GERO HESI PRACTICE EXAN QUESTIONS
AND ANSWERS
An older male client is admitted to the hospital with left-sided heart failure (HF). Which
finding should the registered nurse (RN) document that is consistent with HF?
A. Ascites
B. Pitting edema
C. Jugular distention
D. Coarse and fine crackles - Answer-(D) Coarse and fine crackles
Rationale: In left-sided heart failure, the inadequacy of pumping blood into the aorta
causes blood to back up into the pulmonary capillaries; this pushes intravascular fluid
into the alveoli, which is manifested as crackles or rales. (A, B and C) are manifested in
right-sided heart failure.
An older woman asks the registered nurse (RN) how she can decrease her chances of
getting cystitis. What information should the RN provide?
A. Void and empty the bladder completely every 2 to 3 hours
B. Take warm sits baths with bubble bath to cleanse the vulva
C. Decrease fluid volume intake to reduce urgency
D. Test urine pH daily using over-the-counter (OTC) dipsticks - Answer-(A) Void and
empty the bladder completely every 2 to 3 hours
Rationale: (A) minimizes over distention, which can compromise blood supply to the
bladder wall and cause irritation to the bladder. (B and C) increase irritation to the
bladder. Although (D) can inform the client of the risk of developing cystitis, testing does
not help decrease the risk of bladder infections.
An older female client who is a new resident at an assisted living facility cannot
remember how to get to her room. What action should the registered nurse (RN)
implement?
A. Schedule therapy and social activities in her room
B. Ask another resident to help the client
C. Show client how to follow hallway signs to her room
D. Move client to a room close to nurses station - Answer-(C) Show client how to follow
hallway signs to her room
Rationale: Teaching the client how to follow hallway signs to her room (B) provides cues
and reminders that foster independence. (A) limits social stimulation in her residential
environment. (B) may be helpful and fosters peer relationships and trusts, but the
client's independence should be fostered first. (D) often contributes to further confusion.
,An older female client arrives for an annual visit by the urologist due to a history of
changes in serum values related to renal function. What changes should the registered
nurse (RN) expect for an older client due to normal aging?
A. Decrease in glomerular filtration rate (GFR)
B. Hematuria during urinalysis
C. Chronic bladder infections
D. Urinary incontinence - Answer-(A) Decrease in glomerular filtration rate (GFR)
Rationale: GFR often decreases (A) with normal aging due to a decrease in blood flow
through the kidneys, causing renal function test results to vary the clearance of
metabolic waste. (B, C and D) are not normal outcomes of aging.
The nursing assessment of an older female elicits information that the client is
diagnosed with Raynaud's phenomenon. Which exposure should the nurse instruct the
client to avoid?
A. Alcohol consumption
B. Warm climates
C. Cold climates
D. Active exercise - Answer-(C) Cold climates
Rationale: Exposure to cold environments (C) can cause prolonged painful
vasoconstriction of the peripheral extremities (especially in hands) in client's with
Raynaud's phenomenon. (B) provides the best environment for clients suffering from
this disease. There is no correlation between (A) or (D) that exacerbates Raynaud's
symptoms.
An older resident is newly admitted to an assisted living community. Which actions
should the registered nurse (RN) implement to provide the resident ways to maintain
safe medication administration? (Select all that apply.)
A. Locked medication storage in the client's room
B. Medication administration record (MAR)
C. Payment forms for prescribed medications
D. Delivery of adequate supply of medication
E. List of findings indicating medication effectiveness - Answer-(A), (B), (D), (E)
Rationale: (A, B, D and E) are correct. For safe self-medication in an assisted living
community, the resident should be provided a locked storage box (A), create a
medication administration record to monitor medication (B), establish adequate
medication supply (D) and a reference to evaluate the effectiveness of medications (E).
(C) is not the responsibility of the nurse.
An older male client is seeking counseling about his recent sexual issues with his
partner. What issue should the registered nurse (RN) explore in this discussion?
A. Certain mediations may impact sexual function
B. Normal aging affects sexual function in male clients
, C. Safe sex is not necessary with older sexually active elders
D. Sexual interest usually declines with aging in male clients - Answer-(A) Certain
medications may impact sexual function
Rationale: Certain medications can have a direct influence on sexual function and
should be discussed with older clients (A). (B) does not have drastic effects for older
male clients. Some men may experience a decline in testosterone and sperm
production, but sexual dysfunction is not a part of normal aging in the male client. The
incidence of STIs has increased and may be related to a lack of education for this age
group about preventative measures (C). Older clients continue to have interest in sex
(D) as long as there is not a direct influence of medication side effects that cause sexual
dysfunction
An older male client with Parkinson's disease (PD) is discharged home with levodopa-
carbidopa (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." - 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 - 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
AND ANSWERS
An older male client is admitted to the hospital with left-sided heart failure (HF). Which
finding should the registered nurse (RN) document that is consistent with HF?
A. Ascites
B. Pitting edema
C. Jugular distention
D. Coarse and fine crackles - Answer-(D) Coarse and fine crackles
Rationale: In left-sided heart failure, the inadequacy of pumping blood into the aorta
causes blood to back up into the pulmonary capillaries; this pushes intravascular fluid
into the alveoli, which is manifested as crackles or rales. (A, B and C) are manifested in
right-sided heart failure.
An older woman asks the registered nurse (RN) how she can decrease her chances of
getting cystitis. What information should the RN provide?
A. Void and empty the bladder completely every 2 to 3 hours
B. Take warm sits baths with bubble bath to cleanse the vulva
C. Decrease fluid volume intake to reduce urgency
D. Test urine pH daily using over-the-counter (OTC) dipsticks - Answer-(A) Void and
empty the bladder completely every 2 to 3 hours
Rationale: (A) minimizes over distention, which can compromise blood supply to the
bladder wall and cause irritation to the bladder. (B and C) increase irritation to the
bladder. Although (D) can inform the client of the risk of developing cystitis, testing does
not help decrease the risk of bladder infections.
An older female client who is a new resident at an assisted living facility cannot
remember how to get to her room. What action should the registered nurse (RN)
implement?
A. Schedule therapy and social activities in her room
B. Ask another resident to help the client
C. Show client how to follow hallway signs to her room
D. Move client to a room close to nurses station - Answer-(C) Show client how to follow
hallway signs to her room
Rationale: Teaching the client how to follow hallway signs to her room (B) provides cues
and reminders that foster independence. (A) limits social stimulation in her residential
environment. (B) may be helpful and fosters peer relationships and trusts, but the
client's independence should be fostered first. (D) often contributes to further confusion.
,An older female client arrives for an annual visit by the urologist due to a history of
changes in serum values related to renal function. What changes should the registered
nurse (RN) expect for an older client due to normal aging?
A. Decrease in glomerular filtration rate (GFR)
B. Hematuria during urinalysis
C. Chronic bladder infections
D. Urinary incontinence - Answer-(A) Decrease in glomerular filtration rate (GFR)
Rationale: GFR often decreases (A) with normal aging due to a decrease in blood flow
through the kidneys, causing renal function test results to vary the clearance of
metabolic waste. (B, C and D) are not normal outcomes of aging.
The nursing assessment of an older female elicits information that the client is
diagnosed with Raynaud's phenomenon. Which exposure should the nurse instruct the
client to avoid?
A. Alcohol consumption
B. Warm climates
C. Cold climates
D. Active exercise - Answer-(C) Cold climates
Rationale: Exposure to cold environments (C) can cause prolonged painful
vasoconstriction of the peripheral extremities (especially in hands) in client's with
Raynaud's phenomenon. (B) provides the best environment for clients suffering from
this disease. There is no correlation between (A) or (D) that exacerbates Raynaud's
symptoms.
An older resident is newly admitted to an assisted living community. Which actions
should the registered nurse (RN) implement to provide the resident ways to maintain
safe medication administration? (Select all that apply.)
A. Locked medication storage in the client's room
B. Medication administration record (MAR)
C. Payment forms for prescribed medications
D. Delivery of adequate supply of medication
E. List of findings indicating medication effectiveness - Answer-(A), (B), (D), (E)
Rationale: (A, B, D and E) are correct. For safe self-medication in an assisted living
community, the resident should be provided a locked storage box (A), create a
medication administration record to monitor medication (B), establish adequate
medication supply (D) and a reference to evaluate the effectiveness of medications (E).
(C) is not the responsibility of the nurse.
An older male client is seeking counseling about his recent sexual issues with his
partner. What issue should the registered nurse (RN) explore in this discussion?
A. Certain mediations may impact sexual function
B. Normal aging affects sexual function in male clients
, C. Safe sex is not necessary with older sexually active elders
D. Sexual interest usually declines with aging in male clients - Answer-(A) Certain
medications may impact sexual function
Rationale: Certain medications can have a direct influence on sexual function and
should be discussed with older clients (A). (B) does not have drastic effects for older
male clients. Some men may experience a decline in testosterone and sperm
production, but sexual dysfunction is not a part of normal aging in the male client. The
incidence of STIs has increased and may be related to a lack of education for this age
group about preventative measures (C). Older clients continue to have interest in sex
(D) as long as there is not a direct influence of medication side effects that cause sexual
dysfunction
An older male client with Parkinson's disease (PD) is discharged home with levodopa-
carbidopa (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." - 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 - 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
