HESI PN GERONTOLOGY V1 & V2 TEST BANK 200 EXAM QUESTIONS WITH CORRECT ANSWERS AND DETAILED RATIONALES FOR THE EVOLVE EXIT EXAM

HESI PN GERONTOLOGY V1 & V2 TEST BANK 200 EXAM QUESTIONS WITH CORRECT ANSWERS AND DETAILED RATIONALES FOR THE EVOLVE EXIT EXAM 1. An older adult client reports increased difficulty seeing at night and trouble distinguishing colors. These symptoms are most consistent with which age-related change? A. Glaucoma B. Macular degeneration C. Cataract formation D. Diabetic retinopathy Correct Answer: C. Cataract formation Cataracts cause cloudy lens opacity leading to decreased night vision, blurred vision, and color distortion. Glaucoma typically causes peripheral vision loss, macular degeneration affects central vision, and diabetic retinopathy causes floaters and vision fluctuations. ________________________________________ 2. The practical nurse is assessing an older client's gait. Which finding is considered a normal age-related change? A. Shuffling gait with short steps B. Widened base of support C. Toe-first walking pattern D. Rapid, jerky movements Correct Answer: B. Widened base of support Older adults typically develop a widened base of support and slower gait to compensate for decreased balance and stability. Shuffling gait, toe-first walking, and rapid jerky movements are abnormal findings requiring further assessment. ________________________________________ 3. An older client prescribed digoxin has a serum potassium level of 3.1 mEq/L. The practical nurse should be most concerned about which complication? A. Hyperglycemia B. Digoxin toxicity C. Hypertension D. Renal failure Correct Answer: B. Digoxin toxicity Hypokalemia (potassium 3.5 mEq/L) predisposes clients to digoxin toxicity. Signs include abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, and AV dissociation. ________________________________________ 4. Which intervention is most important for the practical nurse to include in a fall prevention plan for an older adult client? A. Restrict fluid intake after 6 PM B. Keep bed in lowest position with brakes locked C. Encourage client to wear socks without nonskid soles D. Place all personal items out of reach to encourage mobility Correct Answer: B. Keep bed in lowest position with brakes locked Keeping the bed in the lowest position with brakes locked reduces injury risk if the client falls. Nonskid footwear should be encouraged, fluids should not be restricted without medical indication, and personal items should be within reach. ________________________________________ 5. The practical nurse is caring for an older client with a stage 2 pressure ulcer on the sacrum. Which wound characteristic would the PN expect to observe? A. Nonblanchable erythema B. Partial-thickness skin loss with exposed dermis C. Full-thickness tissue loss with exposed bone D. Intact skin with discoloration Correct Answer: B. Partial-thickness skin loss with exposed dermis Stage 2 pressure ulcers involve partial-thickness skin loss with exposed dermis, presenting as a shallow open ulcer with a red-pink wound bed, without slough. Stage 1 shows nonblanchable erythema, stage 3 involves full-thickness loss, and stage 4 exposes bone or tendon. ________________________________________ 6. An older adult client with Alzheimer disease is started on donepezil. The practical nurse should evaluate the medication's effectiveness by assessing which parameter? A. Increased appetite and weight gain B. Improved ability to solve simple problems C. Decreased agitation and wandering D. Improved sleep patterns Correct Answer: B. Improved ability to solve simple problems Donepezil is a cholinesterase inhibitor used to improve cognitive functioning in Alzheimer disease. Effectiveness is assessed by improvements in memory, attention, reasoning, and problem-solving abilities. ________________________________________ 7. Which statement by an older client indicates an understanding of proper nutrition for bone health? A. "I should take calcium supplements on an empty stomach." B. "I need adequate vitamin D to help absorb calcium." C. "I only need to worry about calcium after age 80." D. "Dairy products are the only source of calcium." Correct Answer: B. "I need adequate vitamin D to help absorb calcium." Vitamin D is essential for calcium absorption. Calcium supplements should be taken with food for better absorption. Bone health is important throughout aging, and calcium can be obtained from various dietary sources. ________________________________________ 8. The practical nurse notes that an older client's international normalized ratio (INR) is 5.0 while taking warfarin. Which action should the PN anticipate? A. The provider will increase the warfarin dose B. The provider will decrease the warfarin dose C. The provider will maintain the current warfarin dose D. The provider will add heparin to the medication regimen Correct Answer: B. The provider will decrease the warfarin dose The therapeutic INR range is typically 2.0 to 4.5 depending on the condition. An INR of 5.0 is above therapeutic range, indicating increased bleeding risk, requiring warfarin dose reduction. ________________________________________ 9. An older client with benign prostatic hypertrophy (BPH) asks about complications of untreated BPH. Which response by the PN is most accurate? A. "Untreated BPH leads to prostatitis." B. "Untreated BPH causes painful kidney stones." C. "Untreated BPH will develop into bladder infection." D. "Untreated BPH causes urinary reflux and possibly hydronephrosis." Correct Answer: D. "Untreated BPH causes urinary reflux and possibly hydronephrosis." Untreated BPH can lead to urinary retention, increased bladder pressure, urinary reflux, and hydronephrosis (kidney swelling) due to backflow of urine. ________________________________________ 10. Which physiological change of aging contributes to increased risk of constipation in older adults? A. Increased gastric acid secretion B. Decreased intestinal motility