NUR 2214 NURSING CARE OF THE OLDER ADULT QUIZ 4
2026/2027 | Questions and Answers Already Graded A |
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Part 1: Cognitive & Mental Health Disorders in Older Adults
This section covers dementia, delirium, and depression—the three Ds that challenge
geriatric nursing practice. Pay attention to distinguishing features and appropriate
interventions.
Q1: A 78-year-old patient is admitted with sudden onset confusion that fluctuates
throughout the day. The nurse notes the patient has difficulty focusing attention and
appears disoriented to place. Which condition is most likely present?
A. Alzheimer's disease, given the progressive memory impairment evident in this
presentation
B. Major depressive disorder, as confusion often masks underlying depression in older
adults
C. Delirium, characterized by acute onset, fluctuating course, and inattention [CORRECT]
D. Normal aging changes, since mild confusion is expected in hospitalized older adults
Correct Answer: C
Rationale: Delirium presents with acute onset (hours to days), fluctuating severity, and
core features of inattention and disorganized thinking. The DELIRIUM mnemonic
,reminds us to check for Drugs, Electrolytes, Lack of drugs/constipation, Infection,
Retention (urinary), Intracranial issues, and Underlying hypoxia/MI. Alzheimer's has
insidious onset, not sudden. Depression may cause pseudo-dementia but lacks the
acute fluctuating pattern. Confusion is never "normal" aging.
Q2: A nursing student asks the preceptor about the pathological hallmarks of
Alzheimer's disease. Which response best describes the characteristic brain changes?
A. Lewy bodies scattered throughout the cortex and brainstem, causing fluctuating
cognition
B. Multiple cortical and subcortical infarcts leading to step-wise cognitive decline
C. Amyloid plaques and neurofibrillary tangles disrupting neuronal communication
[CORRECT]
D. Frontal and temporal lobe atrophy primarily affecting personality and language
Correct Answer: C
Rationale: Alzheimer's disease is neuropathologically defined by extracellular
amyloid-beta plaques and intracellular neurofibrillary tangles composed of
hyperphosphorylated tau protein. Lewy bodies characterize Lewy body dementia.
Step-wise decline describes vascular dementia. Frontotemporal atrophy describes
frontotemporal dementia.
Q3: An 82-year-old with Alzheimer's dementia becomes agitated and attempts to leave
the unit, stating "I need to pick up my children from school." Which nursing response
demonstrates validation therapy?
A. "Your children are grown adults now—let's look at this photo album together instead"
, B. "You can't leave the unit; it's against hospital policy for your safety"
C. "You must be worried about your children. Tell me about them. Would you like to walk
with me?" [CORRECT]
D. "It's 3 PM and you're in the hospital. Your children are not waiting for you"
Correct Answer: C
Rationale: Validation therapy acknowledges the emotional truth behind the behavior
rather than confronting the confused reality. It reduces distress by accepting the
patient's feelings and redirecting gently. Option A confronts reality too harshly; B is
authoritarian; D uses reality orientation which can increase agitation in
moderate-to-severe dementia.
Q4: A patient with Lewy body dementia is prescribed haloperidol for behavioral
symptoms. What is the nurse's priority action?
A. Administer the medication as ordered to control agitation
B. Hold the medication and contact the prescriber immediately [CORRECT]
C. Give the medication with food to reduce gastrointestinal upset
D. Monitor blood pressure for orthostatic hypotension after administration
Correct Answer: B
Rationale: Patients with Lewy body dementia have severe sensitivity to antipsychotics,
including potentially fatal neuroleptic malignant syndrome and worsening
parkinsonism. The AGS Beers Criteria strongly recommend avoiding antipsychotics in
2026/2027 | Questions and Answers Already Graded A |
Rasmussen College | Pass Guaranteed
Part 1: Cognitive & Mental Health Disorders in Older Adults
This section covers dementia, delirium, and depression—the three Ds that challenge
geriatric nursing practice. Pay attention to distinguishing features and appropriate
interventions.
Q1: A 78-year-old patient is admitted with sudden onset confusion that fluctuates
throughout the day. The nurse notes the patient has difficulty focusing attention and
appears disoriented to place. Which condition is most likely present?
A. Alzheimer's disease, given the progressive memory impairment evident in this
presentation
B. Major depressive disorder, as confusion often masks underlying depression in older
adults
C. Delirium, characterized by acute onset, fluctuating course, and inattention [CORRECT]
D. Normal aging changes, since mild confusion is expected in hospitalized older adults
Correct Answer: C
Rationale: Delirium presents with acute onset (hours to days), fluctuating severity, and
core features of inattention and disorganized thinking. The DELIRIUM mnemonic
,reminds us to check for Drugs, Electrolytes, Lack of drugs/constipation, Infection,
Retention (urinary), Intracranial issues, and Underlying hypoxia/MI. Alzheimer's has
insidious onset, not sudden. Depression may cause pseudo-dementia but lacks the
acute fluctuating pattern. Confusion is never "normal" aging.
Q2: A nursing student asks the preceptor about the pathological hallmarks of
Alzheimer's disease. Which response best describes the characteristic brain changes?
A. Lewy bodies scattered throughout the cortex and brainstem, causing fluctuating
cognition
B. Multiple cortical and subcortical infarcts leading to step-wise cognitive decline
C. Amyloid plaques and neurofibrillary tangles disrupting neuronal communication
[CORRECT]
D. Frontal and temporal lobe atrophy primarily affecting personality and language
Correct Answer: C
Rationale: Alzheimer's disease is neuropathologically defined by extracellular
amyloid-beta plaques and intracellular neurofibrillary tangles composed of
hyperphosphorylated tau protein. Lewy bodies characterize Lewy body dementia.
Step-wise decline describes vascular dementia. Frontotemporal atrophy describes
frontotemporal dementia.
Q3: An 82-year-old with Alzheimer's dementia becomes agitated and attempts to leave
the unit, stating "I need to pick up my children from school." Which nursing response
demonstrates validation therapy?
A. "Your children are grown adults now—let's look at this photo album together instead"
, B. "You can't leave the unit; it's against hospital policy for your safety"
C. "You must be worried about your children. Tell me about them. Would you like to walk
with me?" [CORRECT]
D. "It's 3 PM and you're in the hospital. Your children are not waiting for you"
Correct Answer: C
Rationale: Validation therapy acknowledges the emotional truth behind the behavior
rather than confronting the confused reality. It reduces distress by accepting the
patient's feelings and redirecting gently. Option A confronts reality too harshly; B is
authoritarian; D uses reality orientation which can increase agitation in
moderate-to-severe dementia.
Q4: A patient with Lewy body dementia is prescribed haloperidol for behavioral
symptoms. What is the nurse's priority action?
A. Administer the medication as ordered to control agitation
B. Hold the medication and contact the prescriber immediately [CORRECT]
C. Give the medication with food to reduce gastrointestinal upset
D. Monitor blood pressure for orthostatic hypotension after administration
Correct Answer: B
Rationale: Patients with Lewy body dementia have severe sensitivity to antipsychotics,
including potentially fatal neuroleptic malignant syndrome and worsening
parkinsonism. The AGS Beers Criteria strongly recommend avoiding antipsychotics in
