HESI EXIT Geriatric Nursing FAQs
1. What are the common physical changes that occur in aging, and how do they affect nursing care?
As part of geriatric nursing care studied in the HESI EXIT and NCLEX-PN exams, aging involves many physical changes that affect how nurses provide care. Older adults often experience decreased skin elasticity, reduced muscle mass (sarcopenia), decreased bone density (osteoporosis), sensory declines (vision and hearing), and decreased renal function.
These changes require nurses to adapt care plans to prevent pressure ulcers, encourage mobility and fall prevention, support sensory aids, and adjust medications carefully due to altered drug metabolism.
Nursing care considerations include:
- Regular skin assessments and repositioning to prevent ulcers (see NPIAP Guidelines)
- Encouraging strength exercises and mobility aids
- Monitoring calcium and vitamin D intake for bone health
- Using assistive devices for vision and hearing support
- Monitoring kidney function to adjust medication dosages
2. What are the most common chronic conditions in older adults, and how should they be managed in nursing care?
Common chronic diseases such as hypertension, diabetes mellitus, arthritis, cognitive decline (e.g., Alzheimer’s disease), and osteoporosis are frequent topics in the HESI EXIT and NCLEX-PN exams. Managing these conditions involves a multidisciplinary approach focusing on medication management, lifestyle modification, and patient education.
Management tips for nurses include:
- Monitoring blood pressure and promoting lifestyle changes for hypertension (American Heart Association)
- Educating on blood sugar control and foot care for diabetic patients
- Encouraging physical therapy and joint protection for arthritis
- Providing cognitive support and safety measures for dementia patients
- Educating on fall prevention and bone health for osteoporosis
3. How can nurses effectively manage pain in elderly patients, particularly those with dementia or cognitive impairments?
Pain management in elderly patients with cognitive impairment is a complex but essential part of geriatric nursing and is often tested in HESI EXIT and NCLEX-PN exams. Because these patients may have trouble communicating pain, nurses should use observational tools such as the Pain Assessment in Advanced Dementia (PAINAD) scale.
Strategies include:
- Employing non-pharmacological interventions like massage, music therapy, or heat/cold application
- Using acetaminophen or NSAIDs carefully for mild to moderate pain, adjusting for kidney or liver function
- Considering opioids cautiously for severe pain, monitoring for side effects
- Collaborating with multidisciplinary teams for comprehensive pain management
Learn more about pain assessment in dementia at the Alzheimer’s Association.
4. What are the unique considerations in geriatric pharmacology, and how should medications be managed in older adults?
Physiological changes in aging affect drug absorption, distribution, metabolism, and excretion, making geriatric pharmacology a critical subject for HESI EXIT and NCLEX-PN candidates.
Key considerations for nursing care include:
- Educating on medication timing due to altered GI absorption
- Understanding changes in body fat and water affecting drug distribution
- Adjusting doses for decreased liver and kidney function
- Monitoring for polypharmacy risks and potential adverse drug reactions (ADRs)
- Conducting regular medication reviews and simplifying regimens when possible
5. What are some effective strategies for promoting mental health and preventing depression in older adults?
Maintaining mental health and preventing depression in older adults is vital for quality of life and a key topic in geriatric nursing and HESI EXIT exams. Social isolation, physical decline, and life changes often contribute to depression risk.
Effective nursing strategies include:
- Encouraging social engagement through group activities and family involvement
- Promoting regular physical activity tailored to abilities
- Stimulating mental activity with puzzles, reading, or hobbies
- Supporting proper nutrition and hydration to improve mood
- Providing access to counseling and mental health resources, including cognitive-behavioral therapy (CBT)
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