Gerontology HESI Practice Questions | Complete Exam Pack with
Verified Correct Answers (Latest 2026)
1. An 80-year-old client is admitted with pneumonia. The nurse notes that the
client is confused and lethargic, but the family reports the client was alert at home
yesterday. What is the nurse's priority action?
A. Reorient the client to time and place every hour
B. Request a psychiatry consult for possible dementia
C. Assess for infection-related delirium and notify the healthcare provider
D. Place the client in a quiet room with soft lighting
Rationale: Acute confusion in an older adult with infection is most likely delirium, which is
a medical emergency. The priority is to identify and treat the underlying cause
(pneumonia). Dementia has a gradual onset; this sudden change suggests delirium.
Reorientation is helpful but not the priority. A quiet room may help but does not address
the cause.
2. An older adult client tells the nurse, "I don't understand why I'm so tired all the
time. I used to have so much energy." Which age-related physiological change
best explains this symptom?
A. Increased thyroid hormone production
B. Decreased basal metabolic rate and reduced cardiac reserve
C. Increased red blood cell production
D. Enhanced pulmonary function
Rationale: Aging is associated with a decreased basal metabolic rate and reduced cardiac
reserve, leading to fatigue and decreased energy. Thyroid hormone production typically
decreases, RBC production may decrease, and pulmonary function declines with age.
3. The nurse is performing a medication reconciliation for an 85-year-old client
who takes 12 different medications. Which finding is of greatest concern?
A. The client uses a pill organizer
B. The client takes medications at different times each day
,C. The client takes both warfarin and aspirin daily without a PPI
D. The client fills prescriptions at two different pharmacies
Rationale: The combination of warfarin and aspirin significantly increases bleeding risk,
especially without gastroprotection (PPI). This is a high-risk drug interaction. Using a pill
organizer is positive. Inconsistent timing and multiple pharmacies are concerns but less
immediately dangerous than this combination.
4. An 88-year-old client in a long-term care facility has refused to eat for three
days and is withdrawn. The nurse recognizes these symptoms as most consistent
with:
A. Normal aging
B. Depression
C. Early dementia
D. Delirium
Rationale: Refusal to eat, withdrawal, and social isolation are classic signs of depression in
older adults. This is not normal aging. Dementia typically involves cognitive decline but
may also include appetite changes. Delirium has an acute onset and fluctuating course,
whereas this presentation appears subacute.
5. The nurse is assessing the gait of a 77-year-old client. Which observation is
considered an age-related change rather than a pathological finding?
A. Shuffling gait with short steps
B. Widened base of support and slower walking speed
C. Unsteady gait with leaning to one side
D. Inability to walk without assistance
Rationale: A widened base of support and slower gait are normal age-related changes that
help maintain balance. Shuffling may indicate Parkinson's disease or other neurological
conditions. Leaning to one side suggests a focal neurological deficit. Inability to walk
independently is abnormal and requires evaluation.
,6. An older adult client with a history of falls is being discharged home. Which
home modification should the nurse prioritize?
A. Installing a stairlift
B. Removing throw rugs and installing grab bars in the bathroom
C. Replacing all furniture with lower pieces
D. Painting the walls a dark color for contrast
Rationale: Throw rugs are a common tripping hazard, and grab bars in the bathroom are
essential for safe transfers. These are evidence-based, high-impact interventions. A stairlift
may be needed but is not the priority. Lower furniture may be difficult to get out of. Dark
colors reduce contrast and visibility.
7. The nurse is caring for an older adult who has been prescribed digoxin. Which
assessment finding requires immediate intervention?
A. Heart rate of 62 beats per minute
B. Anorexia, nausea, and yellow-green halos around lights
C. Blood pressure of 140/88 mmHg
D. Urinary output of 30 mL per hour
Rationale: Anorexia, nausea, and visual disturbances (yellow-green halos) are classic signs
of digoxin toxicity, which is life-threatening and requires immediate evaluation. A heart
rate of 62 is within acceptable range. BP of 140/88 is elevated but not emergent. Urine
output of 30 mL/hr is borderline but not as urgent as digoxin toxicity.
8. An older adult client has been diagnosed with osteoporosis. Which dietary
recommendation should the nurse include in the teaching plan?
A. Increase intake of red meat and organ meats
B. Increase intake of dairy products and vitamin D-rich foods
C. Decrease calcium intake to reduce kidney stones
D. Limit fluids to prevent urinary calcium loss
Rationale: Osteoporosis management requires adequate calcium and vitamin D to support
bone health. Dairy products are excellent calcium sources. Red meat and organ meats are
high in purines and not bone-healthy. Decreasing calcium would worsen osteoporosis.
Fluid restriction is not recommended.
, 9. The nurse is assessing a 79-year-old client who is taking furosemide. Which
laboratory value requires the nurse's immediate attention?
A. Serum sodium of 138 mEq/L
B. Serum potassium of 3.0 mEq/L
C. Serum creatinine of 1.1 mg/dL
D. Serum glucose of 110 mg/dL
Rationale: Furosemide is a potassium-wasting diuretic. A potassium level of 3.0 mEq/L
indicates significant hypokalemia, which can cause cardiac arrhythmias. The other values
are within normal limits and do not require immediate intervention.
10. The adult child of an older adult client with Alzheimer's disease asks the nurse,
"How can I best communicate with my father when he becomes agitated?" The
nurse's best response is:
A. "Speak loudly so he can hear you better."
B. "Correct him firmly so he knows what is real."
C. "Use a calm, low voice, maintain eye contact, and redirect his attention."
D. "Leave him alone until he calms down."
Rationale: A calm, low voice and redirection are effective de-escalation techniques for
agitation in dementia. Loud voice can escalate agitation. Correcting the client can increase
frustration. Leaving the client alone may compromise safety.
11. The nurse is assessing an older adult for signs of dehydration. Which clinical
finding is least reliable in this population?
A. Decreased urine output
B. Skin turgor over the sternum
C. Orthostatic hypotension
D. Dry mucous membranes
Rationale: Skin turgor is less reliable in older adults because age-related loss of skin
elasticity can falsely suggest dehydration even when the client is euhydrated. Decreased
Verified Correct Answers (Latest 2026)
1. An 80-year-old client is admitted with pneumonia. The nurse notes that the
client is confused and lethargic, but the family reports the client was alert at home
yesterday. What is the nurse's priority action?
A. Reorient the client to time and place every hour
B. Request a psychiatry consult for possible dementia
C. Assess for infection-related delirium and notify the healthcare provider
D. Place the client in a quiet room with soft lighting
Rationale: Acute confusion in an older adult with infection is most likely delirium, which is
a medical emergency. The priority is to identify and treat the underlying cause
(pneumonia). Dementia has a gradual onset; this sudden change suggests delirium.
Reorientation is helpful but not the priority. A quiet room may help but does not address
the cause.
2. An older adult client tells the nurse, "I don't understand why I'm so tired all the
time. I used to have so much energy." Which age-related physiological change
best explains this symptom?
A. Increased thyroid hormone production
B. Decreased basal metabolic rate and reduced cardiac reserve
C. Increased red blood cell production
D. Enhanced pulmonary function
Rationale: Aging is associated with a decreased basal metabolic rate and reduced cardiac
reserve, leading to fatigue and decreased energy. Thyroid hormone production typically
decreases, RBC production may decrease, and pulmonary function declines with age.
3. The nurse is performing a medication reconciliation for an 85-year-old client
who takes 12 different medications. Which finding is of greatest concern?
A. The client uses a pill organizer
B. The client takes medications at different times each day
,C. The client takes both warfarin and aspirin daily without a PPI
D. The client fills prescriptions at two different pharmacies
Rationale: The combination of warfarin and aspirin significantly increases bleeding risk,
especially without gastroprotection (PPI). This is a high-risk drug interaction. Using a pill
organizer is positive. Inconsistent timing and multiple pharmacies are concerns but less
immediately dangerous than this combination.
4. An 88-year-old client in a long-term care facility has refused to eat for three
days and is withdrawn. The nurse recognizes these symptoms as most consistent
with:
A. Normal aging
B. Depression
C. Early dementia
D. Delirium
Rationale: Refusal to eat, withdrawal, and social isolation are classic signs of depression in
older adults. This is not normal aging. Dementia typically involves cognitive decline but
may also include appetite changes. Delirium has an acute onset and fluctuating course,
whereas this presentation appears subacute.
5. The nurse is assessing the gait of a 77-year-old client. Which observation is
considered an age-related change rather than a pathological finding?
A. Shuffling gait with short steps
B. Widened base of support and slower walking speed
C. Unsteady gait with leaning to one side
D. Inability to walk without assistance
Rationale: A widened base of support and slower gait are normal age-related changes that
help maintain balance. Shuffling may indicate Parkinson's disease or other neurological
conditions. Leaning to one side suggests a focal neurological deficit. Inability to walk
independently is abnormal and requires evaluation.
,6. An older adult client with a history of falls is being discharged home. Which
home modification should the nurse prioritize?
A. Installing a stairlift
B. Removing throw rugs and installing grab bars in the bathroom
C. Replacing all furniture with lower pieces
D. Painting the walls a dark color for contrast
Rationale: Throw rugs are a common tripping hazard, and grab bars in the bathroom are
essential for safe transfers. These are evidence-based, high-impact interventions. A stairlift
may be needed but is not the priority. Lower furniture may be difficult to get out of. Dark
colors reduce contrast and visibility.
7. The nurse is caring for an older adult who has been prescribed digoxin. Which
assessment finding requires immediate intervention?
A. Heart rate of 62 beats per minute
B. Anorexia, nausea, and yellow-green halos around lights
C. Blood pressure of 140/88 mmHg
D. Urinary output of 30 mL per hour
Rationale: Anorexia, nausea, and visual disturbances (yellow-green halos) are classic signs
of digoxin toxicity, which is life-threatening and requires immediate evaluation. A heart
rate of 62 is within acceptable range. BP of 140/88 is elevated but not emergent. Urine
output of 30 mL/hr is borderline but not as urgent as digoxin toxicity.
8. An older adult client has been diagnosed with osteoporosis. Which dietary
recommendation should the nurse include in the teaching plan?
A. Increase intake of red meat and organ meats
B. Increase intake of dairy products and vitamin D-rich foods
C. Decrease calcium intake to reduce kidney stones
D. Limit fluids to prevent urinary calcium loss
Rationale: Osteoporosis management requires adequate calcium and vitamin D to support
bone health. Dairy products are excellent calcium sources. Red meat and organ meats are
high in purines and not bone-healthy. Decreasing calcium would worsen osteoporosis.
Fluid restriction is not recommended.
, 9. The nurse is assessing a 79-year-old client who is taking furosemide. Which
laboratory value requires the nurse's immediate attention?
A. Serum sodium of 138 mEq/L
B. Serum potassium of 3.0 mEq/L
C. Serum creatinine of 1.1 mg/dL
D. Serum glucose of 110 mg/dL
Rationale: Furosemide is a potassium-wasting diuretic. A potassium level of 3.0 mEq/L
indicates significant hypokalemia, which can cause cardiac arrhythmias. The other values
are within normal limits and do not require immediate intervention.
10. The adult child of an older adult client with Alzheimer's disease asks the nurse,
"How can I best communicate with my father when he becomes agitated?" The
nurse's best response is:
A. "Speak loudly so he can hear you better."
B. "Correct him firmly so he knows what is real."
C. "Use a calm, low voice, maintain eye contact, and redirect his attention."
D. "Leave him alone until he calms down."
Rationale: A calm, low voice and redirection are effective de-escalation techniques for
agitation in dementia. Loud voice can escalate agitation. Correcting the client can increase
frustration. Leaving the client alone may compromise safety.
11. The nurse is assessing an older adult for signs of dehydration. Which clinical
finding is least reliable in this population?
A. Decreased urine output
B. Skin turgor over the sternum
C. Orthostatic hypotension
D. Dry mucous membranes
Rationale: Skin turgor is less reliable in older adults because age-related loss of skin
elasticity can falsely suggest dehydration even when the client is euhydrated. Decreased
