NUR 255 Exam 3: Aging & Mental Health Nursing 2026 Galen College
1. An 82-year-old patient is admitted with sudden confusion and disorientation
that fluctuates throughout the day. Which condition should the nurse suspect?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Delirium
D. Normal Age-Related Decline
Answer: C
Rationale: Delirium is characterized by an acute, sudden onset and fluctuating levels of
consciousness, whereas dementia is chronic and progressive.
2. Which assessment finding is a hallmark symptom of Alzheimer’s Disease?
A. Sudden loss of motor function
B. Intermittent visual hallucinations
C. Progressive short-term memory loss
D. High fever and neck rigidity
Answer: C
Rationale: The hallmark of Alzheimer’s is progressive, irreversible impairment of memory,
especially short-term memory, followed by cognitive decline.
,3. When communicating with an elderly patient who has presbycusis, which
action should the nurse take?
A. Shout directly into the patient’s ear
B. Speak slowly in a low-pitched tone while facing the patient
C. Use a high-pitched voice
D. Communicate only through written notes
Answer: B
Rationale: Presbycusis involves the loss of high-frequency sound perception; speaking in a
lower pitch and facing the patient facilitates lip-reading and better hearing.
4. A nurse is caring for a patient with late-stage dementia who is ‘sundowning.’
Which intervention is most appropriate?
A. Provide caffeine to keep the patient alert
B. Increase room lighting in the evening
C. Restrict fluids after 4 PM
D. Apply physical restraints to prevent wandering
Answer: B
Rationale: Sundowning is increased confusion in the late afternoon/evening. Providing
adequate lighting can help reduce shadows and disorientation.
5. What is the therapeutic serum level for a patient taking Lithium for Bipolar
Disorder maintenance?
A. 0.1 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: B
Rationale: The standard therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
, 6. A patient is prescribed Clozapine for treatment-resistant schizophrenia.
Which laboratory value must be monitored weekly?
A. Serum potassium
B. Platelet count
C. Blood Urea Nitrogen (BUN)
D. White Blood Cell (WBC) count
Answer: D
Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC), requiring regular
monitoring of the absolute neutrophil count (ANC) and WBCs.
7. Which of the following is considered a ‘negative’ symptom of schizophrenia?
A. Auditory hallucinations
B. Flat affect
C. Delusions of grandeur
D. Disorganized speech
Answer: B
Rationale: Negative symptoms represent a loss of normal function, such as flat affect (lack
of emotion), alogia, and avolition. Hallucinations and delusions are positive symptoms.
8. A patient with depression states, ‘I have nothing to live for anymore.’ What is
the nurse’s priority action?
A. Administer an antidepressant immediately
B. Document the statement in the chart
C. Tell the patient that life is worth living
D. Ask the patient, ‘Are you thinking of hurting yourself?’
Answer: D
Rationale: Safety is the priority. The nurse must directly assess for suicidal ideation and
intent when a patient expresses hopelessness.
1. An 82-year-old patient is admitted with sudden confusion and disorientation
that fluctuates throughout the day. Which condition should the nurse suspect?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Delirium
D. Normal Age-Related Decline
Answer: C
Rationale: Delirium is characterized by an acute, sudden onset and fluctuating levels of
consciousness, whereas dementia is chronic and progressive.
2. Which assessment finding is a hallmark symptom of Alzheimer’s Disease?
A. Sudden loss of motor function
B. Intermittent visual hallucinations
C. Progressive short-term memory loss
D. High fever and neck rigidity
Answer: C
Rationale: The hallmark of Alzheimer’s is progressive, irreversible impairment of memory,
especially short-term memory, followed by cognitive decline.
,3. When communicating with an elderly patient who has presbycusis, which
action should the nurse take?
A. Shout directly into the patient’s ear
B. Speak slowly in a low-pitched tone while facing the patient
C. Use a high-pitched voice
D. Communicate only through written notes
Answer: B
Rationale: Presbycusis involves the loss of high-frequency sound perception; speaking in a
lower pitch and facing the patient facilitates lip-reading and better hearing.
4. A nurse is caring for a patient with late-stage dementia who is ‘sundowning.’
Which intervention is most appropriate?
A. Provide caffeine to keep the patient alert
B. Increase room lighting in the evening
C. Restrict fluids after 4 PM
D. Apply physical restraints to prevent wandering
Answer: B
Rationale: Sundowning is increased confusion in the late afternoon/evening. Providing
adequate lighting can help reduce shadows and disorientation.
5. What is the therapeutic serum level for a patient taking Lithium for Bipolar
Disorder maintenance?
A. 0.1 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.0 mEq/L
Answer: B
Rationale: The standard therapeutic range for lithium maintenance is 0.6 to 1.2 mEq/L.
Levels above 1.5 mEq/L are considered toxic.
, 6. A patient is prescribed Clozapine for treatment-resistant schizophrenia.
Which laboratory value must be monitored weekly?
A. Serum potassium
B. Platelet count
C. Blood Urea Nitrogen (BUN)
D. White Blood Cell (WBC) count
Answer: D
Rationale: Clozapine carries a risk of agranulocytosis (severe low WBC), requiring regular
monitoring of the absolute neutrophil count (ANC) and WBCs.
7. Which of the following is considered a ‘negative’ symptom of schizophrenia?
A. Auditory hallucinations
B. Flat affect
C. Delusions of grandeur
D. Disorganized speech
Answer: B
Rationale: Negative symptoms represent a loss of normal function, such as flat affect (lack
of emotion), alogia, and avolition. Hallucinations and delusions are positive symptoms.
8. A patient with depression states, ‘I have nothing to live for anymore.’ What is
the nurse’s priority action?
A. Administer an antidepressant immediately
B. Document the statement in the chart
C. Tell the patient that life is worth living
D. Ask the patient, ‘Are you thinking of hurting yourself?’
Answer: D
Rationale: Safety is the priority. The nurse must directly assess for suicidal ideation and
intent when a patient expresses hopelessness.
