NRNP 6568 FINAL EXAM ACTUAL EXAM 2026 (WALDEN UNIVERSITY) | ALL
QUESTIONS AND CORRECT ANSWERS (DETAILED EXPLANATIONS) | VERIFIED
ANSWERS | UPDATED VERSION
Question 1
Larry is a 69-year-old male experiencing cognitive decline. When evaluating him for a potential
diagnosis of dementia, the nurse practitioner understands that according to the DSM-5, cognitive
decline must be present in at least one specific domain. Which of the following is NOT one of
the recognized cognitive domains?
A) Complex attention
B) Executive function
C) Social cognition
D) Perceptual-motor
E) Long-term musical memory
Correct Answer: E) Long-term musical memory
Rationale: Dementia requires a documented decline in at least one of the following cognitive
domains: complex attention, executive function, learning and memory, language,
perceptual-motor, or social cognition. While music memory is a specific function, it is not
listed as a primary diagnostic domain. Diagnosis is based on the impact these deficits have
on social and occupational functioning and the ability to perform activities of daily living
(ADLs).
Question 2
A nurse practitioner is educating a family about the progression of dementia. Which statement
regarding the course of this illness is correct?
A) The onset is typically acute and triggered by stress.
B) Symptoms generally improve over time with proper nutrition.
, 2
C) The onset is gradual and the course of illness is typically slow and progressive.
D) Dementia is always reversible if the underlying systemic disorder is treated.
E) Executive functioning is usually the last domain to be affected.
Correct Answer: C) The onset is gradual and the course of illness is typically slow and
progressive.
Rationale: Dementia is characterized by a gradual onset and a slow, irreversible
progression. Unlike delirium, which has an acute onset and is often reversible, dementia is
a progressive disease process unto itself. While treating underlying systemic disorders is
important for overall health, the cognitive damage in primary dementias (like Alzheimer’s)
cannot be reversed.
Question 3
Mr. Dan, age 75, reports feeling "low" and asks if this is just a normal part of getting older.
Which response by the nurse practitioner is most accurate?
A) Depression is a normal consequence of the aging process.
B) Depression is not a normal part of aging and may be related to physiological influences.
C) Older adults naturally have lower levels of serotonin, making depression inevitable.
D) Depression in the elderly is usually only triggered by financial loss.
E) Psychological theories suggest that depression in the elderly is solely a biological state.
Correct Answer: B) Depression is not a normal part of aging and may be related to
physiological influences.
Rationale: Depression should never be considered a "normal" part of aging. It is often
linked to physiological factors such as medication side effects, cardiac disease, or
, 3
neuroendocrine disturbances. Biological theories suggest that impaired synthesis or
increased metabolism of neurotransmitters like serotonin, norepinephrine, and dopamine
are causative factors, rather than just "getting old."
Question 4
Which nutritional deficiencies are most strongly correlated with an increased risk of geriatric
depression?
A) Vitamin C and Iron
B) Vitamin B12 and Vitamin D
C) Vitamin K and Magnesium
D) Calcium and Vitamin A
E) Zinc and Folate
Correct Answer: B) Vitamin B12 and Vitamin D
Rationale: Studies have shown that deficiencies in Vitamin B12 and Vitamin D correlate
strongly with depression in older adults. Low levels of these vitamins can raise the risk of
developing depressive symptoms two-fold. Assessing these levels is a critical component of
the initial workup for an older adult presenting with mood changes.
Question 5
When treating a 70-year-old patient for geriatric depression, what should be the nurse
practitioner’s very first step in management?
A) Start a high-dose SSRI immediately.
B) Order a second-generation antipsychotic.
C) Evaluate the present medication regimen for contributors to depression.
, 4
D) Refer the patient to an intensive inpatient psychiatric unit.
E) Recommend complete bed rest to conserve energy.
Correct Answer: C) Evaluate the present medication regimen for contributors to depression.
Rationale: The initial step in treating geriatric depression is a thorough review of the
patient's current medications. Many drugs prescribed for chronic conditions (such as beta-
blockers or corticosteroids) can cause or exacerbate depressive symptoms. Removing or
changing these medications is a primary intervention before adding new psychotropic
drugs.
Question 6
A nurse practitioner is considering adding Aripiprazole (Abilify) to a 70-year-old patient’s
antidepressant regimen. What is the clinical rationale for this intervention?
A) Abilify is the first-line treatment for all geriatric depression.
B) It is used to treat the insomnia associated with depression.
C) It is FDA-approved for augmentation in treatment-resistant depression.
D) It is used primarily to increase the patient's appetite.
E) It reverses the side effects of SSRIs.
Correct Answer: C) It is FDA-approved for augmentation in treatment-resistant depression.
Rationale: While SSRIs are the most widely prescribed first-line antidepressants for
achieving remission, some patients do not respond sufficiently. Several second-generation
antipsychotics, including aripiprazole (Abilify), are FDA-approved to be used as
"augmentation" therapy—added to the existing antidepressant—to help achieve better
clinical outcomes.
QUESTIONS AND CORRECT ANSWERS (DETAILED EXPLANATIONS) | VERIFIED
ANSWERS | UPDATED VERSION
Question 1
Larry is a 69-year-old male experiencing cognitive decline. When evaluating him for a potential
diagnosis of dementia, the nurse practitioner understands that according to the DSM-5, cognitive
decline must be present in at least one specific domain. Which of the following is NOT one of
the recognized cognitive domains?
A) Complex attention
B) Executive function
C) Social cognition
D) Perceptual-motor
E) Long-term musical memory
Correct Answer: E) Long-term musical memory
Rationale: Dementia requires a documented decline in at least one of the following cognitive
domains: complex attention, executive function, learning and memory, language,
perceptual-motor, or social cognition. While music memory is a specific function, it is not
listed as a primary diagnostic domain. Diagnosis is based on the impact these deficits have
on social and occupational functioning and the ability to perform activities of daily living
(ADLs).
Question 2
A nurse practitioner is educating a family about the progression of dementia. Which statement
regarding the course of this illness is correct?
A) The onset is typically acute and triggered by stress.
B) Symptoms generally improve over time with proper nutrition.
, 2
C) The onset is gradual and the course of illness is typically slow and progressive.
D) Dementia is always reversible if the underlying systemic disorder is treated.
E) Executive functioning is usually the last domain to be affected.
Correct Answer: C) The onset is gradual and the course of illness is typically slow and
progressive.
Rationale: Dementia is characterized by a gradual onset and a slow, irreversible
progression. Unlike delirium, which has an acute onset and is often reversible, dementia is
a progressive disease process unto itself. While treating underlying systemic disorders is
important for overall health, the cognitive damage in primary dementias (like Alzheimer’s)
cannot be reversed.
Question 3
Mr. Dan, age 75, reports feeling "low" and asks if this is just a normal part of getting older.
Which response by the nurse practitioner is most accurate?
A) Depression is a normal consequence of the aging process.
B) Depression is not a normal part of aging and may be related to physiological influences.
C) Older adults naturally have lower levels of serotonin, making depression inevitable.
D) Depression in the elderly is usually only triggered by financial loss.
E) Psychological theories suggest that depression in the elderly is solely a biological state.
Correct Answer: B) Depression is not a normal part of aging and may be related to
physiological influences.
Rationale: Depression should never be considered a "normal" part of aging. It is often
linked to physiological factors such as medication side effects, cardiac disease, or
, 3
neuroendocrine disturbances. Biological theories suggest that impaired synthesis or
increased metabolism of neurotransmitters like serotonin, norepinephrine, and dopamine
are causative factors, rather than just "getting old."
Question 4
Which nutritional deficiencies are most strongly correlated with an increased risk of geriatric
depression?
A) Vitamin C and Iron
B) Vitamin B12 and Vitamin D
C) Vitamin K and Magnesium
D) Calcium and Vitamin A
E) Zinc and Folate
Correct Answer: B) Vitamin B12 and Vitamin D
Rationale: Studies have shown that deficiencies in Vitamin B12 and Vitamin D correlate
strongly with depression in older adults. Low levels of these vitamins can raise the risk of
developing depressive symptoms two-fold. Assessing these levels is a critical component of
the initial workup for an older adult presenting with mood changes.
Question 5
When treating a 70-year-old patient for geriatric depression, what should be the nurse
practitioner’s very first step in management?
A) Start a high-dose SSRI immediately.
B) Order a second-generation antipsychotic.
C) Evaluate the present medication regimen for contributors to depression.
, 4
D) Refer the patient to an intensive inpatient psychiatric unit.
E) Recommend complete bed rest to conserve energy.
Correct Answer: C) Evaluate the present medication regimen for contributors to depression.
Rationale: The initial step in treating geriatric depression is a thorough review of the
patient's current medications. Many drugs prescribed for chronic conditions (such as beta-
blockers or corticosteroids) can cause or exacerbate depressive symptoms. Removing or
changing these medications is a primary intervention before adding new psychotropic
drugs.
Question 6
A nurse practitioner is considering adding Aripiprazole (Abilify) to a 70-year-old patient’s
antidepressant regimen. What is the clinical rationale for this intervention?
A) Abilify is the first-line treatment for all geriatric depression.
B) It is used to treat the insomnia associated with depression.
C) It is FDA-approved for augmentation in treatment-resistant depression.
D) It is used primarily to increase the patient's appetite.
E) It reverses the side effects of SSRIs.
Correct Answer: C) It is FDA-approved for augmentation in treatment-resistant depression.
Rationale: While SSRIs are the most widely prescribed first-line antidepressants for
achieving remission, some patients do not respond sufficiently. Several second-generation
antipsychotics, including aripiprazole (Abilify), are FDA-approved to be used as
"augmentation" therapy—added to the existing antidepressant—to help achieve better
clinical outcomes.
