HESI PN GERONTOLOGY ACTUAL EXAM 3 LATEST VERSIONS
(VERSION A, B AND C) EACH VERSION CONTAINS 55
QUESTIONS AND CORRECT DETAILED ANSWERS
Question 1
An LPN/LVN is caring for an older adult client with presbycusis. Which of the
following communication strategies is most appropriate?
A) Shout loudly to ensure the client hears.
B) Speak quickly and use complex sentences.
C) Speak clearly and slowly in a lower-pitched voice, facing the client.
D) Avoid eye contact to prevent overstimulation.
E) Only communicate in writing.
Correct Answer: C) Speak clearly and slowly in a lower-pitched voice,
facing the client.
Rationale: Presbycusis is age-related hearing loss, typically affecting
high-frequency sounds. Speaking clearly and slowly in a lower pitch,
while facing the client (to allow for lip-reading), can significantly
improve communication. Shouting can distort sounds,
and rapid/complex speech is difficult to process.
Question 2
Which of the following is a common physiological change associated with
aging that increases an older adult's risk for falls?
A) Increased bone density.
B) Improved vision acuity.
C) Decreased muscle strength and balance.
D) Enhanced pain sensation.
E) Faster reaction time.
Correct Answer: C) Decreased muscle strength and balance.
Rationale: Age-related sarcopenia (muscle loss) and changes in the
vestibular system contribute to decreased muscle strength,
impaired balance, and gait instability, all of which are major risk
factors for falls in older adults.
Question 3
An LPN/LVN is caring for an older adult client with dementia who becomes
agitated during personal care. What is the most appropriate initial nursing
intervention?
A) Immediately restrain the client to prevent injury.
B) Discontinue care and leave the client alone.
C) Use a calm, reassuring tone, attempt to identify the trigger, and offer
simple choices.
D) Tell the client to calm down.
,E) Administer a sedative without physician order.
Correct Answer: C) Use a calm, reassuring tone, attempt to identify
the trigger, and offer simple choices.
Rationale: Agitation in dementia often has a trigger (e.g., pain, fear,
discomfort, environmental overload). The LPN/LVN should first use
de-escalation techniques: maintain a calm demeanor, speak softly,
try to identify the underlying cause, and offer simple choices to
restore a sense of control. Restraints are a last resort and require
an order.
Question 4
Which of the following is a common manifestation of "delirium" in an older
adult?
A) Gradual onset of progressive memory loss over months to years.
B) Stable level of consciousness and attention.
C) Acute, fluctuating changes in attention and cognition.
D) Intact perception and orientation.
E) Always accompanied by a fever.
Correct Answer: C) Acute, fluctuating changes in attention and
cognition.
Rationale: Delirium is characterized by an acute onset, a fluctuating
course, and disturbances in attention, awareness, and cognition
(e.g., disorientation, memory impairment, perceptual disturbances).
It is often reversible and has an identifiable underlying cause (e.g.,
infection, medication side effect, dehydration).
Question 5
An LPN/LVN is providing teaching to an older adult client about medication
safety. Which of the following instructions is most important?
A) "Share your medications with family members to save money."
B) "Take over-the-counter medications without checking with your doctor."
C) "Keep a current list of all your medications, including over-the-counter and
supplements, and review it with your doctor regularly."
D) "Store all medications in a humid bathroom cabinet."
E) "Discontinue medications when you feel better."
Correct Answer: C) "Keep a current list of all your medications,
including over-the-counter and supplements, and review it with your
doctor regularly."
Rationale: Older adults are often on multiple medications
(polypharmacy), increasing the risk of adverse drug reactions and
interactions. Maintaining an accurate, up-to-date medication list
,and reviewing it with the healthcare provider is crucial for
preventing errors and ensuring safety.
Question 6
What is the primary purpose of providing "palliative care" to an older adult
client?
A) To cure their illness aggressively.
B) To prolong life at all costs.
C) To provide comfort, symptom management, and improve quality of life for
clients with serious illness.
D) To only care for clients with a terminal diagnosis.
E) To prepare for surgery.
Correct Answer: C) To provide comfort, symptom management, and
improve quality of life for clients with serious illness.
Rationale: Palliative care focuses on relieving suffering and improving
the quality of life for clients and their families facing serious illness,
regardless of prognosis or whether they are receiving curative
treatment. Hospice care is a form of palliative care for terminal
illness.
Question 7
An LPN/LVN is caring for an older adult client who is exhibiting signs of
dehydration. Which of the following findings should the LPN/LVN expect?
A) Edema in the lower extremities.
B) Increased urine output.
C) Dry mucous membranes, thirst, and confusion.
D) Weight gain.
E) Bounding pulse.
Correct Answer: C) Dry mucous membranes, thirst, and confusion.
Rationale: Older adults are at higher risk for dehydration. Signs
include dry mucous membranes, increased thirst (though thirst
sensation can be diminished), confusion, lethargy, decreased urine
output, and a weak, rapid pulse. Edema and weight gain indicate
fluid overload.
Question 8
Which of the following describes a common age-related change in the
cardiovascular system?
A) Increased elasticity of blood vessels.
B) Decreased stiffness of heart valves.
C) Thickening and stiffening of arterial walls.
, D) Increased maximum heart rate.
E) Decreased blood pressure.
Correct Answer: C) Thickening and stiffening of arterial walls.
Rationale: With aging, arterial walls tend to thicken and stiffen
(arteriosclerosis), leading to increased peripheral vascular
resistance and often contributing to hypertension. The heart also
undergoes changes, including mild hypertrophy, and maximum
heart rate decreases.
Question 9
An LPN/LVN is providing teaching to an older adult client about fall
prevention. Which of the following instructions is most appropriate?
A) "Wear loose-fitting, long clothing."
B) "Keep pathways clear of clutter and use good lighting."
C) "Avoid all physical activity to prevent falls."
D) "Use throw rugs on slippery floors."
E) "Take your time when getting up from a sitting or lying position."
Correct Answer: B) "Keep pathways clear of clutter and use good
lighting."
Rationale: Environmental modifications are crucial for fall prevention.
Removing clutter, ensuring adequate lighting (especially at night),
and securing rugs can significantly reduce tripping hazards. Taking
time to change positions (option E) is also important to prevent
orthostatic hypotension, which contributes to falls, but B addresses
environmental factors.
Question 10
What is the primary purpose of a "living will"?
A) To designate financial beneficiaries.
B) To designate a healthcare power of attorney.
C) To state a person's wishes regarding medical treatment in advance, should
they become incapacitated.
D) To outline funeral arrangements.
E) To legally divorce a spouse.
Correct Answer: C) To state a person's wishes regarding medical
treatment in advance, should they become incapacitated.
Rationale: A living will is a type of advance directive that allows
individuals to specify their preferences for medical care (e.g., life-
sustaining treatments, feeding tubes) if they are unable to
communicate their wishes due to a serious illness or injury.
(VERSION A, B AND C) EACH VERSION CONTAINS 55
QUESTIONS AND CORRECT DETAILED ANSWERS
Question 1
An LPN/LVN is caring for an older adult client with presbycusis. Which of the
following communication strategies is most appropriate?
A) Shout loudly to ensure the client hears.
B) Speak quickly and use complex sentences.
C) Speak clearly and slowly in a lower-pitched voice, facing the client.
D) Avoid eye contact to prevent overstimulation.
E) Only communicate in writing.
Correct Answer: C) Speak clearly and slowly in a lower-pitched voice,
facing the client.
Rationale: Presbycusis is age-related hearing loss, typically affecting
high-frequency sounds. Speaking clearly and slowly in a lower pitch,
while facing the client (to allow for lip-reading), can significantly
improve communication. Shouting can distort sounds,
and rapid/complex speech is difficult to process.
Question 2
Which of the following is a common physiological change associated with
aging that increases an older adult's risk for falls?
A) Increased bone density.
B) Improved vision acuity.
C) Decreased muscle strength and balance.
D) Enhanced pain sensation.
E) Faster reaction time.
Correct Answer: C) Decreased muscle strength and balance.
Rationale: Age-related sarcopenia (muscle loss) and changes in the
vestibular system contribute to decreased muscle strength,
impaired balance, and gait instability, all of which are major risk
factors for falls in older adults.
Question 3
An LPN/LVN is caring for an older adult client with dementia who becomes
agitated during personal care. What is the most appropriate initial nursing
intervention?
A) Immediately restrain the client to prevent injury.
B) Discontinue care and leave the client alone.
C) Use a calm, reassuring tone, attempt to identify the trigger, and offer
simple choices.
D) Tell the client to calm down.
,E) Administer a sedative without physician order.
Correct Answer: C) Use a calm, reassuring tone, attempt to identify
the trigger, and offer simple choices.
Rationale: Agitation in dementia often has a trigger (e.g., pain, fear,
discomfort, environmental overload). The LPN/LVN should first use
de-escalation techniques: maintain a calm demeanor, speak softly,
try to identify the underlying cause, and offer simple choices to
restore a sense of control. Restraints are a last resort and require
an order.
Question 4
Which of the following is a common manifestation of "delirium" in an older
adult?
A) Gradual onset of progressive memory loss over months to years.
B) Stable level of consciousness and attention.
C) Acute, fluctuating changes in attention and cognition.
D) Intact perception and orientation.
E) Always accompanied by a fever.
Correct Answer: C) Acute, fluctuating changes in attention and
cognition.
Rationale: Delirium is characterized by an acute onset, a fluctuating
course, and disturbances in attention, awareness, and cognition
(e.g., disorientation, memory impairment, perceptual disturbances).
It is often reversible and has an identifiable underlying cause (e.g.,
infection, medication side effect, dehydration).
Question 5
An LPN/LVN is providing teaching to an older adult client about medication
safety. Which of the following instructions is most important?
A) "Share your medications with family members to save money."
B) "Take over-the-counter medications without checking with your doctor."
C) "Keep a current list of all your medications, including over-the-counter and
supplements, and review it with your doctor regularly."
D) "Store all medications in a humid bathroom cabinet."
E) "Discontinue medications when you feel better."
Correct Answer: C) "Keep a current list of all your medications,
including over-the-counter and supplements, and review it with your
doctor regularly."
Rationale: Older adults are often on multiple medications
(polypharmacy), increasing the risk of adverse drug reactions and
interactions. Maintaining an accurate, up-to-date medication list
,and reviewing it with the healthcare provider is crucial for
preventing errors and ensuring safety.
Question 6
What is the primary purpose of providing "palliative care" to an older adult
client?
A) To cure their illness aggressively.
B) To prolong life at all costs.
C) To provide comfort, symptom management, and improve quality of life for
clients with serious illness.
D) To only care for clients with a terminal diagnosis.
E) To prepare for surgery.
Correct Answer: C) To provide comfort, symptom management, and
improve quality of life for clients with serious illness.
Rationale: Palliative care focuses on relieving suffering and improving
the quality of life for clients and their families facing serious illness,
regardless of prognosis or whether they are receiving curative
treatment. Hospice care is a form of palliative care for terminal
illness.
Question 7
An LPN/LVN is caring for an older adult client who is exhibiting signs of
dehydration. Which of the following findings should the LPN/LVN expect?
A) Edema in the lower extremities.
B) Increased urine output.
C) Dry mucous membranes, thirst, and confusion.
D) Weight gain.
E) Bounding pulse.
Correct Answer: C) Dry mucous membranes, thirst, and confusion.
Rationale: Older adults are at higher risk for dehydration. Signs
include dry mucous membranes, increased thirst (though thirst
sensation can be diminished), confusion, lethargy, decreased urine
output, and a weak, rapid pulse. Edema and weight gain indicate
fluid overload.
Question 8
Which of the following describes a common age-related change in the
cardiovascular system?
A) Increased elasticity of blood vessels.
B) Decreased stiffness of heart valves.
C) Thickening and stiffening of arterial walls.
, D) Increased maximum heart rate.
E) Decreased blood pressure.
Correct Answer: C) Thickening and stiffening of arterial walls.
Rationale: With aging, arterial walls tend to thicken and stiffen
(arteriosclerosis), leading to increased peripheral vascular
resistance and often contributing to hypertension. The heart also
undergoes changes, including mild hypertrophy, and maximum
heart rate decreases.
Question 9
An LPN/LVN is providing teaching to an older adult client about fall
prevention. Which of the following instructions is most appropriate?
A) "Wear loose-fitting, long clothing."
B) "Keep pathways clear of clutter and use good lighting."
C) "Avoid all physical activity to prevent falls."
D) "Use throw rugs on slippery floors."
E) "Take your time when getting up from a sitting or lying position."
Correct Answer: B) "Keep pathways clear of clutter and use good
lighting."
Rationale: Environmental modifications are crucial for fall prevention.
Removing clutter, ensuring adequate lighting (especially at night),
and securing rugs can significantly reduce tripping hazards. Taking
time to change positions (option E) is also important to prevent
orthostatic hypotension, which contributes to falls, but B addresses
environmental factors.
Question 10
What is the primary purpose of a "living will"?
A) To designate financial beneficiaries.
B) To designate a healthcare power of attorney.
C) To state a person's wishes regarding medical treatment in advance, should
they become incapacitated.
D) To outline funeral arrangements.
E) To legally divorce a spouse.
Correct Answer: C) To state a person's wishes regarding medical
treatment in advance, should they become incapacitated.
Rationale: A living will is a type of advance directive that allows
individuals to specify their preferences for medical care (e.g., life-
sustaining treatments, feeding tubes) if they are unable to
communicate their wishes due to a serious illness or injury.
