NUR 255 Final Exam Study Guide (2026) | Units 9–12 2026 Galen
College
1. A nurse is communicating with a patient who is experiencing a manic episode.
Which approach is most effective?
A. Engage in long, detailed discussions to understand their perspective.
B. Use complex medical terminology to establish authority.
C. Allow the patient to lead the conversation at their own pace.
D. Provide brief, concise, and concrete instructions.
Answer: D
Rationale: In a manic state, patients are easily distracted and have shortened attention
spans. Brief, concise, and firm communication helps manage behavior and focus the patient.
2. Which of the following is a classic clinical finding of delirium but not typically
dementia?
A. Gradual onset of memory loss over several years.
B. Fluctuating levels of consciousness throughout the day.
C. Irreversible decline in cognitive function.
D. Intact attention span and alertness.
Answer: B
Rationale: Delirium is characterized by an acute onset, a fluctuating course, and a
disturbed level of consciousness, whereas dementia is gradual and stable in alertness.
,3. An older adult patient is prescribed a new SSRI for depression. Which
teaching point is most important for safety?
A. ‘You will feel the full effects within 24 hours.’
B. ‘Rise slowly from a sitting or lying position to avoid dizziness.’
C. ‘Stop the medication immediately if you feel nauseated.’
D. ‘You can safely consume alcohol while on this medication.’
Answer: B
Rationale: Older adults are at high risk for orthostatic hypotension and falls when starting
antidepressants. Full effects take weeks, not 24 hours.
4. A patient is exhibiting ‘splitting’ behavior, seeing staff as either ‘all good’ or
‘all bad.’ This is most commonly associated with which disorder?
A. Antisocial Personality Disorder
B. Borderline Personality Disorder
C. Schizotypal Personality Disorder
D. Obsessive-Compulsive Personality Disorder
Answer: B
Rationale: Splitting is a hallmark defense mechanism of Borderline Personality Disorder,
where individuals are unable to integrate positive and negative qualities of others.
5. Which assessment finding should a nurse prioritize in a patient taking
Clozapine?
A. Weight gain of 2 lbs in a month
B. Mild dry mouth
C. Sore throat and fever
D. Drowsiness in the evening
Answer: C
Rationale: Clozapine can cause agranulocytosis (a dangerous drop in white blood cells).
Fever and sore throat are early signs of infection that must be reported immediately.
, 6. An older patient has a score of 12 on the Geriatric Depression Scale (GDS).
How should the nurse interpret this?
A. The patient is within the normal range for their age.
B. The patient is experiencing normal age-related sadness.
C. The score suggests the patient is at high risk for cognitive decline only.
D. The patient is showing signs of moderate depression.
Answer: D
Rationale: On the GDS, a score above 5 suggests depression, and a score above 10 typically
indicates depression that warrants further clinical evaluation.
7. Which medication is considered the ‘gold standard’ for stabilizing moods in
Bipolar I disorder?
A. Sertraline
B. Donepezil
C. Lorazepam
D. Lithium Carbonate
Answer: D
Rationale: Lithium remains the primary mood stabilizer for Bipolar Disorder, though it
requires frequent blood level monitoring for toxicity.
8. A nurse observes an older patient with multiple bruises in various stages of
healing and poor hygiene. What is the priority nursing action?
A. Document the findings and wait for the family to visit.
B. Confront the caregiver immediately.
C. Report the suspected abuse to the appropriate state authorities.
D. Clean the patient and provide a fresh gown.
Answer: C
Rationale: Nurses are mandatory reporters. If abuse or neglect is suspected, it must be
reported to the designated authorities (e.g., Adult Protective Services).
College
1. A nurse is communicating with a patient who is experiencing a manic episode.
Which approach is most effective?
A. Engage in long, detailed discussions to understand their perspective.
B. Use complex medical terminology to establish authority.
C. Allow the patient to lead the conversation at their own pace.
D. Provide brief, concise, and concrete instructions.
Answer: D
Rationale: In a manic state, patients are easily distracted and have shortened attention
spans. Brief, concise, and firm communication helps manage behavior and focus the patient.
2. Which of the following is a classic clinical finding of delirium but not typically
dementia?
A. Gradual onset of memory loss over several years.
B. Fluctuating levels of consciousness throughout the day.
C. Irreversible decline in cognitive function.
D. Intact attention span and alertness.
Answer: B
Rationale: Delirium is characterized by an acute onset, a fluctuating course, and a
disturbed level of consciousness, whereas dementia is gradual and stable in alertness.
,3. An older adult patient is prescribed a new SSRI for depression. Which
teaching point is most important for safety?
A. ‘You will feel the full effects within 24 hours.’
B. ‘Rise slowly from a sitting or lying position to avoid dizziness.’
C. ‘Stop the medication immediately if you feel nauseated.’
D. ‘You can safely consume alcohol while on this medication.’
Answer: B
Rationale: Older adults are at high risk for orthostatic hypotension and falls when starting
antidepressants. Full effects take weeks, not 24 hours.
4. A patient is exhibiting ‘splitting’ behavior, seeing staff as either ‘all good’ or
‘all bad.’ This is most commonly associated with which disorder?
A. Antisocial Personality Disorder
B. Borderline Personality Disorder
C. Schizotypal Personality Disorder
D. Obsessive-Compulsive Personality Disorder
Answer: B
Rationale: Splitting is a hallmark defense mechanism of Borderline Personality Disorder,
where individuals are unable to integrate positive and negative qualities of others.
5. Which assessment finding should a nurse prioritize in a patient taking
Clozapine?
A. Weight gain of 2 lbs in a month
B. Mild dry mouth
C. Sore throat and fever
D. Drowsiness in the evening
Answer: C
Rationale: Clozapine can cause agranulocytosis (a dangerous drop in white blood cells).
Fever and sore throat are early signs of infection that must be reported immediately.
, 6. An older patient has a score of 12 on the Geriatric Depression Scale (GDS).
How should the nurse interpret this?
A. The patient is within the normal range for their age.
B. The patient is experiencing normal age-related sadness.
C. The score suggests the patient is at high risk for cognitive decline only.
D. The patient is showing signs of moderate depression.
Answer: D
Rationale: On the GDS, a score above 5 suggests depression, and a score above 10 typically
indicates depression that warrants further clinical evaluation.
7. Which medication is considered the ‘gold standard’ for stabilizing moods in
Bipolar I disorder?
A. Sertraline
B. Donepezil
C. Lorazepam
D. Lithium Carbonate
Answer: D
Rationale: Lithium remains the primary mood stabilizer for Bipolar Disorder, though it
requires frequent blood level monitoring for toxicity.
8. A nurse observes an older patient with multiple bruises in various stages of
healing and poor hygiene. What is the priority nursing action?
A. Document the findings and wait for the family to visit.
B. Confront the caregiver immediately.
C. Report the suspected abuse to the appropriate state authorities.
D. Clean the patient and provide a fresh gown.
Answer: C
Rationale: Nurses are mandatory reporters. If abuse or neglect is suspected, it must be
reported to the designated authorities (e.g., Adult Protective Services).
