HESI RN GERONTOLY SPECIALITY EXAM
2026/2027 | Newly Released
Actual 55 questions with NGN ,Correct Answers and
Expert Explanations
Q1: The nurse is performing an admission assessment on an 88-year-old patient. Which
age-related change should the nurse differentiate from pathology when assessing the
patient's cardiovascular system?
A. Systolic murmur heard at the left sternal border.
B. Systolic blood pressure increase of 10–15 mm Hg compared to baseline
readings from age 40. [CORRECT]
C. Presence of an S4 heart sound.
D. Orthostatic hypotension with a drop of 20 mm Hg upon standing.
Correct Answer: B
Rationale: Arterial stiffness increases with age, leading to a gradual rise in systolic
blood pressure. Systolic murmurs, S4 sounds, and significant orthostatic drops usually
indicate underlying pathology (valve disease, hypertensive heart disease, or autonomic
dysfunction) rather than normal aging.
Q2: An RN is leading a multidisciplinary team meeting for a complex patient with heart
failure, diabetes, and severe osteoarthritis. Which team member is most appropriate to
address the patient’s inability to cook nutritious meals due to joint pain?
A. Physical Therapist
B. Occupational Therapist [CORRECT]
C. Social Worker
D. Chaplain
Correct Answer: B
,Rationale: Occupational Therapists assess function and instrumental activities of daily
living (IADLs), such as cooking. They can provide assistive devices and energy
conservation techniques to help the patient manage joint pain while preparing food.
Social workers manage finances/discharge planning.
Q3: When prioritizing the care of older adult patients, the nurse understands that
"polypharmacy" is generally defined as taking:
A. Two or more chronic medications.
B. Five or more medications concurrently. [CORRECT]
C. Medications from three different prescribers.
D. Medications that interact with each other.
Correct Answer: B
Rationale: While definitions vary slightly, the standard definition of polypharmacy in
geriatrics is the concurrent use of five or more medications. This number correlates
strongly with adverse drug events, falls, and hospital readmissions.
Q4: Select All That Apply: The nurse is assessing a 75-year-old patient for signs of
depression. Which findings are characteristic of depression in older adults? (Select all
that apply.)
A. Sudden onset of visual hallucinations.
B. Loss of interest in previously enjoyed activities (anhedonia) [CORRECT]
C. Complaints of multiple physical symptoms without a clear organic cause.
[CORRECT]
D. Fluctuating levels of consciousness throughout the day.
E. Expressions of guilt or hopelessness. [CORRECT]
Correct Answer: B, C, E
Rationale: Older adults often present with somatic complaints (pain, fatigue) rather
than sadness. Anhedonia, hopelessness, and guilt are core features. Hallucinations are
rare in depression (more common in delirium/dementia), and fluctuating consciousness
suggests delirium.
, Q5: A patient with moderate stage Alzheimer’s disease is admitted for pneumonia.
Which intervention is priority to promote patient safety during hospitalization?
A. Keep the head of the bed at 30 degrees at all times.
B. Apply a motion-sensor alarm to the bed. [CORRECT]
C. Place a picture of the patient’s family at the bedside.
D. Provide detailed explanations of all procedures in the morning.
Correct Answer: B
Rationale: Patients with dementia are at high risk for falls and wandering. A motion-
sensor alarm provides immediate notification if the patient attempts to get out of bed
unassisted. While repositioning is important, safety/fall prevention is the immediate
priority.
Q6: The nurse is reviewing a patient’s medication list and notes that the patient is taking
Diphenhydramine (Benadryl) daily for insomnia. Based on the Beers Criteria, what is
the nurse's priority action?
A. Document the patient’s sleep pattern.
B. Discuss deprescribing this medication with the provider. [CORRECT]
C. Ask the family to monitor for signs of bruising.
D. Suggest taking the medication with food to reduce GI upset.
Correct Answer: B
Rationale: Diphenhydramine is a highly anticholinergic medication and is on the Beers
Criteria as potentially inappropriate for older adults due to risks of confusion, urinary
retention, constipation, and falls. Deprescribing or finding an alternative is the priori ty.
Q7: A 70-year-old patient is admitted with a hip fracture. The nurse recognizes that the
most likely cause of the fracture is:
A. Bone metastasis.
B. Osteoporosis. [CORRECT]
C. Osteoarthritis.
D. Bone cancer.
Correct Answer: B
2026/2027 | Newly Released
Actual 55 questions with NGN ,Correct Answers and
Expert Explanations
Q1: The nurse is performing an admission assessment on an 88-year-old patient. Which
age-related change should the nurse differentiate from pathology when assessing the
patient's cardiovascular system?
A. Systolic murmur heard at the left sternal border.
B. Systolic blood pressure increase of 10–15 mm Hg compared to baseline
readings from age 40. [CORRECT]
C. Presence of an S4 heart sound.
D. Orthostatic hypotension with a drop of 20 mm Hg upon standing.
Correct Answer: B
Rationale: Arterial stiffness increases with age, leading to a gradual rise in systolic
blood pressure. Systolic murmurs, S4 sounds, and significant orthostatic drops usually
indicate underlying pathology (valve disease, hypertensive heart disease, or autonomic
dysfunction) rather than normal aging.
Q2: An RN is leading a multidisciplinary team meeting for a complex patient with heart
failure, diabetes, and severe osteoarthritis. Which team member is most appropriate to
address the patient’s inability to cook nutritious meals due to joint pain?
A. Physical Therapist
B. Occupational Therapist [CORRECT]
C. Social Worker
D. Chaplain
Correct Answer: B
,Rationale: Occupational Therapists assess function and instrumental activities of daily
living (IADLs), such as cooking. They can provide assistive devices and energy
conservation techniques to help the patient manage joint pain while preparing food.
Social workers manage finances/discharge planning.
Q3: When prioritizing the care of older adult patients, the nurse understands that
"polypharmacy" is generally defined as taking:
A. Two or more chronic medications.
B. Five or more medications concurrently. [CORRECT]
C. Medications from three different prescribers.
D. Medications that interact with each other.
Correct Answer: B
Rationale: While definitions vary slightly, the standard definition of polypharmacy in
geriatrics is the concurrent use of five or more medications. This number correlates
strongly with adverse drug events, falls, and hospital readmissions.
Q4: Select All That Apply: The nurse is assessing a 75-year-old patient for signs of
depression. Which findings are characteristic of depression in older adults? (Select all
that apply.)
A. Sudden onset of visual hallucinations.
B. Loss of interest in previously enjoyed activities (anhedonia) [CORRECT]
C. Complaints of multiple physical symptoms without a clear organic cause.
[CORRECT]
D. Fluctuating levels of consciousness throughout the day.
E. Expressions of guilt or hopelessness. [CORRECT]
Correct Answer: B, C, E
Rationale: Older adults often present with somatic complaints (pain, fatigue) rather
than sadness. Anhedonia, hopelessness, and guilt are core features. Hallucinations are
rare in depression (more common in delirium/dementia), and fluctuating consciousness
suggests delirium.
, Q5: A patient with moderate stage Alzheimer’s disease is admitted for pneumonia.
Which intervention is priority to promote patient safety during hospitalization?
A. Keep the head of the bed at 30 degrees at all times.
B. Apply a motion-sensor alarm to the bed. [CORRECT]
C. Place a picture of the patient’s family at the bedside.
D. Provide detailed explanations of all procedures in the morning.
Correct Answer: B
Rationale: Patients with dementia are at high risk for falls and wandering. A motion-
sensor alarm provides immediate notification if the patient attempts to get out of bed
unassisted. While repositioning is important, safety/fall prevention is the immediate
priority.
Q6: The nurse is reviewing a patient’s medication list and notes that the patient is taking
Diphenhydramine (Benadryl) daily for insomnia. Based on the Beers Criteria, what is
the nurse's priority action?
A. Document the patient’s sleep pattern.
B. Discuss deprescribing this medication with the provider. [CORRECT]
C. Ask the family to monitor for signs of bruising.
D. Suggest taking the medication with food to reduce GI upset.
Correct Answer: B
Rationale: Diphenhydramine is a highly anticholinergic medication and is on the Beers
Criteria as potentially inappropriate for older adults due to risks of confusion, urinary
retention, constipation, and falls. Deprescribing or finding an alternative is the priori ty.
Q7: A 70-year-old patient is admitted with a hip fracture. The nurse recognizes that the
most likely cause of the fracture is:
A. Bone metastasis.
B. Osteoporosis. [CORRECT]
C. Osteoarthritis.
D. Bone cancer.
Correct Answer: B
