NUR 255 Final Exam Review: Units 9–12 Aging & Mental Health 2026
Galen College
1. Which of the following is a primary characteristic of delirium that
distinguishes it from dementia?
A. Gradual onset over months
B. Irreversible decline in cognitive function
C. Acute onset and fluctuating level of consciousness
D. Intact attention span
Answer: C
Rationale: Delirium is characterized by an acute, rapid onset and fluctuations in
consciousness and attention, whereas dementia is gradual and progressive.
2. When assessing an older adult for depression, the nurse should be aware that
which of the following is a common presentation in this population?
A. Explicit reports of profound sadness
B. Somatic complaints like fatigue or pain
C. Increased frequency of crying spells
D. Consistent high energy levels
Answer: B
Rationale: Older adults often mask depression with physical or somatic symptoms such as
persistent pain, fatigue, or GI distress rather than verbalizing emotional sadness.
,3. According to Erikson’s stages of psychosocial development, what is the
developmental task for older adults?
A. Generativity vs. Stagnation
B. Integrity vs. Despair
C. Identity vs. Role Confusion
D. Intimacy vs. Isolation
Answer: B
Rationale: The final stage of Erikson’s theory for late adulthood is Ego Integrity
vs. Despair, where individuals reflect on their lives for meaning.
4. Which physiological change in aging most significantly affects drug
distribution in the body?
A. Increased total body water
B. Decreased serum albumin levels
C. Decreased body fat percentage
D. Increased liver blood flow
Answer: B
Rationale: Decreased serum albumin leads to fewer binding sites for protein-bound drugs,
potentially increasing the level of free, active drug in the system.
5. A nurse is caring for an older adult patient who experiences sundowning.
Which intervention is most appropriate?
A. Using bright lights throughout the night
B. Providing caffeine to keep the patient alert
C. Maintaining a calm, structured routine in the late afternoon
D. Restricting daytime activities to save energy
Answer: C
Rationale: Sundowning is managed by minimizing environmental triggers, maintaining
routines, and providing a calm environment as daylight fades.
, 6. Which of the following activities is classified as an Instrumental Activity of
Daily Living (IADL)?
A. Feeding oneself
B. Toileting
C. Bathing
D. Managing finances
Answer: D
Rationale: IADLs are complex tasks needed for independent living, such as managing
finances, shopping, and meal prep. Bathing and feeding are basic ADLs.
7. The Beers Criteria is used by nurses primarily to identify:
A. Stages of Alzheimer’s disease
B. Risk levels for skin breakdown
C. Nutritional deficiencies
D. Potentially inappropriate medications for older adults
Answer: D
Rationale: The Beers Criteria provides a list of medications that should generally be
avoided or used with caution in the geriatric population.
8. When communicating with an older adult who has presbycusis, the nurse
should:
A. Shout directly into the patient’s ear
B. Speak slowly in a low-pitched voice while facing them
C. Use a high-pitched tone of voice
D. Communicate only through written notes
Answer: B
Rationale: Presbycusis is the loss of high-frequency hearing. Speaking in a lower pitch and
ensuring they can see your face facilitates better communication.
Galen College
1. Which of the following is a primary characteristic of delirium that
distinguishes it from dementia?
A. Gradual onset over months
B. Irreversible decline in cognitive function
C. Acute onset and fluctuating level of consciousness
D. Intact attention span
Answer: C
Rationale: Delirium is characterized by an acute, rapid onset and fluctuations in
consciousness and attention, whereas dementia is gradual and progressive.
2. When assessing an older adult for depression, the nurse should be aware that
which of the following is a common presentation in this population?
A. Explicit reports of profound sadness
B. Somatic complaints like fatigue or pain
C. Increased frequency of crying spells
D. Consistent high energy levels
Answer: B
Rationale: Older adults often mask depression with physical or somatic symptoms such as
persistent pain, fatigue, or GI distress rather than verbalizing emotional sadness.
,3. According to Erikson’s stages of psychosocial development, what is the
developmental task for older adults?
A. Generativity vs. Stagnation
B. Integrity vs. Despair
C. Identity vs. Role Confusion
D. Intimacy vs. Isolation
Answer: B
Rationale: The final stage of Erikson’s theory for late adulthood is Ego Integrity
vs. Despair, where individuals reflect on their lives for meaning.
4. Which physiological change in aging most significantly affects drug
distribution in the body?
A. Increased total body water
B. Decreased serum albumin levels
C. Decreased body fat percentage
D. Increased liver blood flow
Answer: B
Rationale: Decreased serum albumin leads to fewer binding sites for protein-bound drugs,
potentially increasing the level of free, active drug in the system.
5. A nurse is caring for an older adult patient who experiences sundowning.
Which intervention is most appropriate?
A. Using bright lights throughout the night
B. Providing caffeine to keep the patient alert
C. Maintaining a calm, structured routine in the late afternoon
D. Restricting daytime activities to save energy
Answer: C
Rationale: Sundowning is managed by minimizing environmental triggers, maintaining
routines, and providing a calm environment as daylight fades.
, 6. Which of the following activities is classified as an Instrumental Activity of
Daily Living (IADL)?
A. Feeding oneself
B. Toileting
C. Bathing
D. Managing finances
Answer: D
Rationale: IADLs are complex tasks needed for independent living, such as managing
finances, shopping, and meal prep. Bathing and feeding are basic ADLs.
7. The Beers Criteria is used by nurses primarily to identify:
A. Stages of Alzheimer’s disease
B. Risk levels for skin breakdown
C. Nutritional deficiencies
D. Potentially inappropriate medications for older adults
Answer: D
Rationale: The Beers Criteria provides a list of medications that should generally be
avoided or used with caution in the geriatric population.
8. When communicating with an older adult who has presbycusis, the nurse
should:
A. Shout directly into the patient’s ear
B. Speak slowly in a low-pitched voice while facing them
C. Use a high-pitched tone of voice
D. Communicate only through written notes
Answer: B
Rationale: Presbycusis is the loss of high-frequency hearing. Speaking in a lower pitch and
ensuring they can see your face facilitates better communication.
