NSG300 / NSG 300 Exam 4 Foundations of Nursing
- GCU Actual Questions and Answers (Comprehensive Practice
Exam (100+ Questions)
Section 1: Cognition & Mental Status (Delirium, Dementia, Depression)
1. A 78-year-old patient is admitted from a long-term care facility. The nurse notes the
patient is confused, agitated, and attempting to pull out their IV. The family reports this
behavior started "suddenly yesterday." Which condition is most likely causing this change?
A. Alzheimer’s disease
B. Vascular dementia
C. Delirium
D. Parkinson’s disease
Answer: C. Delirium
Rationale: Delirium is characterized by an acute onset (hours to days), fluctuating course,
and is often reversible. It is frequently triggered by infections (e.g., UTI), electrolyte
imbalances, or medications. Dementia (A and B) has a gradual, insidious onset.
2. A nurse is assessing an older adult. Which assessment finding is considered a normal
age-related cognitive change?
A. Getting lost in a familiar neighborhood
B. Occasionally misplacing car keys
C. Inability to manage a checkbook
D. Forgetting the name of a close family member
Answer: B. Occasionally misplacing car keys
Rationale: Normal aging may cause slower processing speeds or minor forgetfulness (e.g.,
misplacing keys). Warning signs of cognitive impairment include disorientation, loss of
ability to calculate/manage finances, poor judgment, and forgetting important dates or
family members.
3. A patient with dementia is wandering the hallway at night. What is the priority nursing
intervention?
A. Apply soft wrist restraints to prevent falling
B. Administer a PRN sedative to promote sleep
C. Provide scheduled toileting and a nighttime snack
D. Place the patient in a chair near the nurse’s station
Answer: C. Provide scheduled toileting and a nighttime snack
Rationale: The priority is non-pharmacological interventions. Wandering often results from
, unmet needs (hunger, bathroom, pain). Restraints (A) are rarely a first-line intervention.
Sedatives (B) can increase fall risk and confusion in the elderly.
4. (Select All That Apply) Which findings suggest a patient is experiencing delirium rather
than dementia?
A. Sudden onset of symptoms
B. Progressive memory loss over 5 years
C. Fluctuating level of consciousness
D. Hallucinations and agitation
E. Irreversible cognitive decline
Answer: A, C, D
Rationale: Delirium has an acute onset (A) and fluctuating levels of consciousness (C).
Hallucinations are common in hyperactive delirium (D). Progressive memory loss (B) and
irreversible decline (E) are hallmarks of dementia.
5. A nurse is using the Mini-Mental State Examination (MMSE-2) on a patient. What is the
primary purpose of this tool?
A. To diagnose Alzheimer's disease definitively
B. To assess a patient's functional ability for ADLs
C. To screen for cognitive impairment and orientation
D. To evaluate a patient's level of depression
Answer: C. To screen for cognitive impairment and orientation
Rationale: The MMSE is a screening tool for cognitive function, testing orientation,
registration, attention, recall, and language. It does not diagnose specific diseases (A) nor
assess functional ADLs (B) or depression (D).
Section 2: Self-Concept & Sexuality
6. A patient states, "I feel so ugly since my mastectomy. My spouse won't look at me."
Which component of self-concept is the patient struggling with?
A. Identity
B. Body image
C. Role performance
D. Self-esteem
Answer: B. Body image
Rationale: Body image involves attitudes and perceptions about one’s physical appearance,
structure, or function. The patient is specifically verbalizing distress about physical
appearance post-surgery.
7. Which statement by a patient indicates a positive self-concept?
A. "I never make the right decision; I let everyone down."
- GCU Actual Questions and Answers (Comprehensive Practice
Exam (100+ Questions)
Section 1: Cognition & Mental Status (Delirium, Dementia, Depression)
1. A 78-year-old patient is admitted from a long-term care facility. The nurse notes the
patient is confused, agitated, and attempting to pull out their IV. The family reports this
behavior started "suddenly yesterday." Which condition is most likely causing this change?
A. Alzheimer’s disease
B. Vascular dementia
C. Delirium
D. Parkinson’s disease
Answer: C. Delirium
Rationale: Delirium is characterized by an acute onset (hours to days), fluctuating course,
and is often reversible. It is frequently triggered by infections (e.g., UTI), electrolyte
imbalances, or medications. Dementia (A and B) has a gradual, insidious onset.
2. A nurse is assessing an older adult. Which assessment finding is considered a normal
age-related cognitive change?
A. Getting lost in a familiar neighborhood
B. Occasionally misplacing car keys
C. Inability to manage a checkbook
D. Forgetting the name of a close family member
Answer: B. Occasionally misplacing car keys
Rationale: Normal aging may cause slower processing speeds or minor forgetfulness (e.g.,
misplacing keys). Warning signs of cognitive impairment include disorientation, loss of
ability to calculate/manage finances, poor judgment, and forgetting important dates or
family members.
3. A patient with dementia is wandering the hallway at night. What is the priority nursing
intervention?
A. Apply soft wrist restraints to prevent falling
B. Administer a PRN sedative to promote sleep
C. Provide scheduled toileting and a nighttime snack
D. Place the patient in a chair near the nurse’s station
Answer: C. Provide scheduled toileting and a nighttime snack
Rationale: The priority is non-pharmacological interventions. Wandering often results from
, unmet needs (hunger, bathroom, pain). Restraints (A) are rarely a first-line intervention.
Sedatives (B) can increase fall risk and confusion in the elderly.
4. (Select All That Apply) Which findings suggest a patient is experiencing delirium rather
than dementia?
A. Sudden onset of symptoms
B. Progressive memory loss over 5 years
C. Fluctuating level of consciousness
D. Hallucinations and agitation
E. Irreversible cognitive decline
Answer: A, C, D
Rationale: Delirium has an acute onset (A) and fluctuating levels of consciousness (C).
Hallucinations are common in hyperactive delirium (D). Progressive memory loss (B) and
irreversible decline (E) are hallmarks of dementia.
5. A nurse is using the Mini-Mental State Examination (MMSE-2) on a patient. What is the
primary purpose of this tool?
A. To diagnose Alzheimer's disease definitively
B. To assess a patient's functional ability for ADLs
C. To screen for cognitive impairment and orientation
D. To evaluate a patient's level of depression
Answer: C. To screen for cognitive impairment and orientation
Rationale: The MMSE is a screening tool for cognitive function, testing orientation,
registration, attention, recall, and language. It does not diagnose specific diseases (A) nor
assess functional ADLs (B) or depression (D).
Section 2: Self-Concept & Sexuality
6. A patient states, "I feel so ugly since my mastectomy. My spouse won't look at me."
Which component of self-concept is the patient struggling with?
A. Identity
B. Body image
C. Role performance
D. Self-esteem
Answer: B. Body image
Rationale: Body image involves attitudes and perceptions about one’s physical appearance,
structure, or function. The patient is specifically verbalizing distress about physical
appearance post-surgery.
7. Which statement by a patient indicates a positive self-concept?
A. "I never make the right decision; I let everyone down."
