Gerontology HESI Practice Questions | Complete Exam Pack with
Verified Correct Answers (Latest 2026-2028)
A frail, elderly client is admitted to the unit with a diagnosis of pneumonia. Which finding
is most important for the registered nurse (RN) to report to the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting - CORRECT ANSWER B. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate oxygenation and
perfusion in this frail elderly client. (A), (C) and (D) are all common with pneumonia, but
the most important finding is confusion and evidence of dehydration, which require
treatment for this frail elderly client.
QUESTION :A frail elderly couple asks the registered nurse (RN) if they have to watch
their salt intake because food does not taste as good as it used to so they have to
season most foods. What information should the RN offer the couple?
A. Boredom may influence how the taste of food is perceived, and different seasonings
can stimulate taste.
B. With age, an increase in sodium intake is needed to compensate for a decrease in
renal function.
C. Short-term memory loss and confusion may be the reason they want to over-season
their food.
D. Taste buds often are dull due to atrophy so older clients should use other seasonings
instead of salt. - CORRECT ANSWER D. Taste buds are often dull due to atrophy
so older clients should use other seasonings instead of salt.
Rationale: Taste buds atrophy with normal aging, which influences an older client's
sensitivity to taste and is often compensated for the use of stronger tasting seasonings.
(A), (B), and (C) are not normal aging processes related to taste.
QUESTION :After taking a 10-day course of an antibiotic that was ineffective, a frail,
elderly client with chronic obstructive pulmonary disease (COPD) is admitted for
pneumonia. The client has a long history of smoking and still smokes a pack of
cigarettes a day. Which finding should the registered nurse (RN) report to the
healthcare provider?
A. Barrel chest with increased chest diameter
B. Crackles and pulse oximetry level of 88%
C. Low hemoglobin and hematocrit levels
,D. Arterial blood gases indicating respiratory acidosis - CORRECT ANSWER B.
Crackles and pulse oximetry level of 88%
Rationale: With pneumonia, crackles in the lungs and low O2 saturation (B) can impact
adequate oxygenation, which should be reported to the HCP. (A) occurs due to chronic
hyperinflation of the lungs and is common in clients with COPD. Anemia (C) is
frequently identified in clients with COPD, and respiratory acidosis (D) due to CO2
retention contributes to a lower blood pH.
QUESTION :An older female client recently moved to an assisted living facility. The
family explains to the registered nurse (RN) that the client is unmanageable and always
confused, disoriented and depressed. The client asks the RN repeatedly, "Where am
I?". How should the RN respond?
A. Explain that she is in a new home called an assisted living community
B. Question the client about her perception of where she might be now.
C. Distract the client with a scenario that she is on an outing with her family.
D. Reassure the client not to worry because she will meet new friends. - CORRECT
ANSWER A. Explain that she is in a new home called an assisted living community.
Rationale: Reality re-orientation (A) is the best response for a client who is confused
because the response is consistent and true. (B, C, and D) do not provide the client with
feedback that is reality based.
QUESTION :A new resident in an assisted living facility is an older client who is
experiencing short-term memory loss and confusion. Which activity should the
registered nurse (RN) schedule the client to do during the day?
A. Arts and crafts
B. Current events discussion group
C. Group sing-along
D. Daily exercise group - CORRECT ANSWER D. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the leader and
minimizes the client's stress to remember. (A), (C), and a current events discussion
group (B) are thought-provoking activities that require attention to detail and short-term
memory to participate in the group activity which may be stressful and frustrating to the
resident who has difficulty remembering sequence of the details.
QUESTION :The hospice nurse is completing a focused assessment of an older female
client with end stage Alzheimer's disease, who recently fractured her hip. What
technique should the registered nurse (RN) use to determine the client's pain?
A. Use the FACE pain scale
B. Ask the client to rate pain on a scale of 1 to 10
C. Observe for facial grimacing
D. Review documentation of recent eating habits - CORRECT ANSWER C.
Observe for facial grimacing
,Rationale: Observing for facial grimacing (C) is the best method for evaluating pain for a
client who cannot communicate due to Alzheimer disease. (A) and (B) may not be
understood by a client with end-stage Alzheimer's disease. (D) is not a helpful tool for
pain assessment.
QUESTION :An older male client arrives at the clinic for an annual physical
examination. While the nurse assesses the client, the client states that he is having
intimacy problems with his wife. Which information should the nurse provide to elicit
more information from the client?
A. Query client to clarify the client's idea of an intimacy problem.
B. Discuss benign prostatic hypertrophy (BPH) and ejaculation.
C. Explore the frequency that he experiences erectile dysfunction (ED)
D. Determine if the client's wife is young enough to get pregnant - CORRECT
ANSWER A. Query client to clarify the client's idea of an intimacy problem.
Rationale: Clarification of the client's concern is needed to appropriately address the
specific concern about intimacy issues (A). (B), (C), and (D) are details that the client
should present, not the RN.
QUESTION :The registered nurse (RN) is caring for an older female client with a 20
year history of rheumatoid arthritis (RA), who is admitted for carpel tunnel release.
Which finding associated with RA should the RN document?
A. Asymmetrical joint deformity
B. Small joint involvement in fingers
C. Crepitation or grating sensation in joints
D. Weight bearing joint involvement - CORRECT ANSWER B. Small joint
involvement in fingers.
Rationale: Small joint involvement (B) is common in rheumatoid arthritis. (A), (C) and
(D) are findings that different OA from RA.
QUESTION :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?
A. Increase protein and carbohydrates in the daily diet
B. Limit activity to bed rest for the first week and increase mobility incrementally each
week
C. Report abdominal distention, constipation or any other nausea and vomiting to the
healthcare provider
D. Drink liquids 2 hours after meals instead of during meals - CORRECT ANSWER
C. Report abdominal distention, constipation, or any nausea and vomiting to the
healthcare provider.
, Rationale: (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.
QUESTION :An older client is transferred to a telemetry unit after placement of a
pacemaker. What action should the registered nurse (RN) take first?
A. View incision site
B. Obtain a blood pressure
C. Establish telemetry monitoring
D. Evaluate client for pain - CORRECT ANSWER C. Establish telemetry
monitoring.
Rationale: The first action is to establish continuous telemetry monitoring (C) to ensure
the pacemaker is functioning properly. (A, B and D) should be implemented after the
client's heart rate and rhythm are successfully being monitored.
QUESTION :Older clients are at highest risk for abuse and neglect due to which
factors? (Select all that apply.)
A. Needs are greater than the caretaker's abilities
B. Client's declining strength
C. Fixed income
D. Longer life expectancy
E. Lack of exposure to technology and trends - CORRECT ANSWER A. Needs
regretter than the caretaker's abilities
B. Client's declining strength
Rationale: When needs are not being met due to lack of ability of the caretaker (A),
stress and feelings of failure may be expressed through neglect and abuse. Decline in
strength (B) increases the older client's vulnerability to resist or respond to elder abuse.
(C, D, E) do not increase the risk for neglect and abuse.
QUESTION :An older female client who has been taking hydrocodone/acetaminophen
(Lortab) q4 hours for chronic back pain for the past 5 years tells the registered nurse
(RN) that she cannot live without her pain pills. When asked if she is addicted, the client
states that she is not an addict because the healthcare provider prescribed the pain
pills. Which coping mechanism should the RN determine the client is using about her
addiction?
A. Lack of knowledge about narcotic medications
B. Rationalization to support narcotic use
C. Transfer of blame to healthcare provider
D. Justification of narcotic use due to chronic pain - CORRECT ANSWER B.
Rationalization to support narcotic use.
Rationale: The client is using rationalization to maintain self-esteem when she is
questioned by stating that she is not addicted because she is taking medication
prescribed by a healthcare provider. (A) may be possible, but the client is being
Verified Correct Answers (Latest 2026-2028)
A frail, elderly client is admitted to the unit with a diagnosis of pneumonia. Which finding
is most important for the registered nurse (RN) to report to the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting - CORRECT ANSWER B. Confusion and dehydration
Rationale: Confusion and dehydration (B) are findings of inadequate oxygenation and
perfusion in this frail elderly client. (A), (C) and (D) are all common with pneumonia, but
the most important finding is confusion and evidence of dehydration, which require
treatment for this frail elderly client.
QUESTION :A frail elderly couple asks the registered nurse (RN) if they have to watch
their salt intake because food does not taste as good as it used to so they have to
season most foods. What information should the RN offer the couple?
A. Boredom may influence how the taste of food is perceived, and different seasonings
can stimulate taste.
B. With age, an increase in sodium intake is needed to compensate for a decrease in
renal function.
C. Short-term memory loss and confusion may be the reason they want to over-season
their food.
D. Taste buds often are dull due to atrophy so older clients should use other seasonings
instead of salt. - CORRECT ANSWER D. Taste buds are often dull due to atrophy
so older clients should use other seasonings instead of salt.
Rationale: Taste buds atrophy with normal aging, which influences an older client's
sensitivity to taste and is often compensated for the use of stronger tasting seasonings.
(A), (B), and (C) are not normal aging processes related to taste.
QUESTION :After taking a 10-day course of an antibiotic that was ineffective, a frail,
elderly client with chronic obstructive pulmonary disease (COPD) is admitted for
pneumonia. The client has a long history of smoking and still smokes a pack of
cigarettes a day. Which finding should the registered nurse (RN) report to the
healthcare provider?
A. Barrel chest with increased chest diameter
B. Crackles and pulse oximetry level of 88%
C. Low hemoglobin and hematocrit levels
,D. Arterial blood gases indicating respiratory acidosis - CORRECT ANSWER B.
Crackles and pulse oximetry level of 88%
Rationale: With pneumonia, crackles in the lungs and low O2 saturation (B) can impact
adequate oxygenation, which should be reported to the HCP. (A) occurs due to chronic
hyperinflation of the lungs and is common in clients with COPD. Anemia (C) is
frequently identified in clients with COPD, and respiratory acidosis (D) due to CO2
retention contributes to a lower blood pH.
QUESTION :An older female client recently moved to an assisted living facility. The
family explains to the registered nurse (RN) that the client is unmanageable and always
confused, disoriented and depressed. The client asks the RN repeatedly, "Where am
I?". How should the RN respond?
A. Explain that she is in a new home called an assisted living community
B. Question the client about her perception of where she might be now.
C. Distract the client with a scenario that she is on an outing with her family.
D. Reassure the client not to worry because she will meet new friends. - CORRECT
ANSWER A. Explain that she is in a new home called an assisted living community.
Rationale: Reality re-orientation (A) is the best response for a client who is confused
because the response is consistent and true. (B, C, and D) do not provide the client with
feedback that is reality based.
QUESTION :A new resident in an assisted living facility is an older client who is
experiencing short-term memory loss and confusion. Which activity should the
registered nurse (RN) schedule the client to do during the day?
A. Arts and crafts
B. Current events discussion group
C. Group sing-along
D. Daily exercise group - CORRECT ANSWER D. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the leader and
minimizes the client's stress to remember. (A), (C), and a current events discussion
group (B) are thought-provoking activities that require attention to detail and short-term
memory to participate in the group activity which may be stressful and frustrating to the
resident who has difficulty remembering sequence of the details.
QUESTION :The hospice nurse is completing a focused assessment of an older female
client with end stage Alzheimer's disease, who recently fractured her hip. What
technique should the registered nurse (RN) use to determine the client's pain?
A. Use the FACE pain scale
B. Ask the client to rate pain on a scale of 1 to 10
C. Observe for facial grimacing
D. Review documentation of recent eating habits - CORRECT ANSWER C.
Observe for facial grimacing
,Rationale: Observing for facial grimacing (C) is the best method for evaluating pain for a
client who cannot communicate due to Alzheimer disease. (A) and (B) may not be
understood by a client with end-stage Alzheimer's disease. (D) is not a helpful tool for
pain assessment.
QUESTION :An older male client arrives at the clinic for an annual physical
examination. While the nurse assesses the client, the client states that he is having
intimacy problems with his wife. Which information should the nurse provide to elicit
more information from the client?
A. Query client to clarify the client's idea of an intimacy problem.
B. Discuss benign prostatic hypertrophy (BPH) and ejaculation.
C. Explore the frequency that he experiences erectile dysfunction (ED)
D. Determine if the client's wife is young enough to get pregnant - CORRECT
ANSWER A. Query client to clarify the client's idea of an intimacy problem.
Rationale: Clarification of the client's concern is needed to appropriately address the
specific concern about intimacy issues (A). (B), (C), and (D) are details that the client
should present, not the RN.
QUESTION :The registered nurse (RN) is caring for an older female client with a 20
year history of rheumatoid arthritis (RA), who is admitted for carpel tunnel release.
Which finding associated with RA should the RN document?
A. Asymmetrical joint deformity
B. Small joint involvement in fingers
C. Crepitation or grating sensation in joints
D. Weight bearing joint involvement - CORRECT ANSWER B. Small joint
involvement in fingers.
Rationale: Small joint involvement (B) is common in rheumatoid arthritis. (A), (C) and
(D) are findings that different OA from RA.
QUESTION :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?
A. Increase protein and carbohydrates in the daily diet
B. Limit activity to bed rest for the first week and increase mobility incrementally each
week
C. Report abdominal distention, constipation or any other nausea and vomiting to the
healthcare provider
D. Drink liquids 2 hours after meals instead of during meals - CORRECT ANSWER
C. Report abdominal distention, constipation, or any nausea and vomiting to the
healthcare provider.
, Rationale: (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.
QUESTION :An older client is transferred to a telemetry unit after placement of a
pacemaker. What action should the registered nurse (RN) take first?
A. View incision site
B. Obtain a blood pressure
C. Establish telemetry monitoring
D. Evaluate client for pain - CORRECT ANSWER C. Establish telemetry
monitoring.
Rationale: The first action is to establish continuous telemetry monitoring (C) to ensure
the pacemaker is functioning properly. (A, B and D) should be implemented after the
client's heart rate and rhythm are successfully being monitored.
QUESTION :Older clients are at highest risk for abuse and neglect due to which
factors? (Select all that apply.)
A. Needs are greater than the caretaker's abilities
B. Client's declining strength
C. Fixed income
D. Longer life expectancy
E. Lack of exposure to technology and trends - CORRECT ANSWER A. Needs
regretter than the caretaker's abilities
B. Client's declining strength
Rationale: When needs are not being met due to lack of ability of the caretaker (A),
stress and feelings of failure may be expressed through neglect and abuse. Decline in
strength (B) increases the older client's vulnerability to resist or respond to elder abuse.
(C, D, E) do not increase the risk for neglect and abuse.
QUESTION :An older female client who has been taking hydrocodone/acetaminophen
(Lortab) q4 hours for chronic back pain for the past 5 years tells the registered nurse
(RN) that she cannot live without her pain pills. When asked if she is addicted, the client
states that she is not an addict because the healthcare provider prescribed the pain
pills. Which coping mechanism should the RN determine the client is using about her
addiction?
A. Lack of knowledge about narcotic medications
B. Rationalization to support narcotic use
C. Transfer of blame to healthcare provider
D. Justification of narcotic use due to chronic pain - CORRECT ANSWER B.
Rationalization to support narcotic use.
Rationale: The client is using rationalization to maintain self-esteem when she is
questioned by stating that she is not addicted because she is taking medication
prescribed by a healthcare provider. (A) may be possible, but the client is being
