HESI RN EVOLVE GERONTOLOGY PRACTICE

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.)

• Locked medication storage in the client's room.
• Medication administration record (MAR).
• Payment forms for prescribed medications.
• Delivery of adequate supply of medication.
• List of findings indicating medication effectiveness.

(ANS-

• Locked medication storage in the client's room.
• Medication administration record (MAR).
• Delivery of adequate supply of medication.
• List of findings indicating medication effectiveness.

(A, B, D, and E) are correct. For safe self-medication in an assisted living community, the resident should be provided a locked storage box (A), create a medication administration record to monitor medication (B), establish adequate medication supply (D), and a reference to evaluate the effectiveness of medications (E). (C) is not the responsibility of the nurse.

When assessing an older client, which age-related changes in the cardiovascular system should the registered nurse (RN) document? (Select all that apply.)

• Dyspnea.
• Chest pain.
• Cardiac murmurs.
• Widening pulse pressure.
• Irregular heart rate.

(ANS-

• Cardiac murmurs.
• Widening pulse pressure. 1 / 4

-For older clients the expected age-related changes in the cardiovascular system include murmurs (C) and widening pulse pressure (D). (A, B, and E) are not normal findings and require further evaluation.

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?

• Anxiety.
• Depression.
• Exhaustion.
• Confusion.

(ANS- B. Depression.

-Depression (B) 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 life style, (B) is most likely and most important for the RN to focus on.

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?

• Offer assistance with toileting q2 hours.
• Use protective disposal undergarment instead of underwear.
• Ask if the client has attempted to void q2 hours.
• Obtain a prescription for intermittent catheterization.

(ANS- A. Offer assistance with toileting q2 hours.

-Maintaining independence and self esteem is important for an older client with incontinence. Toilet assistance (A) decreases the client's chances of accidents and embarrassment by introducing a toilet training program. (B) is not implemented 2 / 4

unless the toileting program is unsuccessful and the client's mental status declines.A confused client will not remember how many times he or she frequented the toilet, so (C) is not helpful for the client. (D) is not indicated for clients with functional incontinence and who can ambulate.

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 registered nurse (RN) advise the client to observe for with this medication?

• Constipation.
• Headaches.
• Muscle weakness.
• Nausea and vomiting.

(ANS- B. Headaches.

-Headaches (B) are the most common side effect with this medication, which the RN should direct the client to report. (A and C) are rare occurrences with this medication. (D) is not considered a side affect of this medication.

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?

• Increase protein and carbohydrates in the daily diet.
• Limit activity to bed rest for the first week and increase mobility incrementally

each week.

• Report abdominal distention, constipation, or any nausea and vomiting to the

healthcare provider.

• Drink liquids 2 hours after meals instead of during meals.

(ANS- C. Report abdominal distention, constipation, or any nausea and vomiting to the healthcare provider.

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-(C) are symptoms that occur with intestinal obstruction and should be addressed immediately. (A, B and D) are not indicated for a client who has been discharged for intestinal obstruction.

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.)

• Increase fiber and liquids in the diet to help prevent constipation and straining.
• Change exercise program to reflect less cardio-exercise and more weight

training.

• Use a therapeutic cushion or frequent repositioning for periods of prolonged

sitting.

• Take frequent warm sitz baths and do not use abrasive paper that can traumatize

tissues.

• Establish bowel habits by scheduling daily time to defecate when the client is

not rushed.(ANS-

• Increase fiber and liquids in the diet to help prevent constipation and straining.
• Use a therapeutic cushion or frequent repositioning for periods of prolonged

sitting.

• Take frequent warm sitz baths and do not use abrasive paper that can traumatize

tissues.

• Establish bowel habits by scheduling daily time to defecate when the client is

not rushed.

-(A, C, D, and E) are correct. Fluids, comfort measures, and establishment of a regular bowel pattern help reduce incidents of hemorrhoid inflammation. Weight training can aggravate hemorrhoids and is not effective in reducing hemorrhoid irritation.

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?

• Certain medications may impact sexual function.
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