NUR 255 Exam 3 Review (2026) | Units 6–8 | Aging & Mental Health
Nursing 2026 Galen Nursing
1. Which of the following is a cardinal sign of delirium that distinguishes it from
dementia?
A. Gradual onset of memory loss
B. Intact language skills but loss of motor function
C. Irreversible decline in cognitive function
D. Acute change in level of consciousness and attention
Answer: D
Rationale: Delirium is characterized by an acute, fluctuating onset of confusion and a
significant change in the level of consciousness or attention, whereas dementia is typically
gradual and progressive.
2. An elderly patient is diagnosed with ‘Pseudodementia.’ Which underlying
condition is most likely responsible for this presentation?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Major Depressive Disorder
D. Vitamin B12 Deficiency
Answer: C
Rationale: Pseudodementia refers to cognitive impairment that mimics dementia but is
actually caused by depression in the elderly; it is often reversible with appropriate
antidepressant treatment.
,3. When administering Donepezil (Aricept) to a patient with Alzheimer’s, the
nurse should monitor for which common side effect?
A. Hypertension
B. Urinary retention
C. Dry mouth and constipation
D. Gastrointestinal distress and diarrhea
Answer: D
Rationale: Donepezil is a cholinesterase inhibitor. By increasing acetylcholine, it often
stimulates the parasympathetic nervous system, leading to GI side effects like nausea,
vomiting, and diarrhea.
4. A patient with Alzheimer’s disease is experiencing ‘agnosia.’ Which behavior
demonstrates this symptom?
A. The patient fails to recognize a fork as a tool for eating.
B. The patient is unable to find the correct words to speak.
C. The patient is unable to perform motor activities despite intact motor function.
D. The patient repeats the same phrase over and over.
Answer: A
Rationale: Agnosia is the failure to recognize or identify objects despite intact sensory
function. Failure to recognize a fork is a classic example.
5. Which assessment finding is a priority for a nurse caring for a patient on
Lithium for Bipolar Disorder?
A. Mild hand tremors and polyuria
B. Weight gain of 2 pounds in a month
C. A serum lithium level of 0.8 mEq/L
D. Blurred vision and persistent GI upset
Answer: D
, Rationale: Blurred vision, persistent nausea/vomiting, and ataxia are signs of moderate to
severe lithium toxicity. Mild tremors and a level of 0.8 are considered therapeutic or
expected side effects.
6. A patient with Schizophrenia is experiencing auditory hallucinations. Which
nursing intervention is most appropriate?
A. Ask the patient, ‘What are the voices saying to you?’
B. Argue with the patient that the voices are not real.
C. Tell the patient you also hear the voices to build rapport.
D. Leave the patient alone to decrease stimulation.
Answer: A
Rationale: It is essential to assess the content of hallucinations, especially to rule out
‘command’ hallucinations that might order the patient to hurt themselves or others.
7. Which medication is most likely to cause Neuroleptic Malignant Syndrome
(NMS)?
A. Sertraline (Zoloft)
B. Lamotrigine (Lamictal)
C. Lorazepam (Ativan)
D. Haloperidol (Haldol)
Answer: D
Rationale: NMS is a life-threatening reaction to antipsychotic medications, most commonly
the first-generation (typical) antipsychotics like Haloperidol.
Nursing 2026 Galen Nursing
1. Which of the following is a cardinal sign of delirium that distinguishes it from
dementia?
A. Gradual onset of memory loss
B. Intact language skills but loss of motor function
C. Irreversible decline in cognitive function
D. Acute change in level of consciousness and attention
Answer: D
Rationale: Delirium is characterized by an acute, fluctuating onset of confusion and a
significant change in the level of consciousness or attention, whereas dementia is typically
gradual and progressive.
2. An elderly patient is diagnosed with ‘Pseudodementia.’ Which underlying
condition is most likely responsible for this presentation?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Major Depressive Disorder
D. Vitamin B12 Deficiency
Answer: C
Rationale: Pseudodementia refers to cognitive impairment that mimics dementia but is
actually caused by depression in the elderly; it is often reversible with appropriate
antidepressant treatment.
,3. When administering Donepezil (Aricept) to a patient with Alzheimer’s, the
nurse should monitor for which common side effect?
A. Hypertension
B. Urinary retention
C. Dry mouth and constipation
D. Gastrointestinal distress and diarrhea
Answer: D
Rationale: Donepezil is a cholinesterase inhibitor. By increasing acetylcholine, it often
stimulates the parasympathetic nervous system, leading to GI side effects like nausea,
vomiting, and diarrhea.
4. A patient with Alzheimer’s disease is experiencing ‘agnosia.’ Which behavior
demonstrates this symptom?
A. The patient fails to recognize a fork as a tool for eating.
B. The patient is unable to find the correct words to speak.
C. The patient is unable to perform motor activities despite intact motor function.
D. The patient repeats the same phrase over and over.
Answer: A
Rationale: Agnosia is the failure to recognize or identify objects despite intact sensory
function. Failure to recognize a fork is a classic example.
5. Which assessment finding is a priority for a nurse caring for a patient on
Lithium for Bipolar Disorder?
A. Mild hand tremors and polyuria
B. Weight gain of 2 pounds in a month
C. A serum lithium level of 0.8 mEq/L
D. Blurred vision and persistent GI upset
Answer: D
, Rationale: Blurred vision, persistent nausea/vomiting, and ataxia are signs of moderate to
severe lithium toxicity. Mild tremors and a level of 0.8 are considered therapeutic or
expected side effects.
6. A patient with Schizophrenia is experiencing auditory hallucinations. Which
nursing intervention is most appropriate?
A. Ask the patient, ‘What are the voices saying to you?’
B. Argue with the patient that the voices are not real.
C. Tell the patient you also hear the voices to build rapport.
D. Leave the patient alone to decrease stimulation.
Answer: A
Rationale: It is essential to assess the content of hallucinations, especially to rule out
‘command’ hallucinations that might order the patient to hurt themselves or others.
7. Which medication is most likely to cause Neuroleptic Malignant Syndrome
(NMS)?
A. Sertraline (Zoloft)
B. Lamotrigine (Lamictal)
C. Lorazepam (Ativan)
D. Haloperidol (Haldol)
Answer: D
Rationale: NMS is a life-threatening reaction to antipsychotic medications, most commonly
the first-generation (typical) antipsychotics like Haloperidol.
