HESI PN Gerontology Exam Actual Exam 2026/2027: Complete
Exam-Style Questions with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Physiologic Changes of Aging
1. An 84-year-old male is admitted for dehydration. The nurse notes that his skin
appears thin, translucent, and fragile with decreased turgor. Which age-related
change best explains this finding?
A) Increased sebaceous gland activity
B) Decreased subcutaneous fat and collagen production ✓
C) Hyperplasia of the stratum corneum
D) Increased capillary fragility alone
Correct Answer: B) Decreased subcutaneous fat and collagen production
Rationale: Aging causes dermal thinning due to reduced collagen, elastin, and
subcutaneous fat. This leads to fragile, translucent skin with poor turgor, increasing
injury risk.
2. A practical nurse is assessing an 88-year-old client during the night shift. The
client reports difficulty seeing in dim light. Which age-related change is the most
likely cause?
A) Cataract formation
B) Presbyopia
C) Decreased rod function in the retina ✓
D) Glaucoma
Correct Answer: C) Decreased rod function in the retina
Rationale: Presbyopia affects near vision, while decreased rod function specifically
impairs dark adaptation. Cataracts cause blurred vision and glare, and glaucoma
affects peripheral vision.
, 3. A 79-year-old female has a blood pressure of 138/82 mmHg while seated. When
she stands, her blood pressure drops to 110/68 mmHg and she reports
dizziness. Which physiologic change contributes most to this orthostatic
hypotension?
A) Increased baroreceptor sensitivity
B) Decreased venous compliance and reduced baroreceptor response ✓
C) Excessive diuretic use alone
D) Increased cardiac contractility
Correct Answer: B) Decreased venous compliance and reduced baroreceptor response
Rationale: Aging reduces baroreceptor sensitivity and venous compliance, slowing
compensatory vasoconstriction when standing. This causes orthostatic hypotension
and fall risk.
4. A nurse is reviewing the vital signs of a 91-year-old client. The temperature is
36.1°C (97.0°F) orally. Which response by the nurse is most appropriate?
A) Report the finding immediately as hypothermia
B) Recognize this as a normal age-related change due to decreased thermoregulation
and a lower baseline temperature ✓
C) Apply a warming blanket
D) Recheck the temperature rectally
Correct Answer: B) Recognize this as a normal age-related change due to decreased
thermoregulation and a lower baseline temperature
Rationale: Older adults often have lower baseline temperatures due to reduced
metabolic rate and thermoregulatory efficiency. A temperature of 97°F can be normal;
infection may present without fever.
5. A practical nurse is caring for a 76-year-old client with a fractured hip. The nurse
notes that the client's respiratory rate is 22 breaths/min and shallow. Which
age-related respiratory change explains this finding?
A) Increased alveolar surface area
B) Decreased lung elasticity and weakened respiratory muscles ✓
C) Increased chest wall compliance
, D) Hyperplasia of the bronchial mucosa
Correct Answer: B) Decreased lung elasticity and weakened respiratory muscles
Rationale: Kyphosis, calcified costal cartilage, and reduced elasticity increase work of
breathing. Respiratory muscles weaken, leading to shallow, rapid breathing and reduced
vital capacity.
6. An 82-year-old client is admitted with urinary retention. The nurse notes a
post-void residual of 250 mL. Which age-related change is most responsible?
A) Increased detrusor muscle tone
B) Weakened detrusor muscle and bladder outlet obstruction from prostate
enlargement or pelvic floor weakness ✓
C) Increased bladder capacity
D) Hyperactive micturition reflex
Correct Answer: B) Weakened detrusor muscle and bladder outlet obstruction from
prostate enlargement or pelvic floor weakness
Rationale: Aging reduces detrusor contractility. In men, BPH causes obstruction; in
women, pelvic floor weakening contributes. This leads to incomplete emptying and
retention.
7. A practical nurse is assessing a 90-year-old client who has difficulty hearing
high-pitched voices. Which term describes this age-related hearing loss?
A) Conductive hearing loss
B) Presbycusis ✓
C) Tinnitus
D) Meniere disease
Correct Answer: B) Presbycusis
Rationale: Presbycusis is bilateral, symmetric, sensorineural hearing loss affecting high
frequencies first. It is the most common age-related hearing change and impacts
speech discrimination.
Exam-Style Questions with Detailed Rationales | 100% Verified |
Pass Guaranteed – A+ Graded
Physiologic Changes of Aging
1. An 84-year-old male is admitted for dehydration. The nurse notes that his skin
appears thin, translucent, and fragile with decreased turgor. Which age-related
change best explains this finding?
A) Increased sebaceous gland activity
B) Decreased subcutaneous fat and collagen production ✓
C) Hyperplasia of the stratum corneum
D) Increased capillary fragility alone
Correct Answer: B) Decreased subcutaneous fat and collagen production
Rationale: Aging causes dermal thinning due to reduced collagen, elastin, and
subcutaneous fat. This leads to fragile, translucent skin with poor turgor, increasing
injury risk.
2. A practical nurse is assessing an 88-year-old client during the night shift. The
client reports difficulty seeing in dim light. Which age-related change is the most
likely cause?
A) Cataract formation
B) Presbyopia
C) Decreased rod function in the retina ✓
D) Glaucoma
Correct Answer: C) Decreased rod function in the retina
Rationale: Presbyopia affects near vision, while decreased rod function specifically
impairs dark adaptation. Cataracts cause blurred vision and glare, and glaucoma
affects peripheral vision.
, 3. A 79-year-old female has a blood pressure of 138/82 mmHg while seated. When
she stands, her blood pressure drops to 110/68 mmHg and she reports
dizziness. Which physiologic change contributes most to this orthostatic
hypotension?
A) Increased baroreceptor sensitivity
B) Decreased venous compliance and reduced baroreceptor response ✓
C) Excessive diuretic use alone
D) Increased cardiac contractility
Correct Answer: B) Decreased venous compliance and reduced baroreceptor response
Rationale: Aging reduces baroreceptor sensitivity and venous compliance, slowing
compensatory vasoconstriction when standing. This causes orthostatic hypotension
and fall risk.
4. A nurse is reviewing the vital signs of a 91-year-old client. The temperature is
36.1°C (97.0°F) orally. Which response by the nurse is most appropriate?
A) Report the finding immediately as hypothermia
B) Recognize this as a normal age-related change due to decreased thermoregulation
and a lower baseline temperature ✓
C) Apply a warming blanket
D) Recheck the temperature rectally
Correct Answer: B) Recognize this as a normal age-related change due to decreased
thermoregulation and a lower baseline temperature
Rationale: Older adults often have lower baseline temperatures due to reduced
metabolic rate and thermoregulatory efficiency. A temperature of 97°F can be normal;
infection may present without fever.
5. A practical nurse is caring for a 76-year-old client with a fractured hip. The nurse
notes that the client's respiratory rate is 22 breaths/min and shallow. Which
age-related respiratory change explains this finding?
A) Increased alveolar surface area
B) Decreased lung elasticity and weakened respiratory muscles ✓
C) Increased chest wall compliance
, D) Hyperplasia of the bronchial mucosa
Correct Answer: B) Decreased lung elasticity and weakened respiratory muscles
Rationale: Kyphosis, calcified costal cartilage, and reduced elasticity increase work of
breathing. Respiratory muscles weaken, leading to shallow, rapid breathing and reduced
vital capacity.
6. An 82-year-old client is admitted with urinary retention. The nurse notes a
post-void residual of 250 mL. Which age-related change is most responsible?
A) Increased detrusor muscle tone
B) Weakened detrusor muscle and bladder outlet obstruction from prostate
enlargement or pelvic floor weakness ✓
C) Increased bladder capacity
D) Hyperactive micturition reflex
Correct Answer: B) Weakened detrusor muscle and bladder outlet obstruction from
prostate enlargement or pelvic floor weakness
Rationale: Aging reduces detrusor contractility. In men, BPH causes obstruction; in
women, pelvic floor weakening contributes. This leads to incomplete emptying and
retention.
7. A practical nurse is assessing a 90-year-old client who has difficulty hearing
high-pitched voices. Which term describes this age-related hearing loss?
A) Conductive hearing loss
B) Presbycusis ✓
C) Tinnitus
D) Meniere disease
Correct Answer: B) Presbycusis
Rationale: Presbycusis is bilateral, symmetric, sensorineural hearing loss affecting high
frequencies first. It is the most common age-related hearing change and impacts
speech discrimination.
