Gerontology HESI Exam 2026 Questions & Verified Answers Geriatric
Nursing Review.
Questions 1–20: Normal Aging & Physiological Changes
1. An 80-year-old reports feeling dizzy when standing up quickly. What age-
related change is the most likely cause?
A) Decreased cardiac output
B) Baroreceptor insensitivity
C) Orthostatic hypotension
D) Reduced intravascular volume
Answer: B) Baroreceptor insensitivity
Rationale: Age-related stiffening of arteries and reduced baroreceptor reflex
response lead to orthostatic hypotension. While decreased cardiac output and
volume occur, baroreceptor insensitivity is the primary mechanism.
2. Which skin change is considered a normal part of aging?
A) Increased sebaceous gland activity
B) Thinning of the dermis
C) Thickening of the epidermis
,D) Increased melanocyte function
Answer: B) Thinning of the dermis
Rationale: Dermal thinning, decreased collagen/elastin, and reduced sebaceous
activity are normal. Epidermis thins, melanocyte function decreases.
3. An older adult’s liver function shows decreased metabolism of certain drugs.
This is primarily due to:
A) Decreased hepatic blood flow
B) Increased liver mass
C) Increased albumin production
D) Faster phase II reactions
Answer: A) Decreased hepatic blood flow
Rationale: Hepatic blood flow decreases by 40–50% with age, reducing first-pass
metabolism. Liver mass decreases, not increases.
4. A nurse notes a widened QRS complex on an 85-year-old’s ECG. Which age-
related change explains this?
A) Increased left ventricular wall thickness
,B) Fibrosis of the conduction system
C) Decreased aortic compliance
D) Increased sympathetic response
Answer: B) Fibrosis of the conduction system
Rationale: Fibrosis and calcification of the cardiac conduction system (SA node,
Bundle of His) can prolong QRS duration and PR interval.
5. Which respiratory change increases infection risk in older adults?
A) Increased ciliary action
B) Decreased cough reflex
C) Increased alveolar surface area
D) Increased macrophage activity
Answer: B) Decreased cough reflex
Rationale: Cough effectiveness declines, mucociliary clearance slows, and immune
senescence increases pneumonia risk.
6. An 88-year-old has a serum creatinine of 0.9 mg/dL (normal range 0.6–1.2). The
nurse interprets this as:
, A) Normal kidney function
B) Possible dehydration
C) Possibly masking significant renal impairment
D) Hyperfiltration
Answer: C) Possibly masking significant renal impairment
Rationale: Age-related muscle loss reduces creatinine production, so normal
creatinine can hide substantially reduced GFR.
7. Which gastrointestinal change is expected in a healthy 75-year-old?
A) Increased gastric acid production
B) Increased esophageal motility
C) Delayed gastric emptying
D) Increased nutrient absorption
Answer: C) Delayed gastric emptying
Rationale: Gastric emptying slows; gastric acid decreases, motility decreases,
absorption slightly declines.
Nursing Review.
Questions 1–20: Normal Aging & Physiological Changes
1. An 80-year-old reports feeling dizzy when standing up quickly. What age-
related change is the most likely cause?
A) Decreased cardiac output
B) Baroreceptor insensitivity
C) Orthostatic hypotension
D) Reduced intravascular volume
Answer: B) Baroreceptor insensitivity
Rationale: Age-related stiffening of arteries and reduced baroreceptor reflex
response lead to orthostatic hypotension. While decreased cardiac output and
volume occur, baroreceptor insensitivity is the primary mechanism.
2. Which skin change is considered a normal part of aging?
A) Increased sebaceous gland activity
B) Thinning of the dermis
C) Thickening of the epidermis
,D) Increased melanocyte function
Answer: B) Thinning of the dermis
Rationale: Dermal thinning, decreased collagen/elastin, and reduced sebaceous
activity are normal. Epidermis thins, melanocyte function decreases.
3. An older adult’s liver function shows decreased metabolism of certain drugs.
This is primarily due to:
A) Decreased hepatic blood flow
B) Increased liver mass
C) Increased albumin production
D) Faster phase II reactions
Answer: A) Decreased hepatic blood flow
Rationale: Hepatic blood flow decreases by 40–50% with age, reducing first-pass
metabolism. Liver mass decreases, not increases.
4. A nurse notes a widened QRS complex on an 85-year-old’s ECG. Which age-
related change explains this?
A) Increased left ventricular wall thickness
,B) Fibrosis of the conduction system
C) Decreased aortic compliance
D) Increased sympathetic response
Answer: B) Fibrosis of the conduction system
Rationale: Fibrosis and calcification of the cardiac conduction system (SA node,
Bundle of His) can prolong QRS duration and PR interval.
5. Which respiratory change increases infection risk in older adults?
A) Increased ciliary action
B) Decreased cough reflex
C) Increased alveolar surface area
D) Increased macrophage activity
Answer: B) Decreased cough reflex
Rationale: Cough effectiveness declines, mucociliary clearance slows, and immune
senescence increases pneumonia risk.
6. An 88-year-old has a serum creatinine of 0.9 mg/dL (normal range 0.6–1.2). The
nurse interprets this as:
, A) Normal kidney function
B) Possible dehydration
C) Possibly masking significant renal impairment
D) Hyperfiltration
Answer: C) Possibly masking significant renal impairment
Rationale: Age-related muscle loss reduces creatinine production, so normal
creatinine can hide substantially reduced GFR.
7. Which gastrointestinal change is expected in a healthy 75-year-old?
A) Increased gastric acid production
B) Increased esophageal motility
C) Delayed gastric emptying
D) Increased nutrient absorption
Answer: C) Delayed gastric emptying
Rationale: Gastric emptying slows; gastric acid decreases, motility decreases,
absorption slightly declines.
