HESI GERIATRICS EXAM 300 ACTUAL QUESTIONS
AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+ ASSURED
PASS
The HESI Geriatrics Exam is a specialized nursing assessment focusing on the
unique physiological, psychosocial, and pharmacological needs of the aging
population. This exam evaluates a student's competency in managing common
geriatric syndromes, including polypharmacy, falls, cognitive impairment, and
chronic disease management. Key topics include age-related physiological
changes, common disorders (cardiovascular, respiratory, neurological, endocrine),
end-of-life and palliative care, medication safety, and ethical/legal considerations.
The exam emphasizes the application of evidence-based nursing interventions and
patient-centered communication. Success on this exam demonstrates readiness to
provide safe, holistic care to older adults across diverse healthcare settings,
preparing students for both clinical practice and licensure.
Section 1: Foundations of Geriatric Nursing (Questions 1-30)
1. The nurse is caring for an 82-year-old client. Which age-related change in the
integumentary system increases the risk for skin breakdown?
A) Increased collagen and elastin fibers
B) Increased subcutaneous fat
C) Decreased sebum production and thinning of the epidermis
D) Hyperpigmentation of the skin
Answer: C
Rationale: Age-related changes in the skin include thinning of the epidermis,
decreased sebum production, and loss of subcutaneous fat. These changes reduce
the skin's protective barrier, making it more susceptible to breakdown, shearing,
,and infection. Increased collagen, increased fat, and hyperpigmentation are not
protective changes.
2. An older adult client reports difficulty hearing high-pitched voices, especially in
crowded rooms. The nurse suspects which type of hearing loss?
A) Conductive hearing loss
B) Sensorineural hearing loss
C) Mixed hearing loss
D) Central auditory processing disorder
Answer: B
Rationale: Sensorineural hearing loss, often age-related (presbycusis), is
characterized by difficulty hearing high-frequency sounds and understanding
speech in noisy environments. It results from damage to the inner ear or auditory
nerve. Conductive loss involves the outer/middle ear, mixed is both, and central is
a processing issue in the brain.
3. The nurse is teaching a group of older adults about age-related vision changes.
Which visual change is considered a normal part of aging?
A) Presbyopia
B) Cataracts
C) Glaucoma
D) Macular degeneration
Answer: A
Rationale: Presbyopia is the normal age-related loss of near vision due to
hardening of the lens. Cataracts, glaucoma, and macular degeneration are
pathologic conditions, though they are more common in older adults. The nurse
should distinguish normal changes from disease.
4. A 75-year-old client asks the nurse about ways to prevent falls. Which
recommendation is most effective?
A) Install grab bars in the bathroom
B) Avoid all physical activity
C) Wear socks without shoes to improve grip
D) Reduce fluid intake to minimize bathroom trips
Answer: A
Rationale: Installing grab bars in the bathroom addresses environmental hazards
and provides support, reducing fall risk. Physical activity should be encouraged,
not avoided. Wearing non-skid footwear is preferred over socks. Fluid restriction
can lead to dehydration and is not recommended.
,5. The nurse is assessing an older adult client for orthostatic hypotension. Which
finding is consistent with this condition?
A) Blood pressure decreases by 10 mmHg upon standing
B) Blood pressure increases by 20 mmHg upon standing
C) Heart rate decreases upon standing
D) The client reports dizziness and blurred vision when rising
Answer: D
Rationale: Orthostatic hypotension is defined as a drop of at least 20 mmHg in
systolic or 10 mmHg in diastolic blood pressure within 3 minutes of standing,
accompanied by symptoms such as dizziness, lightheadedness, or blurred vision. A
decrease of 10 mmHg is not sufficient for a diagnosis.
6. An older adult client is prescribed multiple medications. The nurse should be
most concerned about which age-related change that increases the risk of adverse
drug reactions?
A) Decreased gastric emptying
B) Increased liver metabolism
C) Decreased renal function
D) Increased body water percentage
Answer: C
Rationale: Age-related decline in renal function reduces drug clearance, leading to
accumulation and toxicity of renally excreted medications. Decreased gastric
emptying affects absorption, but renal decline is the most significant concern.
Liver metabolism may decrease, not increase, and body water decreases with age.
7. The nurse is assessing an 80-year-old client's nutritional status. Which finding is
most concerning?
A) Weight loss of 5% of body weight over 1 month
B) Weight loss of 3% of body weight over 3 months
C) Stable weight over 6 months
D) Weight gain of 2 pounds over 1 month
Answer: A
Rationale: Unintentional weight loss of 5% or more over 1 month or 10% over 6
months is significant and warrants further evaluation. Weight loss of 3% over 3
months is less concerning. Stable weight and minimal weight gain are not
concerning.
8. The nurse is teaching an older adult client about medication safety. Which
statement indicates understanding?
A) "I can crush my extended-release pills if they are hard to swallow."
, B) "I will use one pharmacy for all my prescriptions."
C) "I don't need to tell my doctor about over-the-counter medications."
D) "It is safe to share medications with my spouse."
Answer: B
Rationale: Using one pharmacy helps prevent drug interactions and ensures a
complete medication profile. Extended-release pills should not be crushed. All
medications, including OTC, should be disclosed. Sharing medications is unsafe.
9. An older adult client who lives alone is discharged from the hospital. The nurse
should prioritize which safety intervention?
A) Referral to home health services
B) Encouraging the client to drive
C) Advising the client to lock all doors
D) Recommending a low-protein diet
Answer: A
Rationale: Older adults living alone are at risk for social isolation, medication
errors, and falls. A referral to home health services provides monitoring,
medication management, and safety support. Driving may be unsafe, and locking
doors alone does not address other risks.
10. The nurse is assessing an older adult client's cognitive function. Which finding
is a normal age-related change?
A) Difficulty recalling recent events
B) Inability to perform activities of daily living
C) Disorientation to time and place
D) Impaired judgment and reasoning
Answer: A
Rationale: Mild forgetfulness, such as occasional difficulty recalling recent events,
is a normal age-related change. Inability to perform ADLs, disorientation, and
impaired judgment are signs of cognitive impairment or dementia, not normal
aging.
11. The nurse is teaching a client about age-related changes in the gastrointestinal
system. Which change is expected?
A) Increased gastric acid secretion
B) Decreased motility and delayed gastric emptying
C) Increased peristalsis
D) Decreased transit time
Answer: B
AND CORRECT ANSWERS WITH RATIONALE
LATEST UPDATE ALREADY GRADED A+ ASSURED
PASS
The HESI Geriatrics Exam is a specialized nursing assessment focusing on the
unique physiological, psychosocial, and pharmacological needs of the aging
population. This exam evaluates a student's competency in managing common
geriatric syndromes, including polypharmacy, falls, cognitive impairment, and
chronic disease management. Key topics include age-related physiological
changes, common disorders (cardiovascular, respiratory, neurological, endocrine),
end-of-life and palliative care, medication safety, and ethical/legal considerations.
The exam emphasizes the application of evidence-based nursing interventions and
patient-centered communication. Success on this exam demonstrates readiness to
provide safe, holistic care to older adults across diverse healthcare settings,
preparing students for both clinical practice and licensure.
Section 1: Foundations of Geriatric Nursing (Questions 1-30)
1. The nurse is caring for an 82-year-old client. Which age-related change in the
integumentary system increases the risk for skin breakdown?
A) Increased collagen and elastin fibers
B) Increased subcutaneous fat
C) Decreased sebum production and thinning of the epidermis
D) Hyperpigmentation of the skin
Answer: C
Rationale: Age-related changes in the skin include thinning of the epidermis,
decreased sebum production, and loss of subcutaneous fat. These changes reduce
the skin's protective barrier, making it more susceptible to breakdown, shearing,
,and infection. Increased collagen, increased fat, and hyperpigmentation are not
protective changes.
2. An older adult client reports difficulty hearing high-pitched voices, especially in
crowded rooms. The nurse suspects which type of hearing loss?
A) Conductive hearing loss
B) Sensorineural hearing loss
C) Mixed hearing loss
D) Central auditory processing disorder
Answer: B
Rationale: Sensorineural hearing loss, often age-related (presbycusis), is
characterized by difficulty hearing high-frequency sounds and understanding
speech in noisy environments. It results from damage to the inner ear or auditory
nerve. Conductive loss involves the outer/middle ear, mixed is both, and central is
a processing issue in the brain.
3. The nurse is teaching a group of older adults about age-related vision changes.
Which visual change is considered a normal part of aging?
A) Presbyopia
B) Cataracts
C) Glaucoma
D) Macular degeneration
Answer: A
Rationale: Presbyopia is the normal age-related loss of near vision due to
hardening of the lens. Cataracts, glaucoma, and macular degeneration are
pathologic conditions, though they are more common in older adults. The nurse
should distinguish normal changes from disease.
4. A 75-year-old client asks the nurse about ways to prevent falls. Which
recommendation is most effective?
A) Install grab bars in the bathroom
B) Avoid all physical activity
C) Wear socks without shoes to improve grip
D) Reduce fluid intake to minimize bathroom trips
Answer: A
Rationale: Installing grab bars in the bathroom addresses environmental hazards
and provides support, reducing fall risk. Physical activity should be encouraged,
not avoided. Wearing non-skid footwear is preferred over socks. Fluid restriction
can lead to dehydration and is not recommended.
,5. The nurse is assessing an older adult client for orthostatic hypotension. Which
finding is consistent with this condition?
A) Blood pressure decreases by 10 mmHg upon standing
B) Blood pressure increases by 20 mmHg upon standing
C) Heart rate decreases upon standing
D) The client reports dizziness and blurred vision when rising
Answer: D
Rationale: Orthostatic hypotension is defined as a drop of at least 20 mmHg in
systolic or 10 mmHg in diastolic blood pressure within 3 minutes of standing,
accompanied by symptoms such as dizziness, lightheadedness, or blurred vision. A
decrease of 10 mmHg is not sufficient for a diagnosis.
6. An older adult client is prescribed multiple medications. The nurse should be
most concerned about which age-related change that increases the risk of adverse
drug reactions?
A) Decreased gastric emptying
B) Increased liver metabolism
C) Decreased renal function
D) Increased body water percentage
Answer: C
Rationale: Age-related decline in renal function reduces drug clearance, leading to
accumulation and toxicity of renally excreted medications. Decreased gastric
emptying affects absorption, but renal decline is the most significant concern.
Liver metabolism may decrease, not increase, and body water decreases with age.
7. The nurse is assessing an 80-year-old client's nutritional status. Which finding is
most concerning?
A) Weight loss of 5% of body weight over 1 month
B) Weight loss of 3% of body weight over 3 months
C) Stable weight over 6 months
D) Weight gain of 2 pounds over 1 month
Answer: A
Rationale: Unintentional weight loss of 5% or more over 1 month or 10% over 6
months is significant and warrants further evaluation. Weight loss of 3% over 3
months is less concerning. Stable weight and minimal weight gain are not
concerning.
8. The nurse is teaching an older adult client about medication safety. Which
statement indicates understanding?
A) "I can crush my extended-release pills if they are hard to swallow."
, B) "I will use one pharmacy for all my prescriptions."
C) "I don't need to tell my doctor about over-the-counter medications."
D) "It is safe to share medications with my spouse."
Answer: B
Rationale: Using one pharmacy helps prevent drug interactions and ensures a
complete medication profile. Extended-release pills should not be crushed. All
medications, including OTC, should be disclosed. Sharing medications is unsafe.
9. An older adult client who lives alone is discharged from the hospital. The nurse
should prioritize which safety intervention?
A) Referral to home health services
B) Encouraging the client to drive
C) Advising the client to lock all doors
D) Recommending a low-protein diet
Answer: A
Rationale: Older adults living alone are at risk for social isolation, medication
errors, and falls. A referral to home health services provides monitoring,
medication management, and safety support. Driving may be unsafe, and locking
doors alone does not address other risks.
10. The nurse is assessing an older adult client's cognitive function. Which finding
is a normal age-related change?
A) Difficulty recalling recent events
B) Inability to perform activities of daily living
C) Disorientation to time and place
D) Impaired judgment and reasoning
Answer: A
Rationale: Mild forgetfulness, such as occasional difficulty recalling recent events,
is a normal age-related change. Inability to perform ADLs, disorientation, and
impaired judgment are signs of cognitive impairment or dementia, not normal
aging.
11. The nurse is teaching a client about age-related changes in the gastrointestinal
system. Which change is expected?
A) Increased gastric acid secretion
B) Decreased motility and delayed gastric emptying
C) Increased peristalsis
D) Decreased transit time
Answer: B
