HESI PN Gerontology

HESI PN Gerontology Practice Exam (Answered) Verified Solution The practical nurse (PN) is implementing a self-medication program for an older resident who is newly admitted to an assisted living community. Which actions should the PN 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). D. Delivery of adequate supply of medication. E. List of findings indicating medication effectiveness. Which age-related changes in the cardiovascular system should the practical nurse (PN) document when evaluating an older client? (select all that apply.) C. Cardiac murmurs. D. 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 practical nurse (PN) focus on during the next examination? Depression. The practical nurse (PN) is caring for an elderly client with functional incontinence who lives in an assisted living community. The client is alert, mildly confused, and can self ambulate. Which nursing intervention should the PN implement? Offer assistance with toileting q2 hours. The healthcare provider prescribes a new medication, atrovastatin (lipitor), for an older client who arrives at the clinic for an annual physical examination. What common side effect should the practical nurse (PN) advise the client to observe for with this medication? Headaches. The practical nurse (PN) 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? Report abdominal distention, constipation, or any nausea and vomiting to the health care provider. An older client asks the practical nurse (PN) how he can reduce his incidents of hemorrhoidal flare ups. What information should the PN offer the client to prevent rectal discomfort?( Select all that apply.) A. Increase fiber and liquids in the diet to help prevent constipation and straining. C. Use a therapeutic cushion or frequent repositioning for periods of prolonged sitting. D. Take frequent warm sitz baths and use non-abrasive tissue that can tramatize tissues. E. Establish bowel habits by scheduling time where the client is not rushed to defecate daily. An older male client is seeking counseling about his recent sexual issues with his partner. What issue should the practical nurse explore in this discussion? Certain medications may impact sexual function. During the quarterly evaluations of the clients in the assisted living community, the practical nurse (PN) observes for findings of failure to thrive in the gerian population. Which findings should the PN document and report as manifestations related to failure to thrive? (selct all that apply.) A. Unintentional weigh loss B. Increased weakness. C. Increased amounts of sleep. The practical nurse (PN) is reinforcing discharge instructions to the family of an older client with failure to thrive. What information should the PN include to promote nutritional intake for the client? (Select all that apply.) A. Minimize stress level by providing the client a quiet environment during meals. B. Provide food variations that the client can manage without assistance. An older woman asks the practical nurse (PN) how she can decrease her chances of getting cystitis. What information should the PN provide? Void and empty bladder completely q2 to 3 hours. An older male client with Parkinson's disease (PD) is discharged home with levopoda-carbidopa (Sinemet) and instructions to his wife for his care. Which statement best indicated to the practical nurse that the wife understands her husband's needs? "I will notify the healthcare provider if my husband has increasing involuntary movements of his extremities. The home health practical nurse (PN) visits an older woman with heart failure (HF) who is on complete bed rest. Which intervention is most important for the practical nurse (PN) to suggest to the client to prevent complications related to immobility? Perform leg exercises while in bed. An older male client is admitted to the hospital with left sided heart failure (HF). Which finding should the practical nurse document that is consistent of HF? Coarse and fine crackles. An older female client who has been taking hydrocodone/ acetaminophen (Lortab) q4 hours for chronic back pain for the past 5 years, tells the practical nurse (PN) 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 PN determine the client is using about her addiction? Rationalization to support narcotic use. An older male client with heart failure (HF) complains of chronic constipation and wants to retrain his bowel. Which information should the practical nurse (PN) offer the client in establishing regular bowel habits Add whole grain foods and fibrous vegetables to diet. The home health practical nurse (PN) is visiting an older client with chronic hypertension. What evaluation is most important for the PN to complete with each visit? Effectiveness of medication. An older client is admitted for emergency treatment of acute closed-angle glaucoma. The practical nurse (PN) begins administering the prescribed miotic medications and glycerin (Glycol) therapy. Which intervention is most important for the PN to maintain during the client's therapy? Monitor intake and output q2 hours for 24 hours. The practical nurse (PN) 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 PN bring to the attention of the charge nurse? Administer morphine 4 mg IM q2 hour PRN pain. The home health practical nurse (PN) is reinforcing instructions to the the family about how to prevent pressure ulcers for their older family member who is bedridden. Which measure should the PN discuss? Lift the client when turning instead of sliding. The home health practical nurse (PN) is changing an older client's wet to dry dressing. Which observation should the PN evaluate as a therapeutic response with the removal of the dry dressing? Debridment and removal of slough and eschar. The home health practical nurse (PN) is observing an older client for a pressure ulcer. Which finding should the PN observe the area for a stage I pressure ulcer? Deep pink, red, or mottled skin. 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 practical nurse expect to commonly occur with aging? Reduced vital capacity. 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 practical nurse expect for an older client due to normal aging? Decrease in glomerular filtration rate (GFR) A frail elderly couple ask the practical nurse (PN) if they have to watch their salt intake because food does not taste as good as it used to so they have to season most foods. What information should the PN offer the couple? Taste buds often are dull due to atrophy so older client should use other seasonings instead of salt. An older client who is unconscious is admitted after experiencing a head injury from a fall. Glasgow Coma Scale (GCS) is prescribed to evaluate the client. Which focused assessments should the practical nurse use to determine the client's GCS score? (Select all that apply.) A. Verbal response. B. Motor response. C. Eye opening. The practical nurse (PN) is assigned the care of an older client with venous stasis ulcers. A primary goal in the client's plan of care is to decrease swelling in the extremities. What should the PN do to meet this goal? Elevate the legs on pillows. A frail elderly client with chronic obstructive pulmonary disease (COPD) is admitted for pneumonia after taking a 10 day course of an antibiotic that was ineffective. The client has a long history of smoking and still smokes a pack of cigarettes a day. Which finding should the practical nurse (PN) report to the charge nurse? Crackles and pulse oximetry level of 88% The home health practical nurse (PN) visits an older female client with an illegal conduit who has been experiencing chronic urinary tract infections (UTI). Which intervention should the PN recommend the client do to manage the frequency of UTIs? Attach a larger drainage bag while sleeping. An older male client returns to the hospital after discharge 4 days ago for a transurethral resection of the prostate (TURP). The practical nurse (PN) evaluates the function of the 3-way indwelling urinary catheter and the continuous bladder irrigation system. Which finding should the PN report to the charge nurse? The tubing that drains the urinary bladder has bright red urine with clots. An older client with chronic kidney disease (CKD) has an arteriovenous fistula (AV) in the left forearm for hemodialysis. After palpating the AV fistula, which finding is an indication that the AV fistula is functioning properly? Enlarged veins. An older man returns to the medical surgical floor with a 3-way indwelling urinary catheter after a transurethral resection of the proslate (TURP). The practical nurse (PN) observes the catheter's tubing for drainage when he states he needs to void. What should the PN implement based on this finding? Irrigate the bladder through the catheter port. The practical nurse (PN) is caring for an older female client with a 20 year history of rheumatoid arthritis (RS) who is admitted for carpel tunnel release. Which finding associated with RA should the PN document? Small joint involvement in fingers. An older female client who is 3 days postoperative for a right hip repair is admitted to the rehabilitation center for strengthening in activities of daily living (ADL). The practical nurse (PN) is mobilizing the client to go to physical therapy (PT). Which action should the PN implement first? Direct client to use the overhead trapeze. An older female client is recently transferred to a rehabilitation facility after a total hip replacement and asks the practical nurse (PN) if she broke her hip because she is old. How should the PN best respond? Older women commonly lose bone calcium which increases the risk of fracture. An older client is admitted a preliminary diagnosis of Addison's Disease. Which skin finding should the practical nurse (PN) document that is typical with Addison's? Hyperpigmentation. An older female client recently moved to an assisted living facility. The family explain to the practical nurse (PN) that the client is unmanageable and always confused, disoriented, and depressed. The client asks the PN repeatedly, "Where am I?" How should the PN respond? Explain that she is in a new home called an assisted living community. An older female client who is a new resident at an assisted living facility can not remember how to get to her room. What action should the practical nurse (PN) implement? Show client how to follow hallway signs to her room. An older client who is a new resident is an assisted living facility is having short-term memory loss and confusion. Which activity should the practical nurse (PN) schedule the client to do during the day? Daily exercise group. An older male client who is a new resident in an assisted living community is having difficulty going to sleep since his arrival. Which intervention should the practical nurse (PN) implement first? Ask the client what has helped him in the past. the practical nurse (PN) is taking the vital signs of an older male client who arrives at the clinic for an annual physical examination. The client states he really came for this visit because he is having intimacy problems with his wife? What information should the PN present to obtain more information from the client? Explain that a decrease of testosterone levels can affect libido. The hospice nurse is completing a focused assessment of an older female client with end stage Alzheimer disease who recently fractured her hip. What technique should the practical nurse (PN) use to determine the client's pain? Observe for facial grimacing. Older clients are at highest risk for abuse and neglect due to which factors? (select all that apply.) A.Needs are greater than the caretaker's abilities. B. Client's declining strength. A frail elderly client is admitted to the unit with a diagnosis of pneumonia. Which finding is most important for the practical nurse (PN) to report the healthcare provider? Confusion and dehydration. The practical nurse (PN) is observing the skin of an older client? Which finding should the PN document as consistent with normal aging process? Decreased elasticity in skin. An older client is transferred to a telemetry unit after placement of a pacemaker. What action should the practical nurse (PN) take first ? Establish telemetry monitoring. The practical nurse (PN) is caring for an older female with Raynaud's phenomenon. Which exposure should the PN instruct the client to avoid? Cold climates A family member brings their aging father to the clinic because he has been alert and oriented during the day but agitated and disoriented in the evening. The practical nurse (PN) reviews the client's list of current medications with the client and family. What rationale supports this action taken by the PN? Multiple medications can contribute to sun-downer like symptoms. The practical nurse (PN) is giving medications through a gastric tube (GT) to an older client who is a resident in a long-term care facility. The PN interrupts the continuous GT feeding. In which sequence should the PN implement these actions for administration of crushed medications? (Place in the order from the first to last step) 1. Crush the medication into a powder or fine granules. 2. Dissolve each crushed medication in a medicine cup. 3. Flush the feeding tube of feeding solution. 4.Administer each medication separately. 5. Flush GT to clear the medication from the tubing. 6. Reconnect the gastric feeding tube. Osteoporosis increases the risk for a hip fracture in older adults, and women are more likely to have osteoporosis than men. Women of which ethnic group have the highest risk of a hip fracture. (Arrange the highest risk first, on top, and lowest risk last, on bottom.) 1. Caucasian 2. Asian 3. Hispanic 4. African American