HESI Gerontology Exam V2 | 2026 Q&A
with Rationale (HESI Gerontology Exam
2026)
1. An 82-year-old client is admitted with a suspected urinary tract infection (UTI). Which
clinical manifestation should the nurse expect the client to exhibit first?
A. High-grade fever and chills
B. Urgency and frequency of urination
C. Severe flank pain and hematuria
D. New onset of confusion or agitation
Correct Answer: D
Rationale: Older adults often present with atypical symptoms of infection due to age-
related changes in the immune system. Confusion or a sudden change in mental status is
frequently the first sign of a UTI in the geriatric population. Nurses must prioritize
neurological assessments when a sudden change in behavior is observed.
2. A client with age-related macular degeneration (AMD) is being discharged. Which
instruction is most important for the nurse to include in the teaching plan?
A. Wear earplugs to avoid loud noises
B. Avoid driving during daylight hours
C. Use a magnifying glass for reading small print
,D. Monitor for loss of peripheral vision
Correct Answer: C
Rationale: Macular degeneration primarily affects central vision, which is necessary for
tasks such as reading and driving. Using assistive devices like magnifying glasses or high-
contrast materials helps maintain independence. This condition does not typically affect
peripheral vision, which remains intact.
3. The nurse is assessing an older adult’s hearing. The client reports difficulty hearing high-
pitched sounds. How should the nurse document this finding?
A. Otosclerosis
B. Tinnitus
C. Presbycusis
D. Cerumen impaction
Correct Answer: C
Rationale: Presbycusis is the age-related gradual loss of hearing, specifically affecting the
ability to hear high-frequency sounds. It is a common sensory change in older adults
caused by degeneration of the cochlea or auditory nerve. Documentation should reflect this
as a normal physiological change of aging.
4. An 80-year-old client reflects on their life and expresses satisfaction with their
accomplishments. According to Erikson, which stage is this client demonstrating?
A. Integrity vs. Despair
, B. Identity vs. Role Confusion
C. Generativity vs. Stagnation
D. Intimacy vs. Isolation
Correct Answer: A
Rationale: Erikson’s final psychosocial stage for older adults is Integrity vs. Despair. A
sense of integrity is achieved when an individual feels their life has been meaningful and
successful. If the individual views their life as a series of failures, they may experience
despair and fear of death.
5. Which finding in an older adult’s skin assessment requires the most immediate follow-up
by the nurse?
A. An asymmetric mole with irregular borders on the back
B. Thin, parchment-like skin on the forearms
C. Increased number of senile lentigines on the hands
D. Small, bright red cherry angiomas on the trunk
Correct Answer: A
Rationale: Asymmetry, irregular borders, and color variations are warning signs of
melanoma, a serious form of skin cancer. While lentigines and angiomas are common
benign age-related changes, suspicious lesions require prompt biopsy. Early detection of
skin cancer is critical in the elderly population due to reduced skin repair mechanisms.
with Rationale (HESI Gerontology Exam
2026)
1. An 82-year-old client is admitted with a suspected urinary tract infection (UTI). Which
clinical manifestation should the nurse expect the client to exhibit first?
A. High-grade fever and chills
B. Urgency and frequency of urination
C. Severe flank pain and hematuria
D. New onset of confusion or agitation
Correct Answer: D
Rationale: Older adults often present with atypical symptoms of infection due to age-
related changes in the immune system. Confusion or a sudden change in mental status is
frequently the first sign of a UTI in the geriatric population. Nurses must prioritize
neurological assessments when a sudden change in behavior is observed.
2. A client with age-related macular degeneration (AMD) is being discharged. Which
instruction is most important for the nurse to include in the teaching plan?
A. Wear earplugs to avoid loud noises
B. Avoid driving during daylight hours
C. Use a magnifying glass for reading small print
,D. Monitor for loss of peripheral vision
Correct Answer: C
Rationale: Macular degeneration primarily affects central vision, which is necessary for
tasks such as reading and driving. Using assistive devices like magnifying glasses or high-
contrast materials helps maintain independence. This condition does not typically affect
peripheral vision, which remains intact.
3. The nurse is assessing an older adult’s hearing. The client reports difficulty hearing high-
pitched sounds. How should the nurse document this finding?
A. Otosclerosis
B. Tinnitus
C. Presbycusis
D. Cerumen impaction
Correct Answer: C
Rationale: Presbycusis is the age-related gradual loss of hearing, specifically affecting the
ability to hear high-frequency sounds. It is a common sensory change in older adults
caused by degeneration of the cochlea or auditory nerve. Documentation should reflect this
as a normal physiological change of aging.
4. An 80-year-old client reflects on their life and expresses satisfaction with their
accomplishments. According to Erikson, which stage is this client demonstrating?
A. Integrity vs. Despair
, B. Identity vs. Role Confusion
C. Generativity vs. Stagnation
D. Intimacy vs. Isolation
Correct Answer: A
Rationale: Erikson’s final psychosocial stage for older adults is Integrity vs. Despair. A
sense of integrity is achieved when an individual feels their life has been meaningful and
successful. If the individual views their life as a series of failures, they may experience
despair and fear of death.
5. Which finding in an older adult’s skin assessment requires the most immediate follow-up
by the nurse?
A. An asymmetric mole with irregular borders on the back
B. Thin, parchment-like skin on the forearms
C. Increased number of senile lentigines on the hands
D. Small, bright red cherry angiomas on the trunk
Correct Answer: A
Rationale: Asymmetry, irregular borders, and color variations are warning signs of
melanoma, a serious form of skin cancer. While lentigines and angiomas are common
benign age-related changes, suspicious lesions require prompt biopsy. Early detection of
skin cancer is critical in the elderly population due to reduced skin repair mechanisms.
