NUR255 Final Exam V1 | Aging &
Mental Health Nursing Q&A with
Rationale | Galen College of
Nursing
1. Which of the following characteristics is most indicative of delirium rather than dementia?
A. Slow, progressive decline in memory
B. Sudden onset with fluctuating levels of consciousness
C. Consistent impairment of cognitive function
D. Irreversible changes in brain structure
Correct Answer: B
Expert Explanation: Delirium is characterized by an acute onset that typically occurs over
hours or days. It involves a disturbance in consciousness and a change in cognition that
fluctuates throughout the day. In contrast, dementia is a slow, progressive, and generally
irreversible decline in mental function.
2. An elderly patient is diagnosed with Alzheimer’s disease. Which pathophysiological change
is primarily associated with this condition?
A. Depletion of dopamine in the basal ganglia
B. Blockage of blood flow to specific regions of the brain
,C. Accumulation of amyloid plaques and neurofibrillary tangles
D. Inflammation of the meninges due to viral infection
Correct Answer: C
Expert Explanation: Alzheimer’s disease is pathologically defined by the presence of
extracellular amyloid-beta plaques and intracellular tau tangles. These structures disrupt
neuronal communication and eventually lead to cell death. Understanding these biological
markers helps nurses explain the disease progression to family members.
3. A nurse observes a patient with dementia becoming increasingly agitated and confused
late in the afternoon. This phenomenon is known as:
A. Sundowning
B. Aphasia
C. Apraxia
D. Agnosia
Correct Answer: A
Expert Explanation: Sundowning refers to the emergence or increment of
neuropsychiatric symptoms like agitation or confusion during late afternoon or evening. It
is commonly seen in patients with Alzheimer’s and other forms of dementia. Providing a
calm environment and maintaining a consistent routine can help mitigate these symptoms.
, 4. Which communication technique is most appropriate for a patient in the late stages of
dementia who is expressing distress?
A. Reality orientation
B. Correcting the patient’s factual errors
C. Using complex multi-step instructions
D. Validation therapy
Correct Answer: D
Expert Explanation: Validation therapy involves acknowledging and respecting the
feelings and meanings behind a patient’s behavior or words, even if they are not based in
current reality. This approach helps build trust and reduces anxiety by meeting the patient
in their emotional state. Correcting factual errors in late-stage dementia often leads to
further agitation and frustration.
5. When assessing an elderly patient for depression, which symptom might be mistaken for
dementia?
A. Rapid and fluent speech patterns
B. Sudden loss of long-term memory
C. Consistently cheerful affect despite memory loss
D. Difficulty concentrating and slowed thinking
Correct Answer: D
Mental Health Nursing Q&A with
Rationale | Galen College of
Nursing
1. Which of the following characteristics is most indicative of delirium rather than dementia?
A. Slow, progressive decline in memory
B. Sudden onset with fluctuating levels of consciousness
C. Consistent impairment of cognitive function
D. Irreversible changes in brain structure
Correct Answer: B
Expert Explanation: Delirium is characterized by an acute onset that typically occurs over
hours or days. It involves a disturbance in consciousness and a change in cognition that
fluctuates throughout the day. In contrast, dementia is a slow, progressive, and generally
irreversible decline in mental function.
2. An elderly patient is diagnosed with Alzheimer’s disease. Which pathophysiological change
is primarily associated with this condition?
A. Depletion of dopamine in the basal ganglia
B. Blockage of blood flow to specific regions of the brain
,C. Accumulation of amyloid plaques and neurofibrillary tangles
D. Inflammation of the meninges due to viral infection
Correct Answer: C
Expert Explanation: Alzheimer’s disease is pathologically defined by the presence of
extracellular amyloid-beta plaques and intracellular tau tangles. These structures disrupt
neuronal communication and eventually lead to cell death. Understanding these biological
markers helps nurses explain the disease progression to family members.
3. A nurse observes a patient with dementia becoming increasingly agitated and confused
late in the afternoon. This phenomenon is known as:
A. Sundowning
B. Aphasia
C. Apraxia
D. Agnosia
Correct Answer: A
Expert Explanation: Sundowning refers to the emergence or increment of
neuropsychiatric symptoms like agitation or confusion during late afternoon or evening. It
is commonly seen in patients with Alzheimer’s and other forms of dementia. Providing a
calm environment and maintaining a consistent routine can help mitigate these symptoms.
, 4. Which communication technique is most appropriate for a patient in the late stages of
dementia who is expressing distress?
A. Reality orientation
B. Correcting the patient’s factual errors
C. Using complex multi-step instructions
D. Validation therapy
Correct Answer: D
Expert Explanation: Validation therapy involves acknowledging and respecting the
feelings and meanings behind a patient’s behavior or words, even if they are not based in
current reality. This approach helps build trust and reduces anxiety by meeting the patient
in their emotional state. Correcting factual errors in late-stage dementia often leads to
further agitation and frustration.
5. When assessing an elderly patient for depression, which symptom might be mistaken for
dementia?
A. Rapid and fluent speech patterns
B. Sudden loss of long-term memory
C. Consistently cheerful affect despite memory loss
D. Difficulty concentrating and slowed thinking
Correct Answer: D
