NUR 255 Exam 2: Aging & Mental Health Nursing 2026
1. Which physiological change in the elderly most significantly impacts the
excretion of medications?
A. Increased hepatic enzyme activity
B. Increased gastric pH levels
C. Decreased total body water percentage
D. Decreased renal blood flow and glomerular filtration rate
Answer: D
Rationale: The kidneys are the primary organs for drug excretion. A decline in renal blood
flow and GFR in older adults leads to slower drug clearance and a higher risk of toxicity.
2. An elderly patient presents with a sudden onset of confusion, fluctuating
levels of consciousness, and visual hallucinations. What is the most likely
diagnosis?
A. Alzheimer’s Disease
B. Major Depressive Disorder
C. Delirium
D. Vascular Dementia
Answer: C
Rationale: Delirium is characterized by an acute, rapid onset, fluctuating course, and
changes in consciousness or perception, often triggered by underlying medical issues.
,3. Which early symptom is most indicative of Alzheimer’s disease?
A. Loss of long-term memory
B. Inability to perform gross motor skills
C. Subtle memory loss of recent events
D. Total loss of verbal communication
Answer: C
Rationale: Early-stage Alzheimer’s typically manifests as difficulty remembering new
information or recent conversations, while long-term memory remains intact initially.
4. The nurse asks a patient, ‘Can you tell me more about how you feel when you
are anxious?’ Which therapeutic communication technique is being used?
A. Summarizing
B. Restating
C. Offering Self
D. Exploring
Answer: D
Rationale: Exploring is a technique that encourages the patient to provide more detail or
depth about a specific topic or feeling.
5. When assessing an elderly patient for fall risk, which factor is the strongest
predictor of a future fall?
A. Living alone in a single-story home
B. Use of a hearing aid
C. History of previous falls
D. Occasional use of reading glasses
Answer: C
Rationale: A history of falling is the single most important predictor of future falls in the
geriatric population.
, 6. Which term describes the use of multiple medications concurrently, often
seen in elderly patients with comorbidities?
B. Polypharmacy
A. Pharmacodynamics
C. Adverse Drug Reaction
D. Therapeutic Index
Answer: B
Rationale: Polypharmacy refers to the use of five or more medications, which increases the
risk of drug-drug interactions and adverse effects in the elderly.
7. Depression in the elderly is often misdiagnosed as dementia because of which
shared symptom?
A. Increased appetite
B. Hyperactivity
C. Cognitive impairment and poor concentration
D. Improved social engagement
Answer: C
Rationale: Depression in older adults can cause ‘pseudodementia,’ where the patient
experiences significant memory gaps and difficulty concentrating.
8. In Schizophrenia, which of the following is considered a ‘negative’ symptom?
A. Auditory hallucinations
B. Delusions of grandeur
C. Disorganized speech
D. Flat affect or apathy
Answer: D
Rationale: Negative symptoms involve the absence of normal behaviors, such as flat affect
(lack of emotion), alogia (poverty of speech), and avolition.
1. Which physiological change in the elderly most significantly impacts the
excretion of medications?
A. Increased hepatic enzyme activity
B. Increased gastric pH levels
C. Decreased total body water percentage
D. Decreased renal blood flow and glomerular filtration rate
Answer: D
Rationale: The kidneys are the primary organs for drug excretion. A decline in renal blood
flow and GFR in older adults leads to slower drug clearance and a higher risk of toxicity.
2. An elderly patient presents with a sudden onset of confusion, fluctuating
levels of consciousness, and visual hallucinations. What is the most likely
diagnosis?
A. Alzheimer’s Disease
B. Major Depressive Disorder
C. Delirium
D. Vascular Dementia
Answer: C
Rationale: Delirium is characterized by an acute, rapid onset, fluctuating course, and
changes in consciousness or perception, often triggered by underlying medical issues.
,3. Which early symptom is most indicative of Alzheimer’s disease?
A. Loss of long-term memory
B. Inability to perform gross motor skills
C. Subtle memory loss of recent events
D. Total loss of verbal communication
Answer: C
Rationale: Early-stage Alzheimer’s typically manifests as difficulty remembering new
information or recent conversations, while long-term memory remains intact initially.
4. The nurse asks a patient, ‘Can you tell me more about how you feel when you
are anxious?’ Which therapeutic communication technique is being used?
A. Summarizing
B. Restating
C. Offering Self
D. Exploring
Answer: D
Rationale: Exploring is a technique that encourages the patient to provide more detail or
depth about a specific topic or feeling.
5. When assessing an elderly patient for fall risk, which factor is the strongest
predictor of a future fall?
A. Living alone in a single-story home
B. Use of a hearing aid
C. History of previous falls
D. Occasional use of reading glasses
Answer: C
Rationale: A history of falling is the single most important predictor of future falls in the
geriatric population.
, 6. Which term describes the use of multiple medications concurrently, often
seen in elderly patients with comorbidities?
B. Polypharmacy
A. Pharmacodynamics
C. Adverse Drug Reaction
D. Therapeutic Index
Answer: B
Rationale: Polypharmacy refers to the use of five or more medications, which increases the
risk of drug-drug interactions and adverse effects in the elderly.
7. Depression in the elderly is often misdiagnosed as dementia because of which
shared symptom?
A. Increased appetite
B. Hyperactivity
C. Cognitive impairment and poor concentration
D. Improved social engagement
Answer: C
Rationale: Depression in older adults can cause ‘pseudodementia,’ where the patient
experiences significant memory gaps and difficulty concentrating.
8. In Schizophrenia, which of the following is considered a ‘negative’ symptom?
A. Auditory hallucinations
B. Delusions of grandeur
C. Disorganized speech
D. Flat affect or apathy
Answer: D
Rationale: Negative symptoms involve the absence of normal behaviors, such as flat affect
(lack of emotion), alogia (poverty of speech), and avolition.
