GERONTOLOGY HESI PRACTICE EXAM
AND CORRECT VALIDATED ANSWERS.
A frail, elderly client is admitted to the unit with a diagnosis of pneumonia.
Which finding is most important for the registered nurse (RN) to report to
the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting - CorreCt Answers -B. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate
oxygenation and perfusion in this frail elderly client. (A), (C) and (D) are all
common with pneumonia, but the most important finding is confusion and
evidence of dehydration, which require treatment for this frail elderly
client.
An older client is admitted with a preliminary diagnosis of Addison's
disease. Which skin finding should the registered nurse (RN) document
that is typical with Addison's disease?
A. Moon face
B. Hyperpigmentation
C. Excessive acne
D. Multiple skin tags - CorreCt Answers -(B) Hyperpigmentation
,Rationale: Addision's disease is characterized by a deficiency in the
production of adrenal cortex hormones, which results in anterior pituitary
feedback to secrete stimulating hormones, such as melanocyte stimulating
hormone (MSH) that increases melanin production. (B) is seen in clients
with Addison's disease. (A and C) are typical of Cushing's syndrome which
is due to excessive adrenal cortisol. (D) are not associated with Addison's
disease.
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 for a hip fracture? (Arrange with the
highest risk first and the lowest risk last.)
A. African American
B. Caucasian
C. Asian
D. Hispanic - CorreCt Answers -(B) Caucasian
(C) Asian
(D) Hispanic
(A) African American
Rationale: Caucasian women have the highest risk for hip fractures
secondary to osteoporosis. Women of Asian descent have the second
highest risk, followed by Hispanic women and African American women.
An older male client returns to the hospital after discharge 4 days ago for a
TURP. The registered nurse (RN) evaluates the function of the 3-way
indwelling urinary catheter and the continuous bladder irrigation system.
Which finding should the RN report to the healthcare provider?
A. Irrigation bag of normal saline is hanging at the level of the client's head
, B. The urinary output is greater than the amount of irrigation fluid instilled
C. The irrigation tubing is attached to the irrigation port on the 3-way
catheter
D. The tubing that drains the urinary bladder has bright red urine with
clots. - CorreCt Answers -(D) The tubing that drains the urinary bladder
has bright red urine with clots.
Rationale: The presence of bright red urine with clots in the tubing draining
the bladder (D) is an abnormal finding indicating active bleeding, which
should have resolved 36-72 hours postoperatively and should be reported.
(A, B and C) indicate that the system is functioning properly.
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 - CorreCt Answers -(B) Depression
Rationale: 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. (A, C and D) are other
symptoms that the client can exhibit, but with the sudden change in
lifestyle, (B) is most likely and most important for the RN to focus on.
An older client who is a resident in a long-term care facility is receiving
medications through a gastric tube (GT). After interrupting the continuous
GT feeding in which sequence should the nurse implement these actions for
AND CORRECT VALIDATED ANSWERS.
A frail, elderly client is admitted to the unit with a diagnosis of pneumonia.
Which finding is most important for the registered nurse (RN) to report to
the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting - CorreCt Answers -B. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate
oxygenation and perfusion in this frail elderly client. (A), (C) and (D) are all
common with pneumonia, but the most important finding is confusion and
evidence of dehydration, which require treatment for this frail elderly
client.
An older client is admitted with a preliminary diagnosis of Addison's
disease. Which skin finding should the registered nurse (RN) document
that is typical with Addison's disease?
A. Moon face
B. Hyperpigmentation
C. Excessive acne
D. Multiple skin tags - CorreCt Answers -(B) Hyperpigmentation
,Rationale: Addision's disease is characterized by a deficiency in the
production of adrenal cortex hormones, which results in anterior pituitary
feedback to secrete stimulating hormones, such as melanocyte stimulating
hormone (MSH) that increases melanin production. (B) is seen in clients
with Addison's disease. (A and C) are typical of Cushing's syndrome which
is due to excessive adrenal cortisol. (D) are not associated with Addison's
disease.
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 for a hip fracture? (Arrange with the
highest risk first and the lowest risk last.)
A. African American
B. Caucasian
C. Asian
D. Hispanic - CorreCt Answers -(B) Caucasian
(C) Asian
(D) Hispanic
(A) African American
Rationale: Caucasian women have the highest risk for hip fractures
secondary to osteoporosis. Women of Asian descent have the second
highest risk, followed by Hispanic women and African American women.
An older male client returns to the hospital after discharge 4 days ago for a
TURP. The registered nurse (RN) evaluates the function of the 3-way
indwelling urinary catheter and the continuous bladder irrigation system.
Which finding should the RN report to the healthcare provider?
A. Irrigation bag of normal saline is hanging at the level of the client's head
, B. The urinary output is greater than the amount of irrigation fluid instilled
C. The irrigation tubing is attached to the irrigation port on the 3-way
catheter
D. The tubing that drains the urinary bladder has bright red urine with
clots. - CorreCt Answers -(D) The tubing that drains the urinary bladder
has bright red urine with clots.
Rationale: The presence of bright red urine with clots in the tubing draining
the bladder (D) is an abnormal finding indicating active bleeding, which
should have resolved 36-72 hours postoperatively and should be reported.
(A, B and C) indicate that the system is functioning properly.
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 - CorreCt Answers -(B) Depression
Rationale: 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. (A, C and D) are other
symptoms that the client can exhibit, but with the sudden change in
lifestyle, (B) is most likely and most important for the RN to focus on.
An older client who is a resident in a long-term care facility is receiving
medications through a gastric tube (GT). After interrupting the continuous
GT feeding in which sequence should the nurse implement these actions for
