HESI GERONTOLOGY {ALREADY GRADED A+ } NEWEST VERSION

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HESI GERONTOLOGY {ALREADY GRADED

A+ } NEWEST VERSION

• An older patient has Tourette syndrome. The GNP knows that part of the

management of this condition includes all of the following except:

• behavior therapy and biofeedback
• high doses of diazepam have been known to be effective.
• individual education plans, including classroom modifications
• family support and counseling

Correct Answer: B) high doses of diazepam have been known to be effective.

Rationale: Treatment options include stimulants (dextroamphetamine, methylphenidate, etc.), alpha-2 adrenergic agonists (clonidine), and neuroleptic agents (risperidone, haloperidol, etc.). Tourette's syndrome is a lifelong condition with unknown etiology.

• As a GNP you know that the major cause of respiratory disability in older adults is

which of the following?

• pneumonia
• lung cancer

C) COPD

• heart disease

Correct Answer: C) COPD

Rationale: COPD is chronic pulmonary obstructive disorder. Cigarette smoking is the most important risk factor for COPD. COPD has no cure and it is the major cause of respiratory disability in older adults.

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• Ms. Chatham, a 65-year-old patient is determined to have a systolic blood pressure

reading of 125. This patient is ______.

• Prehypertensive.
• Stage I Hypertension.
• Stage II Hypertension.
• Normal.

Correct Answer: A) Prehypertensive.

Rationale: As per the 7th report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines, the following is true: Systolic BP <120 xss=removed xss=removed xss=removed xss=removed>

• In order for effective teaching to take place, it is crucial that the GNP use the proper

teaching style for each patient. What teaching style would BEST suit a patient with a "Dependent Learner" style?

• Facilitator.
• Delegator.
• Authority, expert.
• Salesperson, motivator.

Correct Answer: C) Authority, expert.

Rationale: Matching teaching style (TS) to learning style (LS) is crucial for effective communication. The following are the BEST matches: TS/LS: Authority/Dependent; Motivator/Interested; Facilitator/Involved; Delegator/Self-directed.

• Mr. French asks the GNP the maximum number he can have for his LDL Cholesterol

level in order to be considered at a borderline high amount. What answer does she give him?

• 62 mg/dL.

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• 159 mg/dL.
• 83 mg/dL.
• 95 mg/dL.

Correct Answer: B) 159 mg/dL.

Rationale: The following LDL cholesterol guidelines are outlined by the American Heart Association: Less than 100 mg/dL = Optimal; 100-129 mg/dL = Near or above optimal; 130- 159 mg/dL = Borderline high; 160-189 mg/dL = High; 190 mg/dL and above = Very high.

• Mrs. Frasier, a 50-year-old patient, presents with a mosquito bite that she is

concerned about. How do you diagnose this?

• Cyst.
• Bulla.
• Wheal.
• Plaques.

Correct Answer: C) Wheal.

Rationale: Cyst: encapsulated, fluid-filled mass that varies in size. Bulla: fluid-filled, elevated, circumscribed lesion that's larger than 5mm. Wheal: circumscribed, reddening with transient elevation lesion that's 0.5 to 10mm diameter. Plaques: usually a grouping of papules; elevated and a variety of shapes; larger than 5mm.

• There are a good many diseases affecting the elderly that are the result of smoking.

Counseling regarding smoking cessation is part of the GNP's job. The components of

brief intervention for treating tobacco use are:

• Counsel, Document, Caution, Describe, Demonstrate
• Advise, Confer, Describe, Document, Prescribe
• Advise, Counsel, Intervene, Prescribe, Follow-up
• Ask, Advise, Assess, Assist, Arrange

Correct Answer: D) Ask, Advise, Assess, Assist, Arrange

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Rationale: Ask about tobacco use, Advise to quit, Assess willingness to make an attempt to quit, Assist in this quit attempt. Arrange a follow-up.

• Your 89-year-old patient presents with dyspepsia and nausea. After testing, you

determine she is positive for Peptic Ulcer Disease. Of the following, which would LEAST likely be a differential diagnosis for Peptic Ulcer Disease?

• Cholecystitis.
• Migraines.
• Gastric carcinoma.
• Cardiovascular disease.

Correct Answer: B) Migraines.

Rationale: Peptic Ulcer Disease is a gastrointestinal disorder. Other differential diagnoses of the condition are pancreatitis and biliary tract disease.

• You are providing care to a patient who has recently begun dialysis. Her daughter,

with whom she lives and who prepares many of her meals, asks what types of foods she should incorporate into her diet and which she should avoid. Which of the following is NOT a food that this patient should be advised to avoid?

• Avocado.
• Lean red meat.
• Dried fruit.
• Bananas.

Correct Answer: B) Lean red meat.

Rationale: Dialysis patients are encouraged to eat lean meat, including red meat. High quality proteins produce less waste and help the body heal and maintain regular processes. Dialysis patients should avoid foods high in potassium, including avocado, banana, and dried fruit, and should eat other potassium-containing foods in moderation.