HESI Gerontology Exam V2 | 2026 Q&A
with Rationale (HESI Gerontology Exam
2026)
DOMAIN 1: THEORIES OF AGING & NORMAL AGE-RELATED CHANGES
1. The nurse is teaching a group of older adults about normal age-related
changes. Which physiological change is considered a normal part of aging?
• A) Decreased gastric acid secretion
• B) Increased skin turgor
• C) Increased muscle mass
• D) Decreased systolic blood pressure
Answer: A. Decreased gastric acid secretion is a normal age-related change that
can affect medication absorption and nutrient utilization. Skin turgor decreases (not
increases) with age. Muscle mass decreases (sarcopenia). Systolic blood pressure
typically increases with age due to vascular stiffness.
2. The nurse is assessing an 80-year-old client. Which finding is an expected
age-related change in the cardiovascular system?
• A) Decreased systolic blood pressure
• B) Increased cardiac output
• C) Increased peripheral vascular resistance
• D) Decreased heart rate
,Answer: C. Increased peripheral vascular resistance is an expected age-related
cardiovascular change due to arterial stiffening. Systolic blood pressure typically
increases, cardiac output decreases, and resting heart rate remains relatively
stable.
3. A nurse is explaining the biological theory of aging to a group of nursing
students. Which theory suggests that aging results from the accumulation of
cellular damage caused by free radicals?
• A) Programmed theory
• B) Telomere theory
• C) Free radical theory
• D) Immunity theory
Answer: C. The free radical theory of aging proposes that aging results from the
accumulation of cellular damage caused by reactive oxygen species (free radicals).
The programmed theory suggests aging follows a biological timetable. Telomere
theory focuses on shortening of chromosome ends. Immunity theory relates to
declining immune function.
4. An older adult client asks the nurse why their skin is becoming thinner and
more fragile. The nurse's best response is based on which normal age-related
change?
• A) Decreased collagen and elastin production
• B) Increased sebaceous gland activity
• C) Increased melanin production
, • D) Decreased capillary fragility
Answer: A. Normal aging involves decreased collagen and elastin production,
leading to thinner, more fragile skin. Sebaceous gland activity decreases (not
increases). Melanin production decreases, leading to gray hair. Capillary fragility
increases.
5. The nurse is assessing an older adult client's respiratory status. Which
finding is a normal age-related change in the respiratory system?
• A) Increased vital capacity
• B) Decreased residual volume
• C) Decreased cough reflex
• D) Increased chest wall compliance
Answer: C. Decreased cough reflex is a normal age-related change that increases
the risk of aspiration and respiratory infections. Vital capacity decreases, residual
volume increases, and chest wall compliance decreases.
6. An older adult client reports difficulty seeing at night. The nurse recognizes
this as most likely related to which normal age-related change?
• A) Cataract formation
• B) Presbyopia
• C) Decreased pupil size
• D) Macular degeneration
, Answer: C. Decreased pupil size (senile miosis) is a normal age-related change
that reduces the amount of light entering the eye, causing difficulty with night vision.
Cataracts and macular degeneration are pathological conditions. Presbyopia
affects near vision.
7. The nurse is assessing an older adult client's renal function. Which
laboratory finding is consistent with normal age-related changes?
• A) Increased creatinine clearance
• B) Decreased glomerular filtration rate (GFR)
• C) Increased urine-concentrating ability
• D) Decreased serum creatinine
Answer: B. Decreased GFR is a normal age-related change due to loss of
nephrons. Creatinine clearance decreases. Urine-concentrating ability decreases.
Serum creatinine may remain normal despite decreased GFR due to decreased
muscle mass.
8. An older adult client reports feeling dizzy when standing up quickly. The
nurse recognizes this as most likely related to:
• A) Parkinson's disease
• B) Orthostatic hypotension
• C) Meniere's disease
• D) Cerebrovascular accident
with Rationale (HESI Gerontology Exam
2026)
DOMAIN 1: THEORIES OF AGING & NORMAL AGE-RELATED CHANGES
1. The nurse is teaching a group of older adults about normal age-related
changes. Which physiological change is considered a normal part of aging?
• A) Decreased gastric acid secretion
• B) Increased skin turgor
• C) Increased muscle mass
• D) Decreased systolic blood pressure
Answer: A. Decreased gastric acid secretion is a normal age-related change that
can affect medication absorption and nutrient utilization. Skin turgor decreases (not
increases) with age. Muscle mass decreases (sarcopenia). Systolic blood pressure
typically increases with age due to vascular stiffness.
2. The nurse is assessing an 80-year-old client. Which finding is an expected
age-related change in the cardiovascular system?
• A) Decreased systolic blood pressure
• B) Increased cardiac output
• C) Increased peripheral vascular resistance
• D) Decreased heart rate
,Answer: C. Increased peripheral vascular resistance is an expected age-related
cardiovascular change due to arterial stiffening. Systolic blood pressure typically
increases, cardiac output decreases, and resting heart rate remains relatively
stable.
3. A nurse is explaining the biological theory of aging to a group of nursing
students. Which theory suggests that aging results from the accumulation of
cellular damage caused by free radicals?
• A) Programmed theory
• B) Telomere theory
• C) Free radical theory
• D) Immunity theory
Answer: C. The free radical theory of aging proposes that aging results from the
accumulation of cellular damage caused by reactive oxygen species (free radicals).
The programmed theory suggests aging follows a biological timetable. Telomere
theory focuses on shortening of chromosome ends. Immunity theory relates to
declining immune function.
4. An older adult client asks the nurse why their skin is becoming thinner and
more fragile. The nurse's best response is based on which normal age-related
change?
• A) Decreased collagen and elastin production
• B) Increased sebaceous gland activity
• C) Increased melanin production
, • D) Decreased capillary fragility
Answer: A. Normal aging involves decreased collagen and elastin production,
leading to thinner, more fragile skin. Sebaceous gland activity decreases (not
increases). Melanin production decreases, leading to gray hair. Capillary fragility
increases.
5. The nurse is assessing an older adult client's respiratory status. Which
finding is a normal age-related change in the respiratory system?
• A) Increased vital capacity
• B) Decreased residual volume
• C) Decreased cough reflex
• D) Increased chest wall compliance
Answer: C. Decreased cough reflex is a normal age-related change that increases
the risk of aspiration and respiratory infections. Vital capacity decreases, residual
volume increases, and chest wall compliance decreases.
6. An older adult client reports difficulty seeing at night. The nurse recognizes
this as most likely related to which normal age-related change?
• A) Cataract formation
• B) Presbyopia
• C) Decreased pupil size
• D) Macular degeneration
, Answer: C. Decreased pupil size (senile miosis) is a normal age-related change
that reduces the amount of light entering the eye, causing difficulty with night vision.
Cataracts and macular degeneration are pathological conditions. Presbyopia
affects near vision.
7. The nurse is assessing an older adult client's renal function. Which
laboratory finding is consistent with normal age-related changes?
• A) Increased creatinine clearance
• B) Decreased glomerular filtration rate (GFR)
• C) Increased urine-concentrating ability
• D) Decreased serum creatinine
Answer: B. Decreased GFR is a normal age-related change due to loss of
nephrons. Creatinine clearance decreases. Urine-concentrating ability decreases.
Serum creatinine may remain normal despite decreased GFR due to decreased
muscle mass.
8. An older adult client reports feeling dizzy when standing up quickly. The
nurse recognizes this as most likely related to:
• A) Parkinson's disease
• B) Orthostatic hypotension
• C) Meniere's disease
• D) Cerebrovascular accident
