HESI Geriatrics Exam Study Guide (2025/2026 Syllabus)
This guide covers the core domains of geriatric nursing, focusing on the unique
physiological, psychological, and social aspects of caring for the older adult.
Section 1: Foundations of Geriatric Care & Physiological Changes of Aging
1. What is the primary goal of geriatric nursing?
ANSWER ✓ To promote the highest possible level of function, independence, and
quality of life for older adults while managing chronic conditions and preventing
complications.
2. A 78-year-old patient has a slightly elevated serum creatinine level. The nurse
recognizes that this is most likely due to:
ANSWER ✓ An age-related decrease in glomerular filtration rate (GFR) and renal blood
flow. Muscle mass also decreases with age, which affects creatinine production, so even
a slight elevation can indicate significant renal function loss.
3. When assessing an older adult's skin, the nurse notes thinning, increased
fragility, and tenting. These findings are primarily attributed to:
ANSWER ✓ A loss of collagen, elastin, and subcutaneous fat, which are normal
physiological changes of aging.
4. An 85-year-old patient reports constipation. What is a common age-related
gastrointestinal change contributing to this?
ANSWER ✓ Decreased motility of the large intestine and weakened abdominal and
pelvic muscles.
5. Why are older adults at a significantly higher risk for dehydration?
ANSWER ✓ They have a decreased thirst sensation, a reduced ability of the kidneys to
concentrate urine, and a lower total body water percentage.
6. The term "presbycusis" refers to age-related hearing loss, which typically first
affects:
ANSWER ✓ The ability to hear high-frequency sounds, making it difficult to understand
consonants in speech.
7. A nurse is teaching an older adult about their new medication. What teaching
strategy is most effective to accommodate for presbycusis?
, ANSWER ✓ Facing the patient directly in good light, speaking in a low-pitched tone, and
minimizing background noise.
8. "Presbyopia" is the age-related change affecting vision that results in:
ANSWER ✓ Difficulty focusing on close objects, due to a loss of lens elasticity. This
requires the use of reading glasses or bifocals.
9. What is a key reason older adults are more susceptible to hypothermia?
ANSWER ✓ They have a decreased metabolic rate, loss of subcutaneous fat, and
impaired thermoregulation.
10. When administering a medication to an older adult, the nurse understands that
the decreased hepatic function in this population can lead to:
ANSWER ✓ Prolonged drug half-life and increased risk of toxicity due to reduced
metabolism.
Section 2: Cognitive and Psychological Health
11. Differentiate between delirium and dementia.
ANSWER ✓ Delirium is an acute, reversible state of confusion with a sudden onset and
fluctuating course, often caused by an underlying medical condition. Dementia is a
chronic, progressive, and irreversible decline in cognitive function.
12. What is the most common type of dementia?
ANSWER ✓ Alzheimer's Disease, accounting for 60-80% of all dementia cases.
13. A patient with Alzheimer's disease repeatedly asks the same question. The
nurse's best response is to:
ANSWER ✓ Provide a simple, calm answer and redirect the patient to a pleasant,
structured activity. Arguing or pointing out the repetition increases anxiety.
14. Sundowning is a phenomenon characterized by:
ANSWER ✓ Increased confusion, agitation, and behavioral problems that occur in the
late afternoon and evening.
15. A key non-pharmacological intervention for managing sundowning includes:
ANSWER ✓ Maintaining a consistent routine, maximizing exposure to daylight, and
minimizing naps and caffeine later in the day.
This guide covers the core domains of geriatric nursing, focusing on the unique
physiological, psychological, and social aspects of caring for the older adult.
Section 1: Foundations of Geriatric Care & Physiological Changes of Aging
1. What is the primary goal of geriatric nursing?
ANSWER ✓ To promote the highest possible level of function, independence, and
quality of life for older adults while managing chronic conditions and preventing
complications.
2. A 78-year-old patient has a slightly elevated serum creatinine level. The nurse
recognizes that this is most likely due to:
ANSWER ✓ An age-related decrease in glomerular filtration rate (GFR) and renal blood
flow. Muscle mass also decreases with age, which affects creatinine production, so even
a slight elevation can indicate significant renal function loss.
3. When assessing an older adult's skin, the nurse notes thinning, increased
fragility, and tenting. These findings are primarily attributed to:
ANSWER ✓ A loss of collagen, elastin, and subcutaneous fat, which are normal
physiological changes of aging.
4. An 85-year-old patient reports constipation. What is a common age-related
gastrointestinal change contributing to this?
ANSWER ✓ Decreased motility of the large intestine and weakened abdominal and
pelvic muscles.
5. Why are older adults at a significantly higher risk for dehydration?
ANSWER ✓ They have a decreased thirst sensation, a reduced ability of the kidneys to
concentrate urine, and a lower total body water percentage.
6. The term "presbycusis" refers to age-related hearing loss, which typically first
affects:
ANSWER ✓ The ability to hear high-frequency sounds, making it difficult to understand
consonants in speech.
7. A nurse is teaching an older adult about their new medication. What teaching
strategy is most effective to accommodate for presbycusis?
, ANSWER ✓ Facing the patient directly in good light, speaking in a low-pitched tone, and
minimizing background noise.
8. "Presbyopia" is the age-related change affecting vision that results in:
ANSWER ✓ Difficulty focusing on close objects, due to a loss of lens elasticity. This
requires the use of reading glasses or bifocals.
9. What is a key reason older adults are more susceptible to hypothermia?
ANSWER ✓ They have a decreased metabolic rate, loss of subcutaneous fat, and
impaired thermoregulation.
10. When administering a medication to an older adult, the nurse understands that
the decreased hepatic function in this population can lead to:
ANSWER ✓ Prolonged drug half-life and increased risk of toxicity due to reduced
metabolism.
Section 2: Cognitive and Psychological Health
11. Differentiate between delirium and dementia.
ANSWER ✓ Delirium is an acute, reversible state of confusion with a sudden onset and
fluctuating course, often caused by an underlying medical condition. Dementia is a
chronic, progressive, and irreversible decline in cognitive function.
12. What is the most common type of dementia?
ANSWER ✓ Alzheimer's Disease, accounting for 60-80% of all dementia cases.
13. A patient with Alzheimer's disease repeatedly asks the same question. The
nurse's best response is to:
ANSWER ✓ Provide a simple, calm answer and redirect the patient to a pleasant,
structured activity. Arguing or pointing out the repetition increases anxiety.
14. Sundowning is a phenomenon characterized by:
ANSWER ✓ Increased confusion, agitation, and behavioral problems that occur in the
late afternoon and evening.
15. A key non-pharmacological intervention for managing sundowning includes:
ANSWER ✓ Maintaining a consistent routine, maximizing exposure to daylight, and
minimizing naps and caffeine later in the day.
