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HESI PN Gerontology Exam 2026/2027 Actual Exam |
3 Latest Versions A B & C with 55 Questions Each &
Correct Detailed Answers with Rationales | Pass
Guaranteed - A+ Graded
Version A: Geriatric Assessment and Physiology
Q1: Which of the following is a normal age-related change in the cardiovascular system?
A. Increased cardiac output
B. Increased peripheral vascular resistance [CORRECT]
C. Decreased blood pressure
D. Increased elasticity of blood vessels
Correct Answer: B
Rationale: Aging causes arterial stiffening and loss of elasticity, leading to increased peripheral
vascular resistance and a tendency toward hypertension. Cardiac output decreases due to reduced
myocardial efficiency. Vessels lose elasticity, not gain it.
Q2: The nurse is caring for an 80-year-old patient. Which physiological change in the respiratory
system is normal and should be anticipated?
A. Increased vital capacity
B. Decreased residual volume
C. Decreased cough reflex [CORRECT]
D. Increased alveolar elasticity
Correct Answer: C
Rationale: Aging leads to a weakened cough reflex and reduced ciliary action, increasing the risk
of aspiration and infection. Vital capacity decreases, while residual volume increases. Alveoli
lose elasticity.
,2
Q3: An older adult patient states, "I don't feel thirsty even when I haven't drunk anything all
day." Which physiological change explains this?
A. Increased glomerular filtration rate
B. Decreased thirst mechanism [CORRECT]
C. Increased total body water
D. Increased antidiuretic hormone (ADH) production
Correct Answer: B
Rationale: Older adults have a diminished thirst mechanism, placing them at high risk for
dehydration. Total body water decreases, and the GFR typically decreases, reducing the ability to
concentrate urine.
Q4: When assessing an older adult's skin, the nurse notes it appears paper-thin and fragile. This
is primarily due to:
A. Increased melanin production
B. Decreased collagen and elastin [CORRECT]
C. Increased subcutaneous fat
D. Increased sebaceous gland activity
Correct Answer: B
Rationale: Aging skin loses collagen and elastin fibers in the dermis, leading to thinning and
fragility. Subcutaneous fat decreases, and sebaceous gland activity decreases, causing dryness.
Q5: Which assessment finding in an older adult requires immediate follow-up regarding renal
function?
A. Nocturia
B. Urinary incontinence
C. Serum creatinine of 1.0 mg/dL
D. Urinary frequency without dysuria [CORRECT]
,3
Correct Answer: D
Rationale: While nocturia is common, new onset urinary frequency without pain can signal a
urinary tract infection (UTI), which is the most common infection in older adults and can lead to
sepsis. Urinary incontinence, while not "normal," is a common issue but not necessarily an
immediate emergency like an untreated infection. Note: Serum creatinine of 1.0 is normal,
though renal function (GFR) may still be reduced.
Q6: [Polypharmacy] An older adult is prescribed a new medication. The nurse understands that
compared to younger adults, older adults often require:
A. Higher doses due to increased metabolism
B. Lower doses or extended dosing intervals [CORRECT]
C. Less frequent monitoring
D. Intravenous administration for better absorption
Correct Answer: B
Rationale: Due to decreased liver enzyme activity and reduced renal clearance, drug half-life is
prolonged in older adults. Therefore, lower doses or longer intervals are often required to prevent
toxicity.
Q7: The nurse is performing a functional assessment on an older adult. Which tool is commonly
used to assess the ability to perform Activities of Daily Living (ADLs)?
A. Mini-Mental State Exam (MMSE)
B. Katz Index of Independence in Activities of Daily Living [CORRECT]
C. Geriatric Depression Scale (GDS)
D. Mini-Cog
Correct Answer: B
Rationale: The Katz Index measures ADLs (bathing, dressing, toileting, etc.). The MMSE and
Mini-Cog assess cognition. The GDS screens for depression.
, 4
Q8: Which visual change is considered a normal part of aging?
A. Loss of peripheral vision
B. Presbyopia [CORRECT]
C. Sudden loss of central vision
D. Yellowing of the lens causing blue colors to look green
Correct Answer: B
Rationale: Presbyopia (loss of near vision/accommodation) is a universal change of aging.
Sudden vision loss is pathological. Peripheral vision decreases slightly but is not the primary
change. Lens yellowing makes it harder to distinguish blues/greens, but Presbyopia is the most
classic age-related change.
Q9: The nurse is teaching an older adult about nutrition. The nurse explains that the basal
metabolic rate (BMR) decreases with age. To maintain weight, the patient should:
A. Increase caloric intake
B. Decrease caloric intake and maintain activity [CORRECT]
C. Increase carbohydrate intake
D. Drink supplements between meals
Correct Answer: B
Rationale: As BMR drops, caloric needs decrease. To avoid weight gain, caloric intake should be
reduced or physical activity increased.
Q10: When assessing an older adult's blood pressure, the nurse documents a systolic pressure
that is significantly higher in the right arm than the left. What is the nurse's best action?
A. Document this as a normal finding.
B. Retake the blood pressure after the patient rests.
C. Report the finding to the healthcare provider immediately. [CORRECT]
HESI PN Gerontology Exam 2026/2027 Actual Exam |
3 Latest Versions A B & C with 55 Questions Each &
Correct Detailed Answers with Rationales | Pass
Guaranteed - A+ Graded
Version A: Geriatric Assessment and Physiology
Q1: Which of the following is a normal age-related change in the cardiovascular system?
A. Increased cardiac output
B. Increased peripheral vascular resistance [CORRECT]
C. Decreased blood pressure
D. Increased elasticity of blood vessels
Correct Answer: B
Rationale: Aging causes arterial stiffening and loss of elasticity, leading to increased peripheral
vascular resistance and a tendency toward hypertension. Cardiac output decreases due to reduced
myocardial efficiency. Vessels lose elasticity, not gain it.
Q2: The nurse is caring for an 80-year-old patient. Which physiological change in the respiratory
system is normal and should be anticipated?
A. Increased vital capacity
B. Decreased residual volume
C. Decreased cough reflex [CORRECT]
D. Increased alveolar elasticity
Correct Answer: C
Rationale: Aging leads to a weakened cough reflex and reduced ciliary action, increasing the risk
of aspiration and infection. Vital capacity decreases, while residual volume increases. Alveoli
lose elasticity.
,2
Q3: An older adult patient states, "I don't feel thirsty even when I haven't drunk anything all
day." Which physiological change explains this?
A. Increased glomerular filtration rate
B. Decreased thirst mechanism [CORRECT]
C. Increased total body water
D. Increased antidiuretic hormone (ADH) production
Correct Answer: B
Rationale: Older adults have a diminished thirst mechanism, placing them at high risk for
dehydration. Total body water decreases, and the GFR typically decreases, reducing the ability to
concentrate urine.
Q4: When assessing an older adult's skin, the nurse notes it appears paper-thin and fragile. This
is primarily due to:
A. Increased melanin production
B. Decreased collagen and elastin [CORRECT]
C. Increased subcutaneous fat
D. Increased sebaceous gland activity
Correct Answer: B
Rationale: Aging skin loses collagen and elastin fibers in the dermis, leading to thinning and
fragility. Subcutaneous fat decreases, and sebaceous gland activity decreases, causing dryness.
Q5: Which assessment finding in an older adult requires immediate follow-up regarding renal
function?
A. Nocturia
B. Urinary incontinence
C. Serum creatinine of 1.0 mg/dL
D. Urinary frequency without dysuria [CORRECT]
,3
Correct Answer: D
Rationale: While nocturia is common, new onset urinary frequency without pain can signal a
urinary tract infection (UTI), which is the most common infection in older adults and can lead to
sepsis. Urinary incontinence, while not "normal," is a common issue but not necessarily an
immediate emergency like an untreated infection. Note: Serum creatinine of 1.0 is normal,
though renal function (GFR) may still be reduced.
Q6: [Polypharmacy] An older adult is prescribed a new medication. The nurse understands that
compared to younger adults, older adults often require:
A. Higher doses due to increased metabolism
B. Lower doses or extended dosing intervals [CORRECT]
C. Less frequent monitoring
D. Intravenous administration for better absorption
Correct Answer: B
Rationale: Due to decreased liver enzyme activity and reduced renal clearance, drug half-life is
prolonged in older adults. Therefore, lower doses or longer intervals are often required to prevent
toxicity.
Q7: The nurse is performing a functional assessment on an older adult. Which tool is commonly
used to assess the ability to perform Activities of Daily Living (ADLs)?
A. Mini-Mental State Exam (MMSE)
B. Katz Index of Independence in Activities of Daily Living [CORRECT]
C. Geriatric Depression Scale (GDS)
D. Mini-Cog
Correct Answer: B
Rationale: The Katz Index measures ADLs (bathing, dressing, toileting, etc.). The MMSE and
Mini-Cog assess cognition. The GDS screens for depression.
, 4
Q8: Which visual change is considered a normal part of aging?
A. Loss of peripheral vision
B. Presbyopia [CORRECT]
C. Sudden loss of central vision
D. Yellowing of the lens causing blue colors to look green
Correct Answer: B
Rationale: Presbyopia (loss of near vision/accommodation) is a universal change of aging.
Sudden vision loss is pathological. Peripheral vision decreases slightly but is not the primary
change. Lens yellowing makes it harder to distinguish blues/greens, but Presbyopia is the most
classic age-related change.
Q9: The nurse is teaching an older adult about nutrition. The nurse explains that the basal
metabolic rate (BMR) decreases with age. To maintain weight, the patient should:
A. Increase caloric intake
B. Decrease caloric intake and maintain activity [CORRECT]
C. Increase carbohydrate intake
D. Drink supplements between meals
Correct Answer: B
Rationale: As BMR drops, caloric needs decrease. To avoid weight gain, caloric intake should be
reduced or physical activity increased.
Q10: When assessing an older adult's blood pressure, the nurse documents a systolic pressure
that is significantly higher in the right arm than the left. What is the nurse's best action?
A. Document this as a normal finding.
B. Retake the blood pressure after the patient rests.
C. Report the finding to the healthcare provider immediately. [CORRECT]
