NURS 6630 WEEK 9 LATEST UPDATED 2026-2027
ACTUAL FINAL EXAM PREP WITH HIGH YIELD
EXPERT PRACTICE QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH CERTIFIED RATIONALES
A+ GRADE GUARANTEE MOST RECENT!!!
1. A 72-year-old male with Parkinson’s disease dementia is started on
rivastigmine. Which
adverse effect is most common with this medication?
A) Hypertension
B) Bradycardia
C) Gastrointestinal distress
D) Urinary retention
Answer: C
Rationale: Cholinesterase inhibitors like rivastigmine commonly cause
nausea, vomiting, and diarrhea due to increased cholinergic tone.
2. A patient with Alzheimer’s disease is taking donepezil 10 mg daily. He
presents with
new-onset fainting and heart rate of 48 bpm. What is the most
appropriate next step?
A) Increase donepezil to 23 mg daily
B) Add memantine
,C) Discontinue donepezil and evaluate for syncope
D) Continue donepezil and order echocardiogram
Answer: C
Rationale: Donepezil can cause symptomatic bradycardia and heart
block; discontinue and assess cardiac status.
3. Memantine is primarily indicated for which stage of Alzheimer’s
disease?
A) Mild cognitive impairment
B) Mild Alzheimer’s dementia
C) Moderate to severe Alzheimer’s dementia
D) Preclinical Alzheimer’s
Answer: C
Rationale: Memantine, an NMDA receptor antagonist, is approved for
moderate to severe Alzheimer’s dementia.
4. Which medication for Alzheimer’s disease requires dose adjustment
in renal
impairment?
A) Donepezil
B) Rivastigmine
C) Galantamine
D) Memantine
Answer: D
,Rationale: Memantine is excreted renally; dose reduction
recommended for CrCl < 30 mL/min.
5. A patient with dementia exhibits severe agitation, hallucinations, and
aggression. Which
medication class should be avoided due to increased mortality in elderly
dementia
patients?
A) SSRIs
B) Antipsychotics
C) Cholinesterase inhibitors
D) Benzodiazepines
Answer: B
Rationale: FDA black box warning for atypical antipsychotics in
dementia-related psychosis due to increased risk of cerebrovascular
events and mortality.
6. The mechanism of action of memantine involves:
A) Irreversible acetylcholinesterase inhibition
B) NMDA receptor antagonism
C) Dopamine receptor agonism
D) Serotonin reuptake inhibition
Answer: B
Rationale: Memantine blocks excessive glutamate activity at NMDA
receptors, preventing excitotoxicity.
, 7. A patient on donepezil reports vivid nightmares and insomnia. What
is the most
appropriate management?
A) Discontinue donepezil immediately
B) Switch to rivastigmine patch
C) Administer donepezil in the morning
D) Add a benzodiazepine
Answer: C
Rationale: Donepezil can cause sleep disturbances; morning dosing may
reduce nightmares and insomnia.
8. Which cholinesterase inhibitor is available as a transdermal patch?
A) Donepezil
B) Galantamine
C) Rivastigmine
D) Tacrine
Answer: C
Rationale: Rivastigmine is available in oral and patch formulations;
patch may improve GI tolerability.
9. The primary neurotransmitter deficit in Alzheimer’s disease is:
A) Dopamine
B) Norepinephrine
C) Acetylcholine
ACTUAL FINAL EXAM PREP WITH HIGH YIELD
EXPERT PRACTICE QUESTIONS AND CORRECT
VERIFIED ANSWERS WITH CERTIFIED RATIONALES
A+ GRADE GUARANTEE MOST RECENT!!!
1. A 72-year-old male with Parkinson’s disease dementia is started on
rivastigmine. Which
adverse effect is most common with this medication?
A) Hypertension
B) Bradycardia
C) Gastrointestinal distress
D) Urinary retention
Answer: C
Rationale: Cholinesterase inhibitors like rivastigmine commonly cause
nausea, vomiting, and diarrhea due to increased cholinergic tone.
2. A patient with Alzheimer’s disease is taking donepezil 10 mg daily. He
presents with
new-onset fainting and heart rate of 48 bpm. What is the most
appropriate next step?
A) Increase donepezil to 23 mg daily
B) Add memantine
,C) Discontinue donepezil and evaluate for syncope
D) Continue donepezil and order echocardiogram
Answer: C
Rationale: Donepezil can cause symptomatic bradycardia and heart
block; discontinue and assess cardiac status.
3. Memantine is primarily indicated for which stage of Alzheimer’s
disease?
A) Mild cognitive impairment
B) Mild Alzheimer’s dementia
C) Moderate to severe Alzheimer’s dementia
D) Preclinical Alzheimer’s
Answer: C
Rationale: Memantine, an NMDA receptor antagonist, is approved for
moderate to severe Alzheimer’s dementia.
4. Which medication for Alzheimer’s disease requires dose adjustment
in renal
impairment?
A) Donepezil
B) Rivastigmine
C) Galantamine
D) Memantine
Answer: D
,Rationale: Memantine is excreted renally; dose reduction
recommended for CrCl < 30 mL/min.
5. A patient with dementia exhibits severe agitation, hallucinations, and
aggression. Which
medication class should be avoided due to increased mortality in elderly
dementia
patients?
A) SSRIs
B) Antipsychotics
C) Cholinesterase inhibitors
D) Benzodiazepines
Answer: B
Rationale: FDA black box warning for atypical antipsychotics in
dementia-related psychosis due to increased risk of cerebrovascular
events and mortality.
6. The mechanism of action of memantine involves:
A) Irreversible acetylcholinesterase inhibition
B) NMDA receptor antagonism
C) Dopamine receptor agonism
D) Serotonin reuptake inhibition
Answer: B
Rationale: Memantine blocks excessive glutamate activity at NMDA
receptors, preventing excitotoxicity.
, 7. A patient on donepezil reports vivid nightmares and insomnia. What
is the most
appropriate management?
A) Discontinue donepezil immediately
B) Switch to rivastigmine patch
C) Administer donepezil in the morning
D) Add a benzodiazepine
Answer: C
Rationale: Donepezil can cause sleep disturbances; morning dosing may
reduce nightmares and insomnia.
8. Which cholinesterase inhibitor is available as a transdermal patch?
A) Donepezil
B) Galantamine
C) Rivastigmine
D) Tacrine
Answer: C
Rationale: Rivastigmine is available in oral and patch formulations;
patch may improve GI tolerability.
9. The primary neurotransmitter deficit in Alzheimer’s disease is:
A) Dopamine
B) Norepinephrine
C) Acetylcholine
