2026 GERONTOLOGY HESI PRACTICE
QUESTIONS Comprehensive Nursing Gerontology
Review 2026 Edition | Verified Questions with
Detailed Rationales
Core Domains Covered:
Domain I: Theories of Aging & Normal Age-Related Changes (15 questions)
• Biological, psychological, and sociological theories of aging
• Normal physiological changes across body systems
• Age-related sensory and functional changes
• Health promotion and wellness in aging
Domain II: Cardiovascular & Respiratory Changes (12 questions)
• Age-related cardiac and vascular changes
• Common cardiovascular conditions in older adults
• Respiratory changes and risk factors
• Assessment and management strategies
Domain III: Neurological & Cognitive Changes (12 questions)
• Normal cognitive changes versus dementia
• Alzheimer's disease and other dementias
• Delirium and depression in older adults
• Sundowner syndrome and behavioral changes
Domain IV: Musculoskeletal & Integumentary Changes (12 questions)
• Osteoporosis, osteoarthritis, and fractures
• Falls prevention and mobility
• Skin changes and pressure injury prevention
, • Wound healing and care
Domain V: Sensory & Communication Changes (8 questions)
• Vision and hearing changes
• Communication strategies for older adults
• Age-related eye and ear conditions
• Sensory aids and adaptations
Domain VI: Medication Management & Pharmacology (10 questions)
• Polypharmacy and adverse drug reactions
• Age-related pharmacokinetic changes
• Medication reconciliation and safety
• Common medications in geriatric care
Domain VII: Nutrition, Elimination & Hydration (8 questions)
• Nutritional needs and challenges in aging
• Bowel and bladder changes
• Urinary incontinence and constipation
• Hydration and electrolyte balance
Domain VIII: Psychosocial & Mental Health (8 questions)
• Depression, anxiety, and suicide risk
• Social isolation and support systems
• Coping and adaptation in aging
• Spirituality and end-of-life issues
Domain IX: Elder Abuse, Ethics & End-of-Life Care (5 questions)
• Recognizing and reporting elder abuse and neglect
• Ethical issues in geriatric care
• Advanced directives and end-of-life decisions
, • Hospice and palliative care
Domain X: Comprehensive Assessment & Care Planning (5 questions)
• Comprehensive geriatric assessment
• Interdisciplinary team collaboration
• Care transitions and discharge planning
• Community resources and long-term care
Domain I: Theories of Aging & Normal Age-Related Changes
1. The nursing assessment of an older female client elicits a history of
Raynaud's phenomenon. Which exposure should the nurse instruct the client
to avoid?
Answer: C. Cold climates
Rationale: Cold climates can cause prolonged painful vasoconstriction of
the peripheral extremities in clients with Raynaud's phenomenon. The nurse
should educate the client to avoid cold exposure and dress warmly in cold
weather.
A. Alcohol consumption
B. Warm climates
C. Cold climates
D. Active exercise
2. A 78-year-old client reports feeling tired and having less energy than
before. Which statement best reflects the nurse's understanding of normal
age-related changes?
Answer: B. Decreased energy and fatigue may be due to normal age-
related changes, but should be evaluated for underlying pathology
Rationale: While decreased energy and fatigue can be normal age-related
changes, the nurse should also evaluate for underlying pathology such as
anemia, thyroid dysfunction, depression, or cardiovascular disease.
, A. This is not a normal age-related change and requires immediate hospitalization
B. Decreased energy and fatigue may be due to normal age-related changes,
but should be evaluated for underlying pathology
C. This is a normal age-related change that requires no intervention
D. This indicates the client is nearing the end of life
3. Which theory of aging suggests that aging is caused by the accumulation of
free radicals causing cellular damage?
Answer: A. Free radical theory
Rationale: The free radical theory of aging proposes that aging results
from the accumulation of damage caused by free radicals, which are highly
reactive molecules that can damage cellular components such as DNA,
proteins, and lipids.
A. Free radical theory
B. Wear and tear theory
C. Programmed aging theory
D. Immunologic theory
4. Which of the following is a normal age-related change in the cardiovascular
system?
Answer: B. Widening pulse pressure
Rationale: Widening pulse pressure is a normal age-related change in the
cardiovascular system due to decreased arterial compliance and increased
systolic blood pressure. Other normal changes include cardiac murmurs
(often benign) and left ventricular hypertrophy.
A. Dyspnea at rest
B. Widening pulse pressure
C. Chest pain
D. Irregular heart rate
5. An older adult's skin shows decreased turgor and elasticity. This is most
likely due to:
QUESTIONS Comprehensive Nursing Gerontology
Review 2026 Edition | Verified Questions with
Detailed Rationales
Core Domains Covered:
Domain I: Theories of Aging & Normal Age-Related Changes (15 questions)
• Biological, psychological, and sociological theories of aging
• Normal physiological changes across body systems
• Age-related sensory and functional changes
• Health promotion and wellness in aging
Domain II: Cardiovascular & Respiratory Changes (12 questions)
• Age-related cardiac and vascular changes
• Common cardiovascular conditions in older adults
• Respiratory changes and risk factors
• Assessment and management strategies
Domain III: Neurological & Cognitive Changes (12 questions)
• Normal cognitive changes versus dementia
• Alzheimer's disease and other dementias
• Delirium and depression in older adults
• Sundowner syndrome and behavioral changes
Domain IV: Musculoskeletal & Integumentary Changes (12 questions)
• Osteoporosis, osteoarthritis, and fractures
• Falls prevention and mobility
• Skin changes and pressure injury prevention
, • Wound healing and care
Domain V: Sensory & Communication Changes (8 questions)
• Vision and hearing changes
• Communication strategies for older adults
• Age-related eye and ear conditions
• Sensory aids and adaptations
Domain VI: Medication Management & Pharmacology (10 questions)
• Polypharmacy and adverse drug reactions
• Age-related pharmacokinetic changes
• Medication reconciliation and safety
• Common medications in geriatric care
Domain VII: Nutrition, Elimination & Hydration (8 questions)
• Nutritional needs and challenges in aging
• Bowel and bladder changes
• Urinary incontinence and constipation
• Hydration and electrolyte balance
Domain VIII: Psychosocial & Mental Health (8 questions)
• Depression, anxiety, and suicide risk
• Social isolation and support systems
• Coping and adaptation in aging
• Spirituality and end-of-life issues
Domain IX: Elder Abuse, Ethics & End-of-Life Care (5 questions)
• Recognizing and reporting elder abuse and neglect
• Ethical issues in geriatric care
• Advanced directives and end-of-life decisions
, • Hospice and palliative care
Domain X: Comprehensive Assessment & Care Planning (5 questions)
• Comprehensive geriatric assessment
• Interdisciplinary team collaboration
• Care transitions and discharge planning
• Community resources and long-term care
Domain I: Theories of Aging & Normal Age-Related Changes
1. The nursing assessment of an older female client elicits a history of
Raynaud's phenomenon. Which exposure should the nurse instruct the client
to avoid?
Answer: C. Cold climates
Rationale: Cold climates can cause prolonged painful vasoconstriction of
the peripheral extremities in clients with Raynaud's phenomenon. The nurse
should educate the client to avoid cold exposure and dress warmly in cold
weather.
A. Alcohol consumption
B. Warm climates
C. Cold climates
D. Active exercise
2. A 78-year-old client reports feeling tired and having less energy than
before. Which statement best reflects the nurse's understanding of normal
age-related changes?
Answer: B. Decreased energy and fatigue may be due to normal age-
related changes, but should be evaluated for underlying pathology
Rationale: While decreased energy and fatigue can be normal age-related
changes, the nurse should also evaluate for underlying pathology such as
anemia, thyroid dysfunction, depression, or cardiovascular disease.
, A. This is not a normal age-related change and requires immediate hospitalization
B. Decreased energy and fatigue may be due to normal age-related changes,
but should be evaluated for underlying pathology
C. This is a normal age-related change that requires no intervention
D. This indicates the client is nearing the end of life
3. Which theory of aging suggests that aging is caused by the accumulation of
free radicals causing cellular damage?
Answer: A. Free radical theory
Rationale: The free radical theory of aging proposes that aging results
from the accumulation of damage caused by free radicals, which are highly
reactive molecules that can damage cellular components such as DNA,
proteins, and lipids.
A. Free radical theory
B. Wear and tear theory
C. Programmed aging theory
D. Immunologic theory
4. Which of the following is a normal age-related change in the cardiovascular
system?
Answer: B. Widening pulse pressure
Rationale: Widening pulse pressure is a normal age-related change in the
cardiovascular system due to decreased arterial compliance and increased
systolic blood pressure. Other normal changes include cardiac murmurs
(often benign) and left ventricular hypertrophy.
A. Dyspnea at rest
B. Widening pulse pressure
C. Chest pain
D. Irregular heart rate
5. An older adult's skin shows decreased turgor and elasticity. This is most
likely due to:
