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geriatrics HESI/final exam
Get Quizlet's official HESI A2 - 1 term, 1 practice question, 1 full practice test
(NCLEX review questions)
Terms in this set (98)
Your older female patient is complaining because she is having frequent UTIs. Which normal age-related change is most likely to be a contributing factor?
Decreased bladder muscle tone
Which are normal age-related changes? (Select all that apply.)
1 Decreased visual acuity
4 Increased gastric pH
8 Decreased serum albumin
10 Decreased rate of peristalsis
What are patients who have had Parkinson disease for 10 years likely to exhibit? (Select all that apply.)
1 Rigidity and tremors when at rest
An older adult is coming to your clinic for treatment for a gastric ulcer. Which treatment would the nurse expect to be ordered?
What should the nurse explain when discussing expected changes in the female reproductive system to an older adult?
Production of vaginal secretions decreases
The nurse performs a skin assessment of an older adult. Which finding is abnormal and needs to be reported?
A dark, elevated patch that bleeds when touched
The nurse encourages the patient to maintain a steady weight in the recommended range to decrease risk of which common endocrine disease observed in older adults?
What is the activity that best promotes health maintenance for the typical older adult?
One 30-minute walk, 3 to 5 times a week
The nurse recognizes that regular dental visits are:
Recommended on a yearly basis for all older adults, even those with dentures.
An older adult does not follow through with health recommendations from the primary health care provider. The older adult does not take prescribed medications or keep medical appointments. Which patient problem should the LPN/LVN anticipate seeing on the care plan?
Nonadherence with the treatment plan
Which immunizations should older adults receive on a yearly basis? (Select all that apply.)
When attempting to help an older adult improve his or her health maintenance practices, the nurse will need to assess which factors? (Select all that apply.)
Your patient tells you she understands that she is at greater risk of certain diseases because of her Hispanic American heritage. Based on what you have learned, which disorder(s) might she be at greater risk for? (Select all that apply.)
Which interventions would be appropriate when teaching a patient with presbycusis? (Select all that apply.)
Use visual cues or written materials.
Face the patient when talking.
Speak without food or drink in your mouth.
The nurse is caring for an older adult in a rehabilitation unit. Which actions by the nurse are most likely to enhance communication with the patient? (Select all that apply.)
Identify yourself; remind the person who you are.
Use pictures and gestures in addition to words.
Be patient, and avoid interrupting.
A nurse is caring for an older adult who is upset about having to move into a skilled nursing facility. Which communication technique used by the nurse is most effective at establishing an empathetic climate?
A nurse is discharging an older adult patient from a rehabilitation facility after a left hip replacement. The nurse providing discharge teaching knows that older adults are most responsive to what type of information?
When the information is relevant to their lives
An older adult who resides in a long-term care facility has been refusing food and fluids for the past 2 days. He repeatedly says, "Leave me alone!" What is the best initial nursing intervention?
Assess to identify changes in physical or emotional status.
An older woman recently moved to the United States from the Middle East. She does not like to drink cow's milk or eat most cheeses. What is a culturally acceptable food that would best help meet the need for calcium?
An older man who lives alone is placed on a sodium restricted diet because of heart failure. He asks you to help him make good diet choices. Which foods should he avoid? (Select all that apply.)
Canned tomato soup
Deli bologna or ham
Frozen spaghetti dinner
An 85-year-old woman is admitted to the hospital. Clinical indicators of inadequate nutrition include: (Select all that apply.)
Thin, brittle hair
Hemoglobin 10.2 g/dL; Hematocrit 45%
An older adult is taking furosemide to reduce edema. Dietary teaching would best include increasing the intake of which foods? (Select all that apply.)
An older nursing home resident has poor skin turgor, dry mucous membranes, and very concentrated urine. What are the best directions to give to the nursing assistant? (Select all that apply.)
Offer smaller amounts of fluids every hour during the day.
Identify the beverages that the resident prefers.
Following an appointment with the primary care provider, the nurse is performing patient education to an independent living older adult about a newly prescribed medication. Which factor is most likely to interfere with the effectiveness of this process?
The nurse is in a hurry.
What is an example of a medication that can be crushed?
A calcium tablet
You are administering medication through a transdermal patch. What are some precautions? (Select all that apply.)
Remove all old patches before applying a new patch.
Cleanse the skin after removing an old patch.
Verify the dosage strength of the patch.
A resident in a long-term care facility has an order for digoxin 0.25 mg every morning in tablet form. If the nurse assesses that this resident has been having difficulty swallowing, what should the nurse do?
Discuss the possibility of an order change to liquid form with the primary care provider.
Older adults are more likely to experience adverse drug reactions because of which of the following? (Select all that apply.)
The number of medications they take daily
Physiologic changes in metabolism and excretion
What should you include in a lesson plan for the independent living older person?
Avoid drinking alcohol if taking acetaminophen.
You are caring for a new patient who had a heart transplant 5 years ago. She takes seven medications every day, including antirejection drugs, cardiac medications, and inhalers. She mentions feeling "depressed," and wants your advice about trying a new "natural" remedy she found on the Internet. Which would be the best response?
"You really should talk with your doctor first, because many things can interfere with your antirejection and heart medications, even herbs and supplements."
Which assessment tool is most highly regarded and often used to determine the mental status of the older adult?
When assessing the respiratory system of an older adult, the nurse hears continuous, coarse, low-pitched sounds. How would these sounds be reported?
Gurgles (low-pitched wheezes)
When taking a radial pulse of an older adult, the nurse finds it difficult to count a weak and thready pulse. What should the nurse do?
Take an apical pulse instead.
When performing an assessment of the gastrointestinal system of an older adult, the nurse would proceed in what order? Place the parts of a gastrointestinal system assessment in sequence from first to last.
1. Palpate abdomen.
2. Observe abdomen for scars.
3. Obtain a health history.
4. Inspect the oral cavity.
5. Auscultate bowel sounds.
When performing an interview with an older adult, the nurse should consider physical environment factors by: (Select all that apply.)
Explaining what will take place during the assessment
Ensuring privacy and minimum noise levels
Selecting a room with a comfortable temperature
Seeking a location in close proximity to a restroom
Select the factors that can contribute to the development of hypothermia in older adults. (Select all that apply.)
Decreased muscle tissue.
Decreased sensory perception of cold.
Decreased subcutaneous fat
Which manifestation(s) indicate(s) serious heat-related problems? (Select all that apply.)
The nurse should instruct the nursing assistant who is caring for a patient who is receiving antihypertensive medication to:
Encourage him or her to stand up slowly from sitting or lying position
The nurse is aware that the best predictor of an older adult falling is:
A history of previous falls
Your team is developing a fall reduction program on your unit. Which interventions would be important to remember when developing such a program? (Select all that apply.)
Patient assessment for fall risk factors upon admission and any change in patient condition
Identification and removal of environmental hazards
Encourage patient participation in supervised group exercise program
Perform regular medication reviews
Hearing aids are worn by many older people. Which statement regarding hearing aids is false?
Most people easily adjust to hearing aid use.
Which statement should the nurse consider when assessing pain in an older patient? (Select all that apply.)
Chronic pain is more common with aging.
Cognitive changes may alter the ability to report and describe pain.
Behavioral changes may be indicators of pain.
Which condition is progressive and irreversible?
Which would be most appropriate when considering the environment for a patient with dementia?
Placing family pictures around the room
What is the most appropriate intervention for an older adult with dementia resisting efforts to reposition or ambulate?
Assess the person using the PAINAD scale
What actions can the nurse take to help increase self-esteem in older adults? (Select all that apply.)
Schedule time to sit and listen to older adults talk about their concerns.
Develop activities that allow older adults to reminisce about their life.
The nurse should assess for changes in behavior that are likely to indicate depression such as which of the following? (Select all that apply.)
Increased alcohol consumption
Changes in daily routines
Agitation and irritability
Isolation and withdrawal
Which is true of suicide risk in the older adult?
Suicide is often triggered by pain, a recent loss, or a stressful life event with the older adult.
Which phrase spoken by an older adult would warrant further assessment of their self-perception or self-esteem?
"I can't do anything right anymore."
Which interventions are appropriate for an older adult experiencing anxiety or fear?
Place the resident in a populated area to ensure he or she is not alone.
Identify coping strategies that have helped in the past.
Provide explanations of any procedures that are being done.
The nurse should recognize what signs of suicide risk in older adults? (Select all that apply.)
Loss of a spouse or a close loved one
Increasing complaints of physical ailments
Giving away possessions to friends and family
A new interest in firearms
An older woman was widowed about a year ago. What would normal expected behavior at this stage of grieving include?
Improved energy, interest in new activities and goals
How do roles change as a person ages? (Select all that apply.)
Relocation to new environment may separate friends/family and possessions..
Loss of roles with death of spouse or family members.
Retirement brings loss of previous profession/roles or status.
What characteristics place an older adult at increased potential for social isolation? (Select all that apply.)
Sensory changes .
Decreased physical mobility
Limited financial resources
What is the most appropriate intervention to use for an older adult who always stays in their room?
Spend one-on-one time discussing the older adult's concerns.
Which person is most likely to experience relationship issues?
One who likes solitary activities and states, "I like to be left alone"
What interventions should nurses consider when an older adult is grieving the loss of a role or relationship? (Select all that apply.)
Encourage communication with friends and family members.
Build a trusting relationship.
Be available to discuss loss without stirring up deep emotions or feelings.
Identify support groups, counselors, spiritual advisors, and family members who can provide additional support.
When assessing an older adult, the nurse suspects an increased level of stress when observing which physiologic data? (Select all that apply.)
Elevated pulse and blood pressure
What is the drug most commonly abused by older adults?
Which findings in the patient's history lead the nurse to suspect alcohol abuse? (Select all that apply.)
An older adult tells the nurse that he feels "stressed" and asks what the nurse would recommend. What would be the nurse's best response?
"Are you aware of the tai chi class at the recreation center?"
Which describe characteristics of depression and the older adult? (Select all that apply.)
Persistent feelings of sadness or "emptiness"
Loss of interest in activities and hobbies
An older adult tells the nurse that visiting her primary care provider is very stressful for her. What is the best response?
Help her develop strategies for dealing with her concerns.
The nurse cares for an older adult in an extended-care facility. Which statement indicates possible spiritual disconnection?
"I feel that God abandoned me and that I will die all alone."
The nurse observes an older adult who saves unopened crackers, jelly, and juice packages from the meal tray. What does this behavior most likely indicate?
That the person is frugal and does not want to waste good, usable items
An older Latino patient wants his family to bring folk remedies to the long-term care facility. What is the best response?
Identify the benefits and risks of these remedies.
The nurse is caring for a female patient who identifies herself as an atheist. Which statement made by the nurse indicates that the nurse understands the nature of spirituality?
"Do you have any spiritual practices we can assist you with?"
Which statement is incorrect?
If the patient complains of respiratory difficulties even though vital signs and oxygen saturation are normal, he is most likely developing delirium.
A calorie restricted, low-sodium diet was prescribed for a terminally ill patient who has diabetes, is in kidney failure, and has a do not resuscitate order. As death nears, the patient has very little appetite and picks at the food. What should appropriate nursing interventions include? (Select all that apply.)
Encourage family to bring in small amounts of food from home.
Serve food in a place free from odors.
Encourage the person to eat anything that appeals to them.
Provide good oral hygiene.
Dyspnea, shortness of breath, and irregular breathing patterns are common as death nears. Which simple measures taken by the nurse would help alleviate mild respiratory difficulty? (Select all that apply.)
Administering oxygen by nasal cannula
Instituting measures to reduce anxiety or tension
Elevating the head of the bed
Reminding visitors not to tire the patient
Which is true about the presence of pain at the time of death? Pain is:
One of the greatest fears of the dying person
The nurse is interviewing a patient whose husband died 18 months ago. Which statement indicates that the patient is adjusting to the loss?
"I miss my husband every day. Focusing on our children and going back to work help me focus on future."
List the five stages of death and dying identified by Kübler-Ross.
A 70-year-old married man confides to the nurse that he recently began to have difficulty achieving an erection. He states that, "It wasn't much of a problem until recently." What would be the nurse's best response?
"Did you recently change any medications?"
A 69-year-old woman reports that she avoids intercourse because it is uncomfortable. She asks the nurse if she has any suggestions to relieve this problem. What should the nurse do?
Clarify what she means by "uncomfortable."
An older gentleman who suffers from dementia often masturbates in the lounge area of a long-term care facility. Which nursing interventions would be appropriate? (Select all that apply.)
Provide privacy by escorting him back to his room
Distract him with an activity that he finds interesting.
Why might an older gay person be reluctant to move into a long-term care facility?
They fear that they will receive substandard care.
The nurse is precepting new graduate licensed vocational nurse (LVN) at a nursing home. Which statement by the new graduate indicates that they have good understanding of sexuality in aging population?
"Mr. Wang and Mrs. Levy would like some privacy while they are in Mrs. Levy's room. Would it be OK to place a 'Do Not Disturb' sign on her room door?"
A nurse is caring for a 71-year-old immobile patient who has been in a wheelchair for 2 hours. When repositioning the patient, the nurse observes a reddened area at the base of the buttocks. How would this observation be best documented?
Stage 1 pressure injury at ischial tuberosity
A nurse is caring for an older adult who is bedridden because of progressed Parkinson disease. What is the most appropriate patient problem for this patient?
Potential for altered skin integrity related to immobility
A nurse is caring for an older patient who complains of dry and itchy skin. What advice should the nurse offer?
Advise the patient to bathe less often, use soap sparingly, and apply a skin emollient after each bath.
The nurse notices that an older adult is using a large amount of denture fixative paste. The patient states this is because the denture hurts, otherwise. What is the most important nursing action?
Assess the patient's oral cavity to make sure there is no irritation or breakdown.
Family members are caring for their aging mother at home. Which statement by the daughter indicates the need for further teaching? (Select all that apply.)
"I change Mom's brief whenever it is really wet."
"I'm glad we don't have to see the dentist anymore now that Mom has dentures."
In helping the registered nurse perform an admission and assessment of a new patient, you mutually recognize this patient is at risk for skin tears. Which would be appropriate to include in the care plan? (Select all that apply.)
Move and position the patient gently and carefully.
Use a safe sunblock when sun exposure is expected.
While caring for an older adult the nurse determines that further teaching regarding bowel elimination is needed when the patient makes which statement?
"I'll give myself an enema if I don't have a bowel movement every day."
A nurse is caring for an older adult who recently had small watery bowel movements. The patient now complains of pressure in the rectal area and abdominal cramping. Which is the most appropriate initial nursing action?
Notify the primary care provider of these observations.
A nurse is caring for an older adult with a history of cardiac problems. The nurse knows it is most important to institute measures to prevent which outcome?
A nurse is caring for a patient with urge urinary incontinence. Based on the nature of this problem, the nurse plans to institute which nursing interventions? (Select all that apply.)
Avoid placing throw rugs in her room.
Place her close to the restroom, and remind her of its location.
Orient the patient to the location of nearby restrooms.
An older woman has begun to stay in her apartment, avoiding socializing with her peers in the independent living center. She states that she cannot wait when she needs to urinate. She is afraid that she will have an accident. What is the most appropriate action for the nurse to take?
Provide encouragement, and discuss Kegel exercises and other approaches to cope with incontinence.
A home health nurse is visiting her patients and evaluating their exercise routines. Which patients meet the current recommendations for physical activity? (Select all that apply.)
Marge, a retired nurse, swims 25 minutes every day except Sundays and does strength training with weights on Tuesdays and Fridays.
Yi-Lin plays video fitness 3 times each day, 10 minutes each time, and performs weight lifting 3 times a week.
The nurse is teaching an older adult with a history of severe cardiac problems that the goal is to use exercise to maintain the highest level of function possible. Which directions should be included in the patient education to prevent hypertension or use of the Valsalva maneuver?
Breathe through your mouth while exercising.
The patient problem of altered activity tolerance related to oxygenation problems was identified. Which statement made by the patient would indicate to the nurse the need for further teaching?
"I need to do my activities quickly to get everything done."
The nurse is caring for an older adult residing in a community-based residential facility. The patient states, "I just don't know what to do except sleep. I worked hard all my life; I never had the time or money to do lots of things." Which nursing intervention is the most appropriate to meet this client's diversional activity needs?
Explore the variety of activities that are now available to him.
In promoting sleep hygiene practices for her older adult patient, what should the nurse suggest? (Select all that apply.)
Eat a light snack before bedtime.
Develop a daily exercise program, preferably outdoors.
The wife of an overweight older adult reports that her husband snores very loudly, then stops breathing several times each night. In addition to recommending a visit to the primary care provider, what should the nurse suggest?
The husband should try to lose weight and sleep in a side-lying position.
An older patient requests an evening snack. Which food is most appropriate to facilitate sleep?
Graham cracker with banana and milk
A patient, who lost his wife 6 months ago, has been diagnosed with clinical depression. He plans to ask his primary care provider for a prescription for sleep medication. He asks for advice about what else he can do. The lack of sleep is interfering with his daytime activities, making him feel like he's "in a fog," and he states that his COPD is getting worse. What should the nurse keep in mind when providing an answer?
CBTI is more effective than medications in treating insomnia.
Which of the following are true statements regarding insomnia and its treatment? (Select all that apply.)
Sleep medications can be useful in short-term management of insomnia.
Taking the medication cortisone, especially late in the day, can contribute to insomnia.
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