What is important for the nurse to remember about older adults
and type 2 diabetes? -ANSWER Lipolysis is not a common response to
, meeting the metabolic needs of those with type 2 diabetes; therefore,
ketones are not present in large enough amounts to cause ketoacidosis.
Adults with type 2 diabetes do secrete endogenous insulin, but secretion is
slow and in smaller than adequate amounts. The incidence of chronic
complications depends on the level of glucose control, not developmental
level. The onset of type 2 diabetes is usually gradual, whereas in type 1
diabetes, it is sudden and dramatic.
1. Why do meds need to be decreased with age?
2. Watch for what? - ANSWER 1. need to decrease amount due to
decreased liver and kidney metabolism
2. Polypharmacy
- adverse effects
- interactions
Common musculoskeletal pathologies in elderly population? (2) - ANSWER
1. Arthritis (OA, RA)
2. Osteoporosis
What is the difference b/w OA & RA? - ANSWER - types of joints involved
(OA => WBing jt i.e LS, CS, Hips, Knees)
(RA => smaller overused jts i.e CS, Shoulder, elbow, wrist, fingers, hips,
knees, ankles toes)
What is fluoroquinolone (FQ) for? - ANSWER Gram neg antibiotic for
respiratory, urogenital, and GI infections
1. FQ has a high affinity for what?
2. Toxic to what? - ANSWER 1. Connective tissue
2. Type 1 collagen & promotes collagen degeneration
Additional risk factors of tendon damage increase for elderly using FQ? (6)
- ANSWER type O blood
1. Which tendon is mostly affected using FQ?
2. Signs and symptoms? - ANSWER 1. Achilles (89.8%)
Signs and symptoms of tendon damage from FQ can occur up to how long
b/4 rupturing? - ANSWER 2 weeks
QUESTIONS AND VERIFIED CORRECT ANSWERS/ ALREADY
GRADED A++
The nurse is caring for a 60-year-old client who is diagnosed with
dementia. Which antipsychotic drugs would be contraindicated for the
client? -ANSWER First-generation antipsychotic drugs such as haloperidol
and chlorpromazine are contraindicated because they may increase the
risk of mortality when used to treat dementia-related psychosis in elderly
clients. Quetiapine, aripiprazole, and risperidone are second-generation
antipsychotic drugs that are not contraindicated in elderly adults suffering
from dementia-related psychosis.
When a nurse is admitting an older client to the mental health unit, it is
important to identify any signs of dementia. What signs and symptoms
denote the presence of dementia of the Alzheimer type? -ANSWER Older
clients who have dementia[1][2] often have short-term memory loss. Clients
in whom dementia is developing often have difficulty expressing
themselves (expressive aphasia) or understanding the spoken word
(receptive aphasia). Clients with the diagnosis of schizophrenia or
depression are often indecisive and ambivalent. A client who is
experiencing a manic episode of bipolar disorder experiences flight of
ideas. Loose associations between thoughts are related to schizophrenia,
not dementia.
An older adult client with dementia of the Alzheimer type frequently
switches from being pleasant and happy to being hostile and unhappy
without apparent external cause. How can the nurse best care for this
client? -ANSWER Because these clients experience lability of mood, it is
best to attempt to establish a relationship and give care when they are
feeling receptive. Although the mood swings may be pointed out to the
client, the client may still have limited contact with reality. Also, repeated
attempts to reorient the client may elicit agitated behavior. Encouraging the
client to talk about personal feelings may be of limited help; the client may
be unable to do this. Avoiding caring for the hostile client rejects the client
when the client needs the nurse most.
What age-related changes are associated with the female genitalia? -
ANSWER An elderly female client may have dry, smooth, and thin vaginal
,walls due to atrophy of the vaginal tissue and secretory glands on the
vaginal walls. Graying and thinning pubic hair and decreased size of the
labia majora and clitoris are also normal signs of aging. The client may
have increased flabbiness and fibrosis of the breasts, which hang lower on
the chest wall, along with decreased erection of the nipples.
Which age-related effects on the immune system are seen in the older
client? -ANSWER The effects of aging on the immune system include
increased autoantibodies. Expression of IL-2 receptors, delayed
hypersensitivity reaction, and primary and secondary antibody responses
decrease in older adults because of the effects of aging on the immune
system.
A 70-year-old client is diagnosed with cartilaginous degeneration. Which
action should the nurse take? -ANSWER Clients with cartilaginous
degeneration are advised to take moist heat showers because they
increase blood flow to the region. Isometric exercises are indicated for
clients with muscular atrophy. Sitting in a supportive armchair provides
support to bony structures and prevents further deformities in a client with
kyphosis. Weight-bearing exercises are indicated in clients with decreased
bone density.
The nurse is caring for an older client who is scheduled for a
bronchoscopy. Midazolam has been prescribed for the procedure. What
administration guidelines will the nurse follow? -ANSWER In an older client,
peak effect may be delayed; increments should be smaller and rate of
injection slower. When used for sedation/anxiolysis/amnesia for a
procedure, the dosage must be individualized and titrated. Midazolam
should always be titrated slowly; administer over at least 2 minutes and
allow an additional 2 or more minutes to fully evaluate the sedative effect.
Titration to effect with multiple small doses is essential for safe
administration. Central nervous system depression is the most serious side
effect. A sudden rise in blood pressure shortly after administration has not
been evidenced. Midazolam is given for sedation/anxiolysis/amnesia for a
procedure.
A married couple in their 80s is living independently. They have three adult
children. The husband, who is alert but forgetful, has an enlarged prostate
and at times is incontinent of urine. The wife has diabetes and rheumatoid
arthritis and walks with difficulty. Both need assistance with bathing,
,dressing, and meal preparation. What does the nurse suggest as the most
suitable plan for this couple? -ANSWER Care provided in the home is more
efficient and cost-effective; this couple can manage with assistance from
community resources. There is nothing in the history to demonstrate that
skilled nursing care provided by a nursing home is necessary. Because the
couple appears able to function with assistance at home, it is not necessary
to move them to another setting at this time.
A nurse is caring for an older adult with a hearing loss secondary to aging.
What can the nurse expect to identify when assessing this client? -
ANSWER Cerumen (ear wax) becomes drier and harder as a person ages.
Generally, female voices have a higher pitch than male voices; older adults
with presbycusis (hearing loss caused by the aging process) have more
difficulty hearing higher pitched sounds. There is no greater incidence of
tympanic tears caused by the aging process. The hair in the auditory canal
increases, not decreases. The epithelium of the lining of the ear becomes
thinner and drier.
The biggest problem for an older female client immediately after the
sudden death of her husband will probably be her inability to cope with
what? -ANSWER Anger at her husband for leaving her may make the client
feel guilty for having these feelings. Financial security may or may not be a
problem for this client. Loneliness is something she will have to cope with
later, depending on her support system; it is not an immediate problem.
Estrangement may be something that she will have to cope with later; it is
not an immediate problem.
What can the nurse do to help an older adult successfully complete
Erikson's major task of this stage? -ANSWER Feeling a sense of
satisfaction when considering past achievements allows the client to accept
what life is or was and helps prevent feelings of despair. Investing creative
energies in promoting social welfare is the major task of middle adulthood
(30 to 65 years). Developing deep, lasting relationships with other people
or institutions is the major task of the young adult (20 to 30 years). Feeling
a need to make up for past failings is a negative resolution of the major
task of the older adult.
The nurse is caring for an older client admitted to the hospital with type 2
diabetes. What is important for the nurse to remember about older adults
and type 2 diabetes? -ANSWER Lipolysis is not a common response to
, meeting the metabolic needs of those with type 2 diabetes; therefore,
ketones are not present in large enough amounts to cause ketoacidosis.
Adults with type 2 diabetes do secrete endogenous insulin, but secretion is
slow and in smaller than adequate amounts. The incidence of chronic
complications depends on the level of glucose control, not developmental
level. The onset of type 2 diabetes is usually gradual, whereas in type 1
diabetes, it is sudden and dramatic.
1. Why do meds need to be decreased with age?
2. Watch for what? - ANSWER 1. need to decrease amount due to
decreased liver and kidney metabolism
2. Polypharmacy
- adverse effects
- interactions
Common musculoskeletal pathologies in elderly population? (2) - ANSWER
1. Arthritis (OA, RA)
2. Osteoporosis
What is the difference b/w OA & RA? - ANSWER - types of joints involved
(OA => WBing jt i.e LS, CS, Hips, Knees)
(RA => smaller overused jts i.e CS, Shoulder, elbow, wrist, fingers, hips,
knees, ankles toes)
What is fluoroquinolone (FQ) for? - ANSWER Gram neg antibiotic for
respiratory, urogenital, and GI infections
1. FQ has a high affinity for what?
2. Toxic to what? - ANSWER 1. Connective tissue
2. Type 1 collagen & promotes collagen degeneration
Additional risk factors of tendon damage increase for elderly using FQ? (6)
- ANSWER type O blood
1. Which tendon is mostly affected using FQ?
2. Signs and symptoms? - ANSWER 1. Achilles (89.8%)
Signs and symptoms of tendon damage from FQ can occur up to how long
b/4 rupturing? - ANSWER 2 weeks
