HESI Gerontology Exam (Latest 2023/ 2024 Update) Questions and Verified Answers with Rationales| 100% Correct| Grade A

HESI Gerontology Exam (Latest 2023/ 2024 Update) Questions and Verified Answers with Rationales| 100% Correct| Grade A Q: As a GNP you understand that due to physiological changes of aging, some laboratory test results will have age-related changes. Which of the following values would be the least likely to be affected? red blood cell values white blood cell counts platelet range hemoglobin values Answer: platelet range Due to the physiological changes of aging, red blood cell values tend to decrease, white blood cell counts tend to decrease slightly, hemoglobin values slightly decrease, but platelet range does not vary. Q: The family of a patient with dementia has asked you to tell them more about this condition. You would tell them all of the following except: Dementia is the leading reason for institutionalization of older adults. Some persons diagnosed with dementia have reversible pseudodementia. Irreversible dementia has a gradual onset and a progressive downward course. 50% of the older adult population suffer from some form of dementia. Answer: 50% of the older adult population suffer from some form of dementia. This statement is not true. It is estimated that between 10 and 20% of the older adult population suffer from some form of dementia. There are 1.2 million cases in the United States in people over the age of 65. Q: What is true regarding deep vein thrombosis (DVT)? Contrast venography is the most commonly used test to diagnose this. Because the presentation of DVT varies, making the diagnosis from clinical presentation alone is problematic. Hypocoagulation state presents a considerable risk for DVT. Therapy for patients with DVT is aimed at easing the pain. Answer: Because the presentation of DVT varies, making the diagnosis from clinical presentation alone is problematic. Choice B is the right answer. Contrast venography has the greatest sensitivity and specificity for the condition but due to the cost and nature of the test, ultrasound is more common as first-line diagnostic technique (choice A). A hypercoagulation state presents a considerable risk for DVT (choice C). Therapy for patients with DVT is aimed at minimizing the risk of pulmonary embolism and extension of peripheral thrombus (choice D). Q: It has been determined that an elderly patient is suffering from long term insomnia. Which of the following is LESS likely to be considered a long term cause of the condition? Nocturia. Environmental changes. Congestive heart failure. Alcohol and substance abuse. Answer: Environmental changes. There are various causes of insomnia in the elderly. While some may be the cause of short term insomnia and others long term insomnia, long term insomnia is more common in the elderly than short term. Q: In terms of the elderly which of the following is NOT true of hypothyroidism? Symptoms are often similar to normal aging changes making it difficult to detect in older adults. Symptoms usually have an insidious onset. It usually occurs before age 50. There is a greater risk for developing myxedema coma, which is life-threatening. Answer: It usually occurs before age 50. Hypothyroidism usually occurs after age 50. It is often diagnosed as depression. You must use caution against abruptly discontinuing medication. Q: When treating a patient with oral Vitamin B12, which drug interaction will result in decreased absorption of vitamin B12? aminoglycosides colchicine potassium supplements all of the above Answer: all of the above In addition to the drugs listed in the first three choices, ascorbic acid may destroy the vitamin B12 supplement within one hour of ingestion. These drugs should not be taken concomitantly with oral vitamin B12. Q: You are counseling a 72-year-old woman about nutrition. In the course of counseling you tell her that older adults are at increased risk of Vitamin D deficiency. Which of the following is NOT a factor that contributes to a Vitamin D deficiency? too much exposure to sunlight decreased exercise diminished renal function decreased body mass Answer: too much exposure to sunlight In actuality lack of sun exposure decreases synthesis of Vitamin D. Q: An 88-year-old female patient comes into the clinic with her heart "racing and feeling funny." The ECG confirms atrial fibrillation. The GNP understands that this condition is managed by all of the following except: treating the underlying disease electrical cardioversion heparin as the drug of choice with antithrombotic therapy IV management with digoxin as first line therapy Answer: heparin as the drug of choice with antithrombotic therapy The antithrombotic drug of choice for atrial fibrillation is warfarin (Coumadin). Q: A patient you diagnosed with hypothyroidism was started on levothyroixine. At what interval should the GNP reassess her TSH? 1 to 2 weeks 2 to 4 weeks 4 to 6 weeks 6 to 8 weeks Answer: 6 to 8 weeks In the treatment of hypothyroidism, T4 replacement is needed in the form of levothyroixine (Synthroid or Levoxyl). The initial dosages for an adult is 75 to 125 mcg. For an elderly person, the dose is 75% less than the adult dosage. Because of the long half-life of levothyroxine, the effects of a dosage adjustment or initiation would not cause a change in TSH for approximately five to six drug half-lives, or about 6 to 8 weeks. Q: A 67-year-old diabetic has been taking oral anti-hypoglycemics and is still having poor glycemic control. You make the decision to start insulin therapy. He weighs 60 kg. What should you order as an initial starting dose? 6 units short-acting insulin at breakfast, continue oral medication 6 units intermediate insulin at bedtime, stop oral medication 6 units long-acting before breakfast, stop oral medication 6 units long-acting insulin at bedtime, continue oral medication