Gerontology HESI Practice Questions | Complete Exam Pack with
Verified Correct Answers (Latest 2026-2027)
1. An 82-year-old client reports difficulty focusing on close-up objects like a menu
or a book. The nurse documents this finding as which of the following?
A. Glaucoma
B. Presbycusis
C. Macular degeneration
D. Presbyopia
Rationale: Presbyopia is the age-related loss of near vision caused by hardening of the lens
and weakening of the ciliary muscles. Presbycusis refers to age-related hearing loss.
Glaucoma involves increased intraocular pressure, and macular degeneration affects
central vision.
2. The nurse is assessing the skin of a 78-year-old client. Which age-related change
best explains why this client is at a higher risk for developing pressure injuries?
A. Increased skin turgor
B. Increased sebum production
C. Decreased subcutaneous tissue
D. Increased melanocyte activity
Rationale: Loss of subcutaneous tissue reduces the natural padding over bony
prominences, making the skin more vulnerable to breakdown, shearing, and friction
injuries. Skin turgor typically decreases, sebum production decreases, and melanocyte
activity decreases with aging.
3. The nurse is teaching a group of older adults about hydration. Which
physiological change of aging should the nurse emphasize as a key reason for
,increased dehydration risk?
A. Increased saliva production
B. Diminished thirst mechanism
C. Increased kidney filtration rate
D. Enhanced antidiuretic hormone (ADH) response
Rationale: The thirst mechanism becomes blunted with age, so older adults often do not
feel thirsty even when dehydrated. This leads to inadequate fluid intake. Saliva production
decreases, kidney filtration decreases, and ADH response may be altered.
4. An older adult male client is experiencing urinary frequency, hesitancy, and a
weak stream. The nurse suspects which benign age-related condition?
A. Prostate cancer
B. Benign Prostatic Hyperplasia (BPH)
C. Urinary tract infection
D. Bladder calculi
Rationale: BPH is a common non-cancerous enlargement of the prostate gland in aging
males, causing lower urinary tract symptoms such as frequency, hesitancy, and weak
stream. Prostate cancer may be asymptomatic initially. UTI and bladder stones can cause
similar symptoms but are not benign age-related changes.
5. The nurse notes that an 80-year-old client has dry, itchy skin with flat brown
spots on the hands and face. The nurse correctly identifies these spots as:
A. Actinic keratosis
B. Senile lentigines
C. Seborrheic keratosis
D. Petechiae
Rationale: Senile lentigines (commonly called liver spots or age spots) are flat, brown
pigmented areas resulting from cumulative sun exposure and decreased melanocyte
function with aging. Actinic keratosis is a precancerous scaly lesion. Seborrheic keratosis is
a warty, raised lesion. Petechiae are pinpoint hemorrhages.
,6. Which age-related change contributes to dry and itchy skin in older adults?
A. Increased collagen production
B. Decreased sebum production
C. Increased sweat gland activity
D. Thickening of the dermis
Rationale: Sebaceous glands produce less oil (sebum) with aging, leading to xerosis (dry
skin) and pruritus (itching). Collagen production decreases, sweat gland activity decreases,
and the dermis thins with age.
7. An older adult client asks why they are experiencing hearing loss primarily in
high-frequency ranges. The nurse explains this condition is known as:
A. Otosclerosis
B. Meniere's disease
C. Presbycusis
D. Tinnitus
Rationale: Presbycusis is age-related sensorineural hearing loss that typically affects high-
frequency sounds first. Otosclerosis involves abnormal bone growth in the middle ear.
Meniere's disease causes vertigo and fluctuating hearing loss. Tinnitus is ringing in the
ears.
8. The nurse understands that cardiac output in older adults decreases primarily
due to:
A. Increased heart rate
B. Decreased myocardial contractility
C. Decreased peripheral vascular resistance
D. Increased stroke volume
Rationale: Aging leads to decreased myocardial contractility, reduced stroke volume, and
increased vascular resistance. Heart rate may remain relatively stable, but the heart
becomes less efficient at pumping blood.
, 9. An older adult client has a new murmur auscultated during a routine physical.
The nurse recognizes that age-related valvular changes such as sclerosis and
calcification most commonly affect which valve?
A. Mitral valve
B. Tricuspid valve
C. Pulmonic valve
D. Aortic valve
Rationale: Aortic stenosis is the most common age-related valvular change due to
calcification and sclerosis of the aortic valve. Mitral regurgitation is also common, but
aortic valve changes are most frequently heard.
10. The nurse is caring for an older adult with decreased thyroid activity. Which
finding is consistent with this age-related change?
A. Increased energy levels
B. Weight loss
C. Decreased basal metabolic rate (BMR)
D. Heat intolerance
Rationale: Decreased thyroid activity leads to a lower BMR, which can cause weight gain,
fatigue, cold intolerance, and decreased energy levels. The thyroid gland may atrophy with
age.
11. A 75-year-old client reports constipation. Which age-related gastrointestinal
change contributes to this problem?
A. Increased peristalsis
B. Decreased gastric motility
C. Increased gastric acid secretion
D. Increased intestinal absorption
Rationale: Gastric motility decreases with age, leading to delayed gastric emptying and
increased risk of constipation. Peristalsis decreases, gastric acid secretion often decreases,
and absorption may be altered.
Verified Correct Answers (Latest 2026-2027)
1. An 82-year-old client reports difficulty focusing on close-up objects like a menu
or a book. The nurse documents this finding as which of the following?
A. Glaucoma
B. Presbycusis
C. Macular degeneration
D. Presbyopia
Rationale: Presbyopia is the age-related loss of near vision caused by hardening of the lens
and weakening of the ciliary muscles. Presbycusis refers to age-related hearing loss.
Glaucoma involves increased intraocular pressure, and macular degeneration affects
central vision.
2. The nurse is assessing the skin of a 78-year-old client. Which age-related change
best explains why this client is at a higher risk for developing pressure injuries?
A. Increased skin turgor
B. Increased sebum production
C. Decreased subcutaneous tissue
D. Increased melanocyte activity
Rationale: Loss of subcutaneous tissue reduces the natural padding over bony
prominences, making the skin more vulnerable to breakdown, shearing, and friction
injuries. Skin turgor typically decreases, sebum production decreases, and melanocyte
activity decreases with aging.
3. The nurse is teaching a group of older adults about hydration. Which
physiological change of aging should the nurse emphasize as a key reason for
,increased dehydration risk?
A. Increased saliva production
B. Diminished thirst mechanism
C. Increased kidney filtration rate
D. Enhanced antidiuretic hormone (ADH) response
Rationale: The thirst mechanism becomes blunted with age, so older adults often do not
feel thirsty even when dehydrated. This leads to inadequate fluid intake. Saliva production
decreases, kidney filtration decreases, and ADH response may be altered.
4. An older adult male client is experiencing urinary frequency, hesitancy, and a
weak stream. The nurse suspects which benign age-related condition?
A. Prostate cancer
B. Benign Prostatic Hyperplasia (BPH)
C. Urinary tract infection
D. Bladder calculi
Rationale: BPH is a common non-cancerous enlargement of the prostate gland in aging
males, causing lower urinary tract symptoms such as frequency, hesitancy, and weak
stream. Prostate cancer may be asymptomatic initially. UTI and bladder stones can cause
similar symptoms but are not benign age-related changes.
5. The nurse notes that an 80-year-old client has dry, itchy skin with flat brown
spots on the hands and face. The nurse correctly identifies these spots as:
A. Actinic keratosis
B. Senile lentigines
C. Seborrheic keratosis
D. Petechiae
Rationale: Senile lentigines (commonly called liver spots or age spots) are flat, brown
pigmented areas resulting from cumulative sun exposure and decreased melanocyte
function with aging. Actinic keratosis is a precancerous scaly lesion. Seborrheic keratosis is
a warty, raised lesion. Petechiae are pinpoint hemorrhages.
,6. Which age-related change contributes to dry and itchy skin in older adults?
A. Increased collagen production
B. Decreased sebum production
C. Increased sweat gland activity
D. Thickening of the dermis
Rationale: Sebaceous glands produce less oil (sebum) with aging, leading to xerosis (dry
skin) and pruritus (itching). Collagen production decreases, sweat gland activity decreases,
and the dermis thins with age.
7. An older adult client asks why they are experiencing hearing loss primarily in
high-frequency ranges. The nurse explains this condition is known as:
A. Otosclerosis
B. Meniere's disease
C. Presbycusis
D. Tinnitus
Rationale: Presbycusis is age-related sensorineural hearing loss that typically affects high-
frequency sounds first. Otosclerosis involves abnormal bone growth in the middle ear.
Meniere's disease causes vertigo and fluctuating hearing loss. Tinnitus is ringing in the
ears.
8. The nurse understands that cardiac output in older adults decreases primarily
due to:
A. Increased heart rate
B. Decreased myocardial contractility
C. Decreased peripheral vascular resistance
D. Increased stroke volume
Rationale: Aging leads to decreased myocardial contractility, reduced stroke volume, and
increased vascular resistance. Heart rate may remain relatively stable, but the heart
becomes less efficient at pumping blood.
, 9. An older adult client has a new murmur auscultated during a routine physical.
The nurse recognizes that age-related valvular changes such as sclerosis and
calcification most commonly affect which valve?
A. Mitral valve
B. Tricuspid valve
C. Pulmonic valve
D. Aortic valve
Rationale: Aortic stenosis is the most common age-related valvular change due to
calcification and sclerosis of the aortic valve. Mitral regurgitation is also common, but
aortic valve changes are most frequently heard.
10. The nurse is caring for an older adult with decreased thyroid activity. Which
finding is consistent with this age-related change?
A. Increased energy levels
B. Weight loss
C. Decreased basal metabolic rate (BMR)
D. Heat intolerance
Rationale: Decreased thyroid activity leads to a lower BMR, which can cause weight gain,
fatigue, cold intolerance, and decreased energy levels. The thyroid gland may atrophy with
age.
11. A 75-year-old client reports constipation. Which age-related gastrointestinal
change contributes to this problem?
A. Increased peristalsis
B. Decreased gastric motility
C. Increased gastric acid secretion
D. Increased intestinal absorption
Rationale: Gastric motility decreases with age, leading to delayed gastric emptying and
increased risk of constipation. Peristalsis decreases, gastric acid secretion often decreases,
and absorption may be altered.
