NUR 255 Final Exam Review: Aging & Mental Health Nursing (Units 9-
12) 2026 Galen College
1. An 82-year-old patient presents with acute onset confusion, fluctuating levels
of consciousness, and visual hallucinations. Which condition is most likely?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Major Depressive Disorder
Answer: B
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in consciousness and attention, often triggered by underlying medical issues
like infection.
2. When assessing an older adult for depression, the nurse should be aware that
this population often expresses psychological distress through:
A. Direct verbalization of sadness
B. Somatic (physical) complaints
C. Increased risk-taking behavior
D. Hypomanic episodes
Answer: B
Rationale: Older adults are less likely to report ‘feeling sad’ and more likely to report
physical symptoms like pain, fatigue, or GI distress as manifestations of depression.
,3. What is the primary goal of Validation Therapy when working with a patient
who has late-stage dementia?
A. To force the patient to acknowledge current reality
B. To improve short-term memory through repetition
C. To acknowledge the patient’s feelings and ‘lived’ reality
D. To cure the underlying cognitive impairment
Answer: C
Rationale: Validation therapy focuses on empathy and communication by validating the
emotions behind the patient’s words or actions, rather than correcting their
misconceptions.
4. A patient with Alzheimer’s disease becomes increasingly agitated and
confused in the late afternoon. This phenomenon is known as:
A. Sundowning
B. The Dawn Phenomenon
C. Wernicke’s Encephalopathy
D. Aphasia
Answer: A
Rationale: Sundowning refers to the increased agitation, confusion, and restlessness that
occurs in some patients with dementia during the late afternoon and evening hours.
5. Which neurotransmitter is primarily targeted by donepezil (Aricept) in the
treatment of Alzheimer’s disease?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Answer: C
, Rationale: Donepezil is a cholinesterase inhibitor that works by increasing the levels of
acetylcholine in the brain, which helps improve cognitive function.
6. A nurse suspects elder abuse in a patient living with their adult child. What is
the nurse’s first priority?
A. Confront the adult child about the suspicions
B. Document the findings and wait for more evidence
C. Conduct a private physical assessment of the patient
D. Call the patient’s lawyer
Answer: C
Rationale: Safety and assessment are priorities. The nurse must assess the patient
privately to identify injuries and maintain the patient’s safety before reporting to
authorities.
7. Which of the following is a classic symptom of Lewy Body Dementia that
distinguishes it from Alzheimer’s?
A. Gradual memory loss
B. Step-wise decline in cognition
C. Visual hallucinations and Parkinsonian features
D. Hypertension-related strokes
Answer: C
Rationale: Lewy Body Dementia often presents with vivid visual hallucinations, fluctuating
cognition, and motor symptoms similar to Parkinson’s disease.
12) 2026 Galen College
1. An 82-year-old patient presents with acute onset confusion, fluctuating levels
of consciousness, and visual hallucinations. Which condition is most likely?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Major Depressive Disorder
Answer: B
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in consciousness and attention, often triggered by underlying medical issues
like infection.
2. When assessing an older adult for depression, the nurse should be aware that
this population often expresses psychological distress through:
A. Direct verbalization of sadness
B. Somatic (physical) complaints
C. Increased risk-taking behavior
D. Hypomanic episodes
Answer: B
Rationale: Older adults are less likely to report ‘feeling sad’ and more likely to report
physical symptoms like pain, fatigue, or GI distress as manifestations of depression.
,3. What is the primary goal of Validation Therapy when working with a patient
who has late-stage dementia?
A. To force the patient to acknowledge current reality
B. To improve short-term memory through repetition
C. To acknowledge the patient’s feelings and ‘lived’ reality
D. To cure the underlying cognitive impairment
Answer: C
Rationale: Validation therapy focuses on empathy and communication by validating the
emotions behind the patient’s words or actions, rather than correcting their
misconceptions.
4. A patient with Alzheimer’s disease becomes increasingly agitated and
confused in the late afternoon. This phenomenon is known as:
A. Sundowning
B. The Dawn Phenomenon
C. Wernicke’s Encephalopathy
D. Aphasia
Answer: A
Rationale: Sundowning refers to the increased agitation, confusion, and restlessness that
occurs in some patients with dementia during the late afternoon and evening hours.
5. Which neurotransmitter is primarily targeted by donepezil (Aricept) in the
treatment of Alzheimer’s disease?
A. Dopamine
B. Serotonin
C. Acetylcholine
D. GABA
Answer: C
, Rationale: Donepezil is a cholinesterase inhibitor that works by increasing the levels of
acetylcholine in the brain, which helps improve cognitive function.
6. A nurse suspects elder abuse in a patient living with their adult child. What is
the nurse’s first priority?
A. Confront the adult child about the suspicions
B. Document the findings and wait for more evidence
C. Conduct a private physical assessment of the patient
D. Call the patient’s lawyer
Answer: C
Rationale: Safety and assessment are priorities. The nurse must assess the patient
privately to identify injuries and maintain the patient’s safety before reporting to
authorities.
7. Which of the following is a classic symptom of Lewy Body Dementia that
distinguishes it from Alzheimer’s?
A. Gradual memory loss
B. Step-wise decline in cognition
C. Visual hallucinations and Parkinsonian features
D. Hypertension-related strokes
Answer: C
Rationale: Lewy Body Dementia often presents with vivid visual hallucinations, fluctuating
cognition, and motor symptoms similar to Parkinson’s disease.
