NSG 123 Exam 4: Delirium, Dementia, Alzheimer's, Parkinson's, Migraines,
Epilepsy, Diabetes, Thyroid Disorders | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: Medical-Surgical Nursing I – Neurologic Disorders (Delirium vs Dementia, Alzheimer's
Medications, Parkinson's Disease, Seizures/Epilepsy, Migraines, Cranial Arteritis); Endocrine Disorders
(Diabetes Mellitus Type 1 & 2, DKA, Gestational Diabetes, Insulin Types, Hypothyroidism,
Hyperthyroidism, Grave's Disease, Hashimoto's, Thyroid Storm, Myxedema, Thyroid Cancer)
Source: NSG 123 Exam 4 (Modules 8,9,10,11) Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What is delirium?
Correct Answer: State of temporary acute mental confusion. Usually develops over a 2-3 day period. It
is life-threatening & possibly preventable syndrome. Most frequent complication of hospitalization in
older adults.
1. Priority of safety and treating underlying cause.
2. Can progress to changes in LOC, irreversible brain damage, and death.
2. What is dementia?
Correct Answer: Initial symptoms are related to changes in cognitive function. Symptoms are usually
subtle in onset and often progress slowly. Family members often report: memory loss, mild
disorientation, trouble with words and/or numbers.
1. Eventually destroys a person's ability to function.
2. Alzheimer's disease is most common type.
3. What are nursing interventions for dementia to promote safety?
Correct Answer: Provide calm and predictable environment; avoid changing surroundings and
caregivers; promote physical activity; provide cues and clear, simple instructions; assess for signs of
neglect and abuse; bed alarm, chair alarm, call light, bed in low position. Avoid restraints.
1. Safety is priority as condition progresses.
2. Unpredictable behavior, delusions, and hallucinations may occur.
4. What should the nurse do if elder abuse is suspected?
Correct Answer: If neglect or abuse of any kind—including physical, emotional, sexual, neglect, or
financial abuse—is suspected, the local adult protective services agency must be notified. The
responsibility of the nurse is to report the suspected abuse, not to prove it.
1. Mandatory reporting required by law.
2. Documentation of objective findings is essential.
5. What is the point of medications in Alzheimer's?
Correct Answer: Slow the progression.
1. No cure for Alzheimer's disease.
2. Medications may temporarily improve symptoms or slow decline.
, 6. What two categories of medications are used to treat Alzheimer's?
Correct Answer: Acetylcholinesterase inhibitor & N-methyl-D-aspartate receptor antagonist.
1. Acetylcholinesterase inhibitors increase acetylcholine (Donepezil, Rivastigmine).
2. NMDA antagonist (Memantine) decreases glutamate circulation.
7. What is Donepezil (Aricept) and what to know?
Correct Answer: Drug of choice for Alzheimer's. Before administering, assess patient for allergy,
orientation, and contraindications. Administration should occur at bedtime each day. Only slows
progression. Side effects: GI upset (nausea, diarrhea, insomnia, vomiting). Monitor for GI bleeding.
1. For oral disintegrating tablet, ensure medication is dissolved on tongue.
2. Watch liver disease with acetylcholinesterase inhibitors.
8. What are the cardinal signs of Parkinson's?
Correct Answer: Tremor, Rigidity, Bradykinesia (overall slowing of active movement), Postural
Instability (postural and gait problems). Gradual onset, symptoms progress slowly over a chronic,
prolonged course.
1. What neurotransmitter is decreased in Parkinson's? Dopamine.
2. Diagnosis is clinical from history and presence of two of four cardinal manifestations.
9. What is the confirmation diagnosis of Parkinson's?
Correct Answer: Give patient Levodopa-Carbidopa (Sinemet) and see if they respond to it.
1. Levodopa increases dopamine available in the brain.
2. Carbidopa slows how quickly Levodopa is absorbed.
10. What is deep brain stimulation? When is it recommended?
Correct Answer: Surgical implant to stimulate brain areas, increases dopamine. When nothing else has
worked to treat Parkinson's. Increases dopamine, decreases symptoms (tremors & rigidity).
1. Best plan of care for Parkinson's is medication management.
2. Two things to remember: close monitoring of swallowing safety and intake; measure weights weekly.
11. What is cranial arteritis?
Correct Answer: Inflammation of the cranial arteries; cause of headache in older population (greatest
incidence >70 years). Severe headache localized in region of temporal arteries. Clinical manifestations:
fatigue, malaise, weight loss, fever; tender, swollen, or nodular temporal artery visible.
1. Treatment: early administration of corticosteroid to prevent loss of vision.
2. Do not stop medication abruptly (can lead to relapse).
12. What are the phases of a migraine?
Correct Answer: 1. Premonitory Stage: depression, irritability, food cravings, anorexia, change in
activity, increased urination, diarrhea/constipation. 2. Aura Stage: visual disturbances (light flashes,
bright spots), numbness/tingling of lips/face/hands, mild confusion, weakness, drowsiness, dizziness. 3.
Headache Phase: severe incapacitating pain, photophobia, phonophobia, allodynia. 4. Postdrome Stage:
pain gradually subsides, tiredness, weakness, cognitive difficulties, mood changes.
1. Preventative approach for frequent attacks; abortive approach for less frequent attacks.
2. First-line medication: triptans (contraindicated in ischemic heart disease).
Epilepsy, Diabetes, Thyroid Disorders | Q&A | Grade A | 100% Correct
(Verified Answers) – Nursing Program
Subject: Medical-Surgical Nursing I – Neurologic Disorders (Delirium vs Dementia, Alzheimer's
Medications, Parkinson's Disease, Seizures/Epilepsy, Migraines, Cranial Arteritis); Endocrine Disorders
(Diabetes Mellitus Type 1 & 2, DKA, Gestational Diabetes, Insulin Types, Hypothyroidism,
Hyperthyroidism, Grave's Disease, Hashimoto's, Thyroid Storm, Myxedema, Thyroid Cancer)
Source: NSG 123 Exam 4 (Modules 8,9,10,11) Bank – Latest 2026/2027 Curriculum
Format: Q&A Guide with Clinical Rationale
1. What is delirium?
Correct Answer: State of temporary acute mental confusion. Usually develops over a 2-3 day period. It
is life-threatening & possibly preventable syndrome. Most frequent complication of hospitalization in
older adults.
1. Priority of safety and treating underlying cause.
2. Can progress to changes in LOC, irreversible brain damage, and death.
2. What is dementia?
Correct Answer: Initial symptoms are related to changes in cognitive function. Symptoms are usually
subtle in onset and often progress slowly. Family members often report: memory loss, mild
disorientation, trouble with words and/or numbers.
1. Eventually destroys a person's ability to function.
2. Alzheimer's disease is most common type.
3. What are nursing interventions for dementia to promote safety?
Correct Answer: Provide calm and predictable environment; avoid changing surroundings and
caregivers; promote physical activity; provide cues and clear, simple instructions; assess for signs of
neglect and abuse; bed alarm, chair alarm, call light, bed in low position. Avoid restraints.
1. Safety is priority as condition progresses.
2. Unpredictable behavior, delusions, and hallucinations may occur.
4. What should the nurse do if elder abuse is suspected?
Correct Answer: If neglect or abuse of any kind—including physical, emotional, sexual, neglect, or
financial abuse—is suspected, the local adult protective services agency must be notified. The
responsibility of the nurse is to report the suspected abuse, not to prove it.
1. Mandatory reporting required by law.
2. Documentation of objective findings is essential.
5. What is the point of medications in Alzheimer's?
Correct Answer: Slow the progression.
1. No cure for Alzheimer's disease.
2. Medications may temporarily improve symptoms or slow decline.
, 6. What two categories of medications are used to treat Alzheimer's?
Correct Answer: Acetylcholinesterase inhibitor & N-methyl-D-aspartate receptor antagonist.
1. Acetylcholinesterase inhibitors increase acetylcholine (Donepezil, Rivastigmine).
2. NMDA antagonist (Memantine) decreases glutamate circulation.
7. What is Donepezil (Aricept) and what to know?
Correct Answer: Drug of choice for Alzheimer's. Before administering, assess patient for allergy,
orientation, and contraindications. Administration should occur at bedtime each day. Only slows
progression. Side effects: GI upset (nausea, diarrhea, insomnia, vomiting). Monitor for GI bleeding.
1. For oral disintegrating tablet, ensure medication is dissolved on tongue.
2. Watch liver disease with acetylcholinesterase inhibitors.
8. What are the cardinal signs of Parkinson's?
Correct Answer: Tremor, Rigidity, Bradykinesia (overall slowing of active movement), Postural
Instability (postural and gait problems). Gradual onset, symptoms progress slowly over a chronic,
prolonged course.
1. What neurotransmitter is decreased in Parkinson's? Dopamine.
2. Diagnosis is clinical from history and presence of two of four cardinal manifestations.
9. What is the confirmation diagnosis of Parkinson's?
Correct Answer: Give patient Levodopa-Carbidopa (Sinemet) and see if they respond to it.
1. Levodopa increases dopamine available in the brain.
2. Carbidopa slows how quickly Levodopa is absorbed.
10. What is deep brain stimulation? When is it recommended?
Correct Answer: Surgical implant to stimulate brain areas, increases dopamine. When nothing else has
worked to treat Parkinson's. Increases dopamine, decreases symptoms (tremors & rigidity).
1. Best plan of care for Parkinson's is medication management.
2. Two things to remember: close monitoring of swallowing safety and intake; measure weights weekly.
11. What is cranial arteritis?
Correct Answer: Inflammation of the cranial arteries; cause of headache in older population (greatest
incidence >70 years). Severe headache localized in region of temporal arteries. Clinical manifestations:
fatigue, malaise, weight loss, fever; tender, swollen, or nodular temporal artery visible.
1. Treatment: early administration of corticosteroid to prevent loss of vision.
2. Do not stop medication abruptly (can lead to relapse).
12. What are the phases of a migraine?
Correct Answer: 1. Premonitory Stage: depression, irritability, food cravings, anorexia, change in
activity, increased urination, diarrhea/constipation. 2. Aura Stage: visual disturbances (light flashes,
bright spots), numbness/tingling of lips/face/hands, mild confusion, weakness, drowsiness, dizziness. 3.
Headache Phase: severe incapacitating pain, photophobia, phonophobia, allodynia. 4. Postdrome Stage:
pain gradually subsides, tiredness, weakness, cognitive difficulties, mood changes.
1. Preventative approach for frequent attacks; abortive approach for less frequent attacks.
2. First-line medication: triptans (contraindicated in ischemic heart disease).
