HESI PN GERONTOLOGY EXAM 290 2026
QUESTION BANK LONG TERM CARE MODULE
SOLVED ITEMS AND RESPONSE KEY
◉ When observing an older client with dementia for symptoms of
Sundowning syndrome, it is most important that the practical nurse
(PN) assesses for which finding?
a. Observe for agitation at the end of the day.
b. Perform a neurological and mental status examination.
c. Monitor for medication side effects.
d. Assess for decreased gross motor movement. Answer: a. Observe
for agitation at the end of the day.
Sundowning syndrome is a pattern of agitated behavior in the
evening, believed to be associated with tiredness at the end of the
day combined with fewer orienting stimuli, such as activities and
interactions.
◉ The practical nurse (PN) working at an assisted living facility is
visiting with a client whose spouse died 8 months ago. Which
behavior by the client suggests ineffective coping with the spouse's
death?
,a. Frequently neglects to shower and shave.
b. Insists on visiting the gravesite once a month.
c. Joins an exercise class at the assisted living facility.
d. Keeps their photo albums out and looks through them frequently.
Answer: a. Frequently neglects to shower and shave.
Ineffective coping is manifested by behaviors that may be physically
or psychologically harmful to the individual. Neglecting personal
hygiene is an example of ineffective coping.
◉ When initially monitoring a client after a fall, which information
should the practical nurse (PN) communicate immediately to the
health care provider? (Select all that apply.)
a. Change in the level of consciousness
b. Increasing muscular weakness
c. Changes in pupil size bilaterally
d. Progressive nuchal rigidity
e. Onset of nausea and vomiting Answer: a. Change in the level of
consciousness
e. Onset of nausea and vomiting
,A decrease or change in the level of consciousness is usually the first
indication of neurological deterioration. Nausea and vomiting may
also be present.
◉ An older adult client is seen in the clinic for problems with
urinary frequency, urgency, and nocturia. The symptoms are an
example of which condition?
a. Urinary tract infection (UTI)
b. Normal aging changes
c. Side effect of the diuretic furosemide
d. Partial obstruction of the urethra Answer: b. Normal aging
changes
Normal aging changes in the bladder are decreased capacity,
increased irritability, and incomplete emptying; these changes lead
to frequency, nocturia, urgency, and vulnerability to infection. The
majority of UTIs in the older adult are asymptomatic. Classic signs of
UTIs are fever, dysuria, and flank pain.
◉ An older adult client is recovering from a hip fracture. The health
care provider has prescribed home health care nursing upon
discharge. Which statement describes the primary goal for the
client?
, a. Return the client to his or her previous lifestyle.
b. Avoid dependency on medication therapy.
c. Establish self-care and independence.
d. Maintain a friendly relationship with family members. Answer: c.
Establish self-care and independence.
Loss of independence is a significant issue with the aging population
and is one of the most important issues for the home health practical
nurse (PN) to establish with the client. Establishing the client's
individual goals is the primary concern of the home health care PN.
◉ An older client at a long-term care facility is to be monitored for
early signs of pneumonia. The practical nurse's (PN) observation of
the client will most likely show which early sign(s)/symptom(s)?
(Select all that apply.)
a. Fever
b. Abnormal breath sounds
c. Tachycardia
d. Confusion
e. Tachypnea Answer: c. Tachycardia
d. Confusion
e. Tachypnea
QUESTION BANK LONG TERM CARE MODULE
SOLVED ITEMS AND RESPONSE KEY
◉ When observing an older client with dementia for symptoms of
Sundowning syndrome, it is most important that the practical nurse
(PN) assesses for which finding?
a. Observe for agitation at the end of the day.
b. Perform a neurological and mental status examination.
c. Monitor for medication side effects.
d. Assess for decreased gross motor movement. Answer: a. Observe
for agitation at the end of the day.
Sundowning syndrome is a pattern of agitated behavior in the
evening, believed to be associated with tiredness at the end of the
day combined with fewer orienting stimuli, such as activities and
interactions.
◉ The practical nurse (PN) working at an assisted living facility is
visiting with a client whose spouse died 8 months ago. Which
behavior by the client suggests ineffective coping with the spouse's
death?
,a. Frequently neglects to shower and shave.
b. Insists on visiting the gravesite once a month.
c. Joins an exercise class at the assisted living facility.
d. Keeps their photo albums out and looks through them frequently.
Answer: a. Frequently neglects to shower and shave.
Ineffective coping is manifested by behaviors that may be physically
or psychologically harmful to the individual. Neglecting personal
hygiene is an example of ineffective coping.
◉ When initially monitoring a client after a fall, which information
should the practical nurse (PN) communicate immediately to the
health care provider? (Select all that apply.)
a. Change in the level of consciousness
b. Increasing muscular weakness
c. Changes in pupil size bilaterally
d. Progressive nuchal rigidity
e. Onset of nausea and vomiting Answer: a. Change in the level of
consciousness
e. Onset of nausea and vomiting
,A decrease or change in the level of consciousness is usually the first
indication of neurological deterioration. Nausea and vomiting may
also be present.
◉ An older adult client is seen in the clinic for problems with
urinary frequency, urgency, and nocturia. The symptoms are an
example of which condition?
a. Urinary tract infection (UTI)
b. Normal aging changes
c. Side effect of the diuretic furosemide
d. Partial obstruction of the urethra Answer: b. Normal aging
changes
Normal aging changes in the bladder are decreased capacity,
increased irritability, and incomplete emptying; these changes lead
to frequency, nocturia, urgency, and vulnerability to infection. The
majority of UTIs in the older adult are asymptomatic. Classic signs of
UTIs are fever, dysuria, and flank pain.
◉ An older adult client is recovering from a hip fracture. The health
care provider has prescribed home health care nursing upon
discharge. Which statement describes the primary goal for the
client?
, a. Return the client to his or her previous lifestyle.
b. Avoid dependency on medication therapy.
c. Establish self-care and independence.
d. Maintain a friendly relationship with family members. Answer: c.
Establish self-care and independence.
Loss of independence is a significant issue with the aging population
and is one of the most important issues for the home health practical
nurse (PN) to establish with the client. Establishing the client's
individual goals is the primary concern of the home health care PN.
◉ An older client at a long-term care facility is to be monitored for
early signs of pneumonia. The practical nurse's (PN) observation of
the client will most likely show which early sign(s)/symptom(s)?
(Select all that apply.)
a. Fever
b. Abnormal breath sounds
c. Tachycardia
d. Confusion
e. Tachypnea Answer: c. Tachycardia
d. Confusion
e. Tachypnea
