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HESI GERONTOLOGY EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
HESI GERONTOLOGY EXAM — 250 Practice Questions
SECTION 1: THEORIES OF AGING & NORMAL AGING CHANGES (Questions 1-25)
1. The nurse is educating a group of older adults about normal age-related changes.
Which finding is considered a normal part of aging?
A. Dementia.
B. Delirium.
C. Presbyopia.
D. Depression.
Answer: C. Rationale: Presbyopia (age-related farsightedness) is a normal age-related
change. Dementia, delirium, and depression are not normal aging changes.
2. The nurse is assessing an 80-year-old client. Which skin change is expected in
the older adult?
A. Increased skin turgor.
B. Decreased skin turgor.
C. Increased sebaceous gland activity.
D. Increased sweating.
Answer: B. Rationale: Older adults have decreased skin turgor due to loss of
subcutaneous fat and decreased elasticity. Sebaceous gland activity and sweating
decrease with age.
3. The nurse is assessing the cardiovascular system of an older adult. Which
finding is considered a normal age-related change?
A. Decreased systolic blood pressure.
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B. Increased cardiac output.
C. Decreased elasticity of blood vessels.
D. Decreased peripheral vascular resistance.
Answer: C. Rationale: Decreased elasticity of blood vessels is a normal age-related
change leading to increased systolic blood pressure. Cardiac output decreases,
peripheral vascular resistance increases.
4. The nurse is assessing the respiratory system of an older adult. Which finding is
considered a normal age-related change?
A. Increased lung elasticity.
B. Decreased vital capacity.
C. Increased respiratory muscle strength.
D. Decreased residual volume.
Answer: B. Rationale: Vital capacity decreases with age due to decreased lung
elasticity and respiratory muscle strength. Residual volume increases.
5. The nurse is assessing the renal system of an older adult. Which finding is
considered a normal age-related change?
A. Increased glomerular filtration rate.
B. Decreased number of nephrons.
C. Increased renal blood flow.
D. Increased ability to concentrate urine.
Answer: B. Rationale: The number of nephrons decreases with age, leading to
decreased GFR and decreased ability to concentrate urine.
6. The nurse is assessing the gastrointestinal system of an older adult. Which
finding is considered a normal age-related change?
A. Increased gastric motility.
B. Decreased gastric acid secretion.
C. Increased intestinal absorption.
D. Increased liver function.
Answer: B. Rationale: Gastric acid secretion decreases with age, affecting absorption
of certain nutrients. Gastric motility decreases, and liver function decreases.
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7. The nurse is assessing the neurological system of an older adult. Which finding is
considered a normal age-related change?
A. Significant cognitive decline.
B. Decreased reaction time.
C. Increased memory function.
D. Increased neurotransmitter production.
Answer: B. Rationale: Reaction time decreases with age due to slowed nerve
conduction. Significant cognitive decline is not normal aging.
8. The nurse is assessing the musculoskeletal system of an older adult. Which
finding is considered a normal age-related change?
A. Increased bone density.
B. Increased muscle mass.
C. Decreased bone density.
D. Increased joint flexibility.
Answer: C. Rationale: Bone density decreases with age due to bone resorption
exceeding bone formation. Muscle mass decreases (sarcopenia), and joint flexibility
decreases.
9. The nurse is assessing the sensory system of an older adult. Which finding is
considered a normal age-related change?
A. Improved hearing in high frequencies.
B. Presbyopia.
C. Increased taste sensitivity.
D. Increased sense of smell.
Answer: B. Rationale: Presbyopia is a normal age-related change. Hearing loss in high
frequencies, decreased taste sensitivity, and decreased sense of smell are also normal.
10. The nurse is assessing the endocrine system of an older adult. Which finding is
considered a normal age-related change?
A. Increased thyroid hormone production.
B. Decreased insulin sensitivity.
C. Increased growth hormone production.
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D. Increased adrenal hormone production.
Answer: B. Rationale: Decreased insulin sensitivity (increased insulin resistance) is a
normal age-related change. Thyroid and growth hormone production decrease.
11. According to Erikson's theory, which developmental task is associated with
older adulthood?
A. Generativity vs. stagnation.
B. Integrity vs. despair.
C. Identity vs. role confusion.
D. Intimacy vs. isolation.
Answer: B. Rationale: According to Erikson, the developmental task of older adulthood
is integrity vs. despair. Generativity vs. stagnation is middle adulthood.
12. The nurse is educating an older adult about normal sleep changes. Which sleep
change is expected in older adults?
A. Increased deep sleep.
B. Increased REM sleep.
C. Increased time to fall asleep.
D. Increased total sleep time.
Answer: C. Rationale: Older adults have increased time to fall asleep, decreased deep
sleep, decreased REM sleep, and decreased total sleep time.
13. The nurse is assessing the immune system of an older adult. Which finding is
considered a normal age-related change?
A. Increased immune response.
B. Decreased immune response.
C. Increased antibody production.
D. Increased thymus size.
Answer: B. Rationale: Immune response decreases with age (immunosenescence).
Antibody production decreases, and the thymus decreases in size.
14. The nurse is assessing the integumentary system of an older adult. Which
finding is considered a normal age-related change?
A. Increased skin moisture.
HESI GERONTOLOGY EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
HESI GERONTOLOGY EXAM — 250 Practice Questions
SECTION 1: THEORIES OF AGING & NORMAL AGING CHANGES (Questions 1-25)
1. The nurse is educating a group of older adults about normal age-related changes.
Which finding is considered a normal part of aging?
A. Dementia.
B. Delirium.
C. Presbyopia.
D. Depression.
Answer: C. Rationale: Presbyopia (age-related farsightedness) is a normal age-related
change. Dementia, delirium, and depression are not normal aging changes.
2. The nurse is assessing an 80-year-old client. Which skin change is expected in
the older adult?
A. Increased skin turgor.
B. Decreased skin turgor.
C. Increased sebaceous gland activity.
D. Increased sweating.
Answer: B. Rationale: Older adults have decreased skin turgor due to loss of
subcutaneous fat and decreased elasticity. Sebaceous gland activity and sweating
decrease with age.
3. The nurse is assessing the cardiovascular system of an older adult. Which
finding is considered a normal age-related change?
A. Decreased systolic blood pressure.
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B. Increased cardiac output.
C. Decreased elasticity of blood vessels.
D. Decreased peripheral vascular resistance.
Answer: C. Rationale: Decreased elasticity of blood vessels is a normal age-related
change leading to increased systolic blood pressure. Cardiac output decreases,
peripheral vascular resistance increases.
4. The nurse is assessing the respiratory system of an older adult. Which finding is
considered a normal age-related change?
A. Increased lung elasticity.
B. Decreased vital capacity.
C. Increased respiratory muscle strength.
D. Decreased residual volume.
Answer: B. Rationale: Vital capacity decreases with age due to decreased lung
elasticity and respiratory muscle strength. Residual volume increases.
5. The nurse is assessing the renal system of an older adult. Which finding is
considered a normal age-related change?
A. Increased glomerular filtration rate.
B. Decreased number of nephrons.
C. Increased renal blood flow.
D. Increased ability to concentrate urine.
Answer: B. Rationale: The number of nephrons decreases with age, leading to
decreased GFR and decreased ability to concentrate urine.
6. The nurse is assessing the gastrointestinal system of an older adult. Which
finding is considered a normal age-related change?
A. Increased gastric motility.
B. Decreased gastric acid secretion.
C. Increased intestinal absorption.
D. Increased liver function.
Answer: B. Rationale: Gastric acid secretion decreases with age, affecting absorption
of certain nutrients. Gastric motility decreases, and liver function decreases.
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7. The nurse is assessing the neurological system of an older adult. Which finding is
considered a normal age-related change?
A. Significant cognitive decline.
B. Decreased reaction time.
C. Increased memory function.
D. Increased neurotransmitter production.
Answer: B. Rationale: Reaction time decreases with age due to slowed nerve
conduction. Significant cognitive decline is not normal aging.
8. The nurse is assessing the musculoskeletal system of an older adult. Which
finding is considered a normal age-related change?
A. Increased bone density.
B. Increased muscle mass.
C. Decreased bone density.
D. Increased joint flexibility.
Answer: C. Rationale: Bone density decreases with age due to bone resorption
exceeding bone formation. Muscle mass decreases (sarcopenia), and joint flexibility
decreases.
9. The nurse is assessing the sensory system of an older adult. Which finding is
considered a normal age-related change?
A. Improved hearing in high frequencies.
B. Presbyopia.
C. Increased taste sensitivity.
D. Increased sense of smell.
Answer: B. Rationale: Presbyopia is a normal age-related change. Hearing loss in high
frequencies, decreased taste sensitivity, and decreased sense of smell are also normal.
10. The nurse is assessing the endocrine system of an older adult. Which finding is
considered a normal age-related change?
A. Increased thyroid hormone production.
B. Decreased insulin sensitivity.
C. Increased growth hormone production.
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D. Increased adrenal hormone production.
Answer: B. Rationale: Decreased insulin sensitivity (increased insulin resistance) is a
normal age-related change. Thyroid and growth hormone production decrease.
11. According to Erikson's theory, which developmental task is associated with
older adulthood?
A. Generativity vs. stagnation.
B. Integrity vs. despair.
C. Identity vs. role confusion.
D. Intimacy vs. isolation.
Answer: B. Rationale: According to Erikson, the developmental task of older adulthood
is integrity vs. despair. Generativity vs. stagnation is middle adulthood.
12. The nurse is educating an older adult about normal sleep changes. Which sleep
change is expected in older adults?
A. Increased deep sleep.
B. Increased REM sleep.
C. Increased time to fall asleep.
D. Increased total sleep time.
Answer: C. Rationale: Older adults have increased time to fall asleep, decreased deep
sleep, decreased REM sleep, and decreased total sleep time.
13. The nurse is assessing the immune system of an older adult. Which finding is
considered a normal age-related change?
A. Increased immune response.
B. Decreased immune response.
C. Increased antibody production.
D. Increased thymus size.
Answer: B. Rationale: Immune response decreases with age (immunosenescence).
Antibody production decreases, and the thymus decreases in size.
14. The nurse is assessing the integumentary system of an older adult. Which
finding is considered a normal age-related change?
A. Increased skin moisture.
