GERONTOLOGY HESI RN Practice Exam
Questions and Answers Latest Versions 2026
Latest Versions A+
1. A frail elderly client is admitted with pneumonia. Which finding is
most important for the RN to report to the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting
Answer B Confusion and dehydration
Rationale: In frail older adults, confusion and dehydration indicate
inadequate oxygenation/perfusion and are atypical presentations.
These require immediate intervention. Other options are common but
less critical in this population.
2. An older adult couple complains that food does not taste as good as
before, so they add extra salt. What should the RN teach?
A. Boredom affects taste perception
B. Increased sodium is needed due to decreased renal function
C. Taste buds atrophy with age; use herbs and other seasonings instead
of salt
,D. Short-term memory loss causes over-seasoning
Answer C
Rationale: Age-related atrophy of taste buds reduces sensitivity, leading
to increased seasoning use. Excessive salt risks hypertension and fluid
retention in older adults.
3. An older client with end-stage Alzheimer’s disease fractured her hip.
How should the RN best assess pain?
A. Ask to rate pain 0–10
B. Use the FACES scale
C. Observe for facial grimacing or nonverbal cues
D. Review eating habits
Answer C
Rationale: Clients with advanced dementia cannot reliably self-report.
Nonverbal cues (grimacing, moaning, guarding) are the most reliable
indicators.
4. An older client repeatedly asks, “Where am I?” after moving to
assisted living. How should the RN respond?
A. “You are in a new home called an assisted living community.”
B. Ask the client where she thinks she is
,C. Distract with talk of family
D. Reassure her she will make new friends
Answer A
Rationale: Reality orientation (gentle, consistent factual information) is
appropriate for confusion. Validation or distraction may increase
anxiety.
5. Which activity is most appropriate for an older client with short-term
memory loss and confusion in assisted living?
A. Current events discussion group
B. Arts and crafts
C. Daily exercise group
D. Group sing-along
Answer C
Rationale: Exercise allows mirroring the leader and has lower cognitive
demand, reducing frustration. Activities requiring memory or attention
to detail can cause stress.
6. An older client on chronic hydrocodone/acetaminophen says, “I can’t
live without my pain pills” but denies addiction because “the doctor
prescribed them.” This is an example of:
, A. Denial
B. Rationalization
C. Projection
D. Minimization
Answer B Rationalization
Rationale: The client justifies continued use to protect self-esteem.
Rationalization is common in substance use among older adults.
7. The home health RN visits an older client with chronic hypertension.
What is the most important evaluation each visit?
A. Ability to ambulate
B. Signs of dehydration
C. Effectiveness of medication (BP control)
D. Familial support
Answer C
Rationale: Controlling hypertension prevents stroke, heart failure, and
kidney damage. Medication adherence and effectiveness are priorities.
8. An older client shows sundowning (agitation and disorientation in the
evening). What should the RN review first?
Questions and Answers Latest Versions 2026
Latest Versions A+
1. A frail elderly client is admitted with pneumonia. Which finding is
most important for the RN to report to the healthcare provider?
A. Fever and chills
B. Confusion and dehydration
C. Crackles in the lung fields
D. Nausea and vomiting
Answer B Confusion and dehydration
Rationale: In frail older adults, confusion and dehydration indicate
inadequate oxygenation/perfusion and are atypical presentations.
These require immediate intervention. Other options are common but
less critical in this population.
2. An older adult couple complains that food does not taste as good as
before, so they add extra salt. What should the RN teach?
A. Boredom affects taste perception
B. Increased sodium is needed due to decreased renal function
C. Taste buds atrophy with age; use herbs and other seasonings instead
of salt
,D. Short-term memory loss causes over-seasoning
Answer C
Rationale: Age-related atrophy of taste buds reduces sensitivity, leading
to increased seasoning use. Excessive salt risks hypertension and fluid
retention in older adults.
3. An older client with end-stage Alzheimer’s disease fractured her hip.
How should the RN best assess pain?
A. Ask to rate pain 0–10
B. Use the FACES scale
C. Observe for facial grimacing or nonverbal cues
D. Review eating habits
Answer C
Rationale: Clients with advanced dementia cannot reliably self-report.
Nonverbal cues (grimacing, moaning, guarding) are the most reliable
indicators.
4. An older client repeatedly asks, “Where am I?” after moving to
assisted living. How should the RN respond?
A. “You are in a new home called an assisted living community.”
B. Ask the client where she thinks she is
,C. Distract with talk of family
D. Reassure her she will make new friends
Answer A
Rationale: Reality orientation (gentle, consistent factual information) is
appropriate for confusion. Validation or distraction may increase
anxiety.
5. Which activity is most appropriate for an older client with short-term
memory loss and confusion in assisted living?
A. Current events discussion group
B. Arts and crafts
C. Daily exercise group
D. Group sing-along
Answer C
Rationale: Exercise allows mirroring the leader and has lower cognitive
demand, reducing frustration. Activities requiring memory or attention
to detail can cause stress.
6. An older client on chronic hydrocodone/acetaminophen says, “I can’t
live without my pain pills” but denies addiction because “the doctor
prescribed them.” This is an example of:
, A. Denial
B. Rationalization
C. Projection
D. Minimization
Answer B Rationalization
Rationale: The client justifies continued use to protect self-esteem.
Rationalization is common in substance use among older adults.
7. The home health RN visits an older client with chronic hypertension.
What is the most important evaluation each visit?
A. Ability to ambulate
B. Signs of dehydration
C. Effectiveness of medication (BP control)
D. Familial support
Answer C
Rationale: Controlling hypertension prevents stroke, heart failure, and
kidney damage. Medication adherence and effectiveness are priorities.
8. An older client shows sundowning (agitation and disorientation in the
evening). What should the RN review first?
