HESI Gerontological Nursing Practice
Examination 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A Instant
Download Pdf
1. An older adult resident in a long-term care facility exhibits a sudden onset
of confusion, increased agitation, and urinary incontinence. The nurse should
suspect which underlying condition?
A) Early-onset Alzheimer's disease
B) Normal age-related cognitive decline
C) Urinary tract infection (UTI)
D) Chronic depression
Older adults rarely exhibit classic symptoms of infection such as fever or
dysuria. Instead, an acute change in mental status (delirium), sudden
confusion, and worsening incontinence are hallmark atypical presentations of
a urinary tract infection (UTI) in this population.
2. When administering medications to an 82-year-old patient, the nurse
monitors for toxic side effects. Which physiological change of aging most
significantly alters medication clearance?
A) Decreased gastric pH
B) Decreased glomerular filtration rate (GFR)
C) Increased total body water
D) Hypertrophy of liver tissue
Aging causes a natural decline in renal blood flow and a decreased
glomerular filtration rate (GFR). This reduces the kidneys' ability to excrete
,drugs, prolonging medication half-lives and significantly elevating the risk of
toxicity.
3. A nurse is reviewing the medication administration record of a 78-year-old
patient using the Beers Criteria. Which medication should the nurse identify
as potentially inappropriate for this patient?
A) Acetaminophen
B) Diphenhydramine
C) Metoprolol
D) Lisinopril
Diphenhydramine is a first-generation antihistamine with potent
anticholinergic properties. According to the Beers Criteria, it is highly
inappropriate for older adults because it causes severe drowsiness, blurred
vision, urinary retention, and significantly increases fall risks.
4. An older adult client with mild cognitive impairment repeatedly gets lost
trying to find the dining hall in an assisted living facility. Which intervention
should the nurse implement first?
A) Restrict the client to their room during meal times
B) Request a prescription for a mild sedative
C) Place highly visible, color-coded directional signs along the hallway
D) Assign another resident to guide the client to every meal
Utilizing environmental visual cues like color-coded signs supports the
patient's independence and spatial re-orientation. It preserves autonomy and
dignity without prematurely restricting mobility or relying on others.
5. A nurse conducts a skin assessment on a bedridden 85-year-old client.
Which age-related physiological change makes this client highly susceptible to
skin tears and shear injuries?
,A) Hypertrophy of the subcutaneous fat layer
B) Thinning and flattening of the dermal-epidermal junction
C) Increased production of sebum and eccrine sweat
D) Increased elasticity of collagen fibers
Aging causes thinning of the dermis and a flattening of the dermal-epidermal
junction. This decreases the structural bond between skin layers, making
older skin fragile and highly vulnerable to skin tears, friction, and pressure
injuries.
6. An older adult client with pneumonia presents with confusion and
dehydration. Which finding is most important for the nurse to report to the
healthcare provider?
A) Fever and chills
B) Confusion and dehydration
C) Crackles in the lung fields
D) Nausea and vomiting
Confusion and dehydration are findings of inadequate oxygenation and
perfusion in this frail elderly client. These require immediate treatment and
are more critical indicators of deterioration than the other common
pneumonia findings.
7. A frail elderly couple asks the nurse about salt intake because food does
not taste as good as it used to. What information should the nurse offer?
A) Boredom may influence how the taste of food is perceived
B) With age, an increase in sodium intake is needed to compensate for renal
changes
C) Short-term memory loss and confusion may be the reason they want to
over-season
D) Taste buds often are dull due to atrophy, so older clients should use other
seasonings instead of salt
, Taste buds atrophy with normal aging, which influences an older client's
sensitivity to taste. Using herbs and other seasonings instead of salt helps
avoid exacerbating hypertension and cardiovascular strain.
8. An older female client recently moved to an assisted living facility and
repeatedly asks, "Where am I?" How should the nurse 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
Reality re-orientation is the best response for a client who is confused
because the response is consistent and true. Providing truthful, calm
orientation helps reduce confusion and anxiety.
9. A new resident in an assisted living facility is experiencing short-term
memory loss and confusion. Which activity should the nurse 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
A daily exercise group allows the client to mirror the leader and minimizes the
client's stress to remember. Activities requiring short-term memory and
attention to detail may be stressful and frustrating.
10. The nurse is assessing an older adult who reports decreased visual acuity.
Which age-related change in the eye is most responsible for this finding?
A) Presbyopia resulting from loss of lens elasticity
B) Increased tear production
Examination 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A Instant
Download Pdf
1. An older adult resident in a long-term care facility exhibits a sudden onset
of confusion, increased agitation, and urinary incontinence. The nurse should
suspect which underlying condition?
A) Early-onset Alzheimer's disease
B) Normal age-related cognitive decline
C) Urinary tract infection (UTI)
D) Chronic depression
Older adults rarely exhibit classic symptoms of infection such as fever or
dysuria. Instead, an acute change in mental status (delirium), sudden
confusion, and worsening incontinence are hallmark atypical presentations of
a urinary tract infection (UTI) in this population.
2. When administering medications to an 82-year-old patient, the nurse
monitors for toxic side effects. Which physiological change of aging most
significantly alters medication clearance?
A) Decreased gastric pH
B) Decreased glomerular filtration rate (GFR)
C) Increased total body water
D) Hypertrophy of liver tissue
Aging causes a natural decline in renal blood flow and a decreased
glomerular filtration rate (GFR). This reduces the kidneys' ability to excrete
,drugs, prolonging medication half-lives and significantly elevating the risk of
toxicity.
3. A nurse is reviewing the medication administration record of a 78-year-old
patient using the Beers Criteria. Which medication should the nurse identify
as potentially inappropriate for this patient?
A) Acetaminophen
B) Diphenhydramine
C) Metoprolol
D) Lisinopril
Diphenhydramine is a first-generation antihistamine with potent
anticholinergic properties. According to the Beers Criteria, it is highly
inappropriate for older adults because it causes severe drowsiness, blurred
vision, urinary retention, and significantly increases fall risks.
4. An older adult client with mild cognitive impairment repeatedly gets lost
trying to find the dining hall in an assisted living facility. Which intervention
should the nurse implement first?
A) Restrict the client to their room during meal times
B) Request a prescription for a mild sedative
C) Place highly visible, color-coded directional signs along the hallway
D) Assign another resident to guide the client to every meal
Utilizing environmental visual cues like color-coded signs supports the
patient's independence and spatial re-orientation. It preserves autonomy and
dignity without prematurely restricting mobility or relying on others.
5. A nurse conducts a skin assessment on a bedridden 85-year-old client.
Which age-related physiological change makes this client highly susceptible to
skin tears and shear injuries?
,A) Hypertrophy of the subcutaneous fat layer
B) Thinning and flattening of the dermal-epidermal junction
C) Increased production of sebum and eccrine sweat
D) Increased elasticity of collagen fibers
Aging causes thinning of the dermis and a flattening of the dermal-epidermal
junction. This decreases the structural bond between skin layers, making
older skin fragile and highly vulnerable to skin tears, friction, and pressure
injuries.
6. An older adult client with pneumonia presents with confusion and
dehydration. Which finding is most important for the nurse to report to the
healthcare provider?
A) Fever and chills
B) Confusion and dehydration
C) Crackles in the lung fields
D) Nausea and vomiting
Confusion and dehydration are findings of inadequate oxygenation and
perfusion in this frail elderly client. These require immediate treatment and
are more critical indicators of deterioration than the other common
pneumonia findings.
7. A frail elderly couple asks the nurse about salt intake because food does
not taste as good as it used to. What information should the nurse offer?
A) Boredom may influence how the taste of food is perceived
B) With age, an increase in sodium intake is needed to compensate for renal
changes
C) Short-term memory loss and confusion may be the reason they want to
over-season
D) Taste buds often are dull due to atrophy, so older clients should use other
seasonings instead of salt
, Taste buds atrophy with normal aging, which influences an older client's
sensitivity to taste. Using herbs and other seasonings instead of salt helps
avoid exacerbating hypertension and cardiovascular strain.
8. An older female client recently moved to an assisted living facility and
repeatedly asks, "Where am I?" How should the nurse 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
Reality re-orientation is the best response for a client who is confused
because the response is consistent and true. Providing truthful, calm
orientation helps reduce confusion and anxiety.
9. A new resident in an assisted living facility is experiencing short-term
memory loss and confusion. Which activity should the nurse 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
A daily exercise group allows the client to mirror the leader and minimizes the
client's stress to remember. Activities requiring short-term memory and
attention to detail may be stressful and frustrating.
10. The nurse is assessing an older adult who reports decreased visual acuity.
Which age-related change in the eye is most responsible for this finding?
A) Presbyopia resulting from loss of lens elasticity
B) Increased tear production
