HESI RN EVOLVE Gerontology Practice Exam

HESI RN EVOLVE Gerontology Practice Exam 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 forms for prescribed medications C) Payment forms for prescribed medications D) Delivery of adequate supply of medication E) List of findings indicating medication effectiveness A,B,D,E For safe self-medication in an assisted living community, the resident should be provided a locked storage box, create a medication administration record to monitor medication, establish adequate medication supply, and a reference to evaluate the effectiveness of medication When assessing an older client, which age-related changes in the cardiovascular system should the registered nurse (RN) document? (Select all that apply.) A) Dyspnea B) Chest pain C) Cardiac murmurs D) Widening pulse pressure E) Irregular heart rate C,D For older clients the expected age-related changes in the cardiovascular system include murmurs and widening pulse pressure An older client who recently moved into an assisted living community refuses to eat or join any activities. When evaluating the client further, what should the registered nurse (RN) focus on during the next examination? A) Anxiety B) Depression C) Exhaustion D) Confusion B Depression is a symptom that an older client is likely to experience with a sudden change in living accommodations when a loss of personal identity can create low self-esteem The registered nurse (RN) is caring for an elderly client with functional incontinence who lives in an assisted living community. The client is alert and mildly confused and can self ambulate. Which nursing intervention should the RN implement? A) Offer assistance with toileting q2 hours B) Use protective disposal undergarment instead of underwear C) Ask if the client has attempted to void q2 hours D) Obtain a prescription for intermittent catherization A Maintaining independence and self-esteem is important for an older client with incontinence. Toilet assistance decreases the client's chances of accidents and embarrassment by introducing a toilet training program The healthcare provider prescribes a new medication, atorvastatin (Lipitor, for an older client who arrives at the clinic for an annual physical examination. What common side effect should the registered nurse (RN) advise the client to observe for with this medication? A) Constipation B) Headaches C) Muscle weakness D) Nausea and vomiting B Headaches are the most common side effect with this medication, which the RN should direct the client to report The registered nurse (RN) is re-enforcing discharge instructions with the family of an older client who was recently admitted for an intestinal obstruction. Which statement indicates that the family understands the instructions? A) Increase protein and carbohydrates in the daily diet B) Limit activity to bed rest for the first week and increase mobility incrementally each week C) Report abdominal distention, constipation or any nausea and vomiting to the healthcare provider D) Drink liquids 2 hours after meals instead of during meals C These are symptoms that occur with intestinal obstruction and should be addressed immediately An older male client asks the registered nurse (RN) how he can reduce his incidents of hemorrhoidal flare ups. What information should the RN offer the client about how to prevent rectal discomfort? (Select all that apply). A) Increase fiber and liquids in the diet to help prevent constipation and straining B) Change exercise program to reflect less cardio-exercise and more weight training C) Use a therapeutic cushion for frequent repositioning for periods of prolonged sitting D) Take frequent warm sitz baths and do not use abrasive paper that can traumatize tissues E) Establish bowel habits by scheduling daily time to defecate when the client is not rushed A,C,D,E Fluids, comfort measures, and establishment of a regular bowel pattern help reduce incidents of hemorrhoid inflammation. During the quarterly evaluations of the clients in the assisted living community, the registered nurse (RN) assesses for findings of failure to thrive in the older population. Which findings should the RN document and report as manifestations related to failure to thrive? (Select all that apply.) A) Unintentional weight loss B) Increased weakness C) Increased amounts of sleep D) Irritation and agitation E) Seeking constant attention from caregiver A,B,C Symptoms of failure to thrive in the older population include weight loss, weakness, and excessive sleep, which should be documented and evaluated by a healthcare provider immediately 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 medications 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 A Certain medications can have a direct influence on sexual function and should be discussed with older clients The registered nurse (RN) is reinforcing discharge instructions to the family of an older client with failure to thrive. What information should the RN include to promote nutritional intake for the client? (Select all that apply). A) Minimize stress level by providing the client with a quiet environment during meals B) Provide food variations that the client can manage without assistance C) Assist the client with eating meals in bed in a semi-fowlers position D) Encourage fluid intake before meals to decrease dehydration E) Offer any type of food to the client as long as calories are consumed A,B These continue to promote independence and decreased stress for the client, which will cause decreased self worth and depression 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 sitz 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 A Frequent bladder emptying minimizes overdistention, which can compromise blood supply to the bladder wall and cause irritation to the bladder An older male client with Parkinson's disease (PD) is discharged home with levodopa-carbidopa (Sinemet) and instructions to his wife for his care. Which 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 form 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." B Increasing involuntary movements 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 Upgrade to remove ads Only $3.99/month The home health registered nurse (RN) visits an older woman with heart failure (HF) who is on complete bed rest. Which intervention is most important for the RN to suggest to the client to prevent complications related to immobility? A) Get as much sleep as possible B) Perform leg exercises while in bed C) Increase protein intake to combat fatigue D) Invite friends to visit to decrease risk for depression B The client is at risk for complications related to immobility. Active leg exercises should be performed frequently to decrease the risk for thrombophlebitis. An older male client is admitted to the hospital with left-sided heart failure (HF). Which fining should the registered nurse (RN) document that is consistent with HF? A) Ascites B) Pitting edema C) Jugular distention D) Coarse and fine crackles D 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. Ascites, pitting edema, and jugular vein distention are manifested in right-sided heart failure An older female client who has been taking hydrocodone/acetaminophen (Lortab) q4 hours for chronic back pain for the past 5 years tells the registered nurse (RN) that she cannot live without her pain pills. When asked if she is addicted, the client states that she is not an addict because the healthcare provider prescribed the pain pills. Which coping mechanism should the RN determine the client is using about her addiction? A) Lack of knowledge about narcotic medications B) Rationalization to support narcotic use C) Transfer of blame to healthcare provider D) Justification of narcotic use due to chronic pain B The client is using rationalization to maintain self-esteem when she is questioned by stating that she is not addicted because she is taking medication prescribed by a healthcare provider. An older male client with heart failure (HF) complains of chronic constipation and wants to retrain his bowel. Which information should the registered nurse (RN) offer the client for establishing regular bowel habits? A) Add whole grain foods an fibrous vegetables to diet B) Drink water and fluids up to 3,000 ml daily C) Use a stool softener of glycerin suppository PRN D) Plan daily exercise based on fatigue level A Increasing daily fiber with increasing fluid intake are the best tools to use when retraining bowl habits. Encouraging 3,000 ml of water daily may cause fluid overload for this older client and potentially exacerbate HR The home health registered nurse (RN) is visiting an older client with chronic hypertension. What evaluation is most important for the RN to complete with each visit? A) Effectiveness of medication B) Ability to ambulate C) Signs of dehydration D) Familial support A The highest priority in the care of an older client with chronic hypertension is evaluation of the effectiveness o blood pressure medication and the client's compliance to prevent complications related to chronic disease An older male client is admitted for emergency treatment of acute closed-angle glaucoma. The registered nurse (RN) begins administering the prescribed miotic medications and glycerin (Glycol) therapy. Which intervention is most important for the RN to maintain during the client's therapy? A) Maintain lighting control in the room during therapy B) Monitor intake and output q2 hours for 24 hours C) Place an eye patch over the affected eye during sleep D) Administer the eye drops at the scheduled intervals B Monitoring intake and output is most important during the administration of glycerin due to the rapid acting osmotic diuretic effect of glycerin therapy. The registered nurse (RN) is assigned the care of an older client who returns to the unit after surgery for closed angle glaucoma. Which intervention in the plan of care should the RN bring to the attention of the healthcare team? A) Assist with ambulating to commode B) Monitor intake and output q 8 hours C) Administer morphine 4 mg IM q2 hour PRN pain D) Place an eye path on operative eye during sleep C Morphine side effects include nausea, vomiting, and constipation, causing straining on stool, all of which can increase intraocular pressure and cause intraocular bleeding during the postoperative period. Administration of morphine 0.4 mg IM q 2 hours PRN pain should be discussed with the healthcare team to determine the risk of the side effects for the client. The home health registered nurse (RN) is reinforcing instructions to the family about how to prevent pressure ulcers for their older family member who is bedridden. Which measure should the RN discuss? A) Lift the client when turning instead of sliding B) Massage directly over reddened sites C) Change client's position every 4 hours D) Place pillow under both the knees A Lifting instead of sliding decreases chances of friction and shearing while moving the client. The home health registered nurse (RN) is changing an older client's wet to dry dressing. Which observation should the RN evaluate as a therapeutic response with the removal of the dry dressing? A) Debridement and removal of slough and eschar B) Drainage of purulent exudate from the wound C) Moist skin edges around the wound field D) Presence of capillary growth in the wound