NR 601 Final exam Actual Exam
NR 601 FINAL EXAM ACTUAL EXAM 2025/2026 COMPLETE
200 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!!
A 67-year-old female with a history of congestive heart failure and myocardial
infarction is admitted to the hospital because of increasing altered mental status
and decreased arousal over the last week. Physical examination reveals a confused
woman with right lower lobe crackles and a pulse oximetry of 86% on room air.
While you are interviewing the patient, she is irritable, paranoid, and inattentive,
which her family tells you is out of character. You notice waxing and waning in her
alertness and impaired short-term memory during your examination. Which one
of the following features present in this patient best distinguishes delirium from
depression or dementia?
a. Irritability
b. Inattentiveness
c. Paranoia
d. Aggressiveness
b. Inattentiveness
A 72-year-old man with colonic diverticulosis was admitted to the hospital with
gastrointestinal bleeding and abdominal pain. He underwent colonoscopy under
conscious sedation using fentanyl and midazolam. The following day, the patient
was positive on the Confusion Assessment Method performed by the geriatric
consultation services. Presence of delirium in this patient predisposes him to all of
the following except:
a. Higher risk of institutionalization
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, NR 601 Final exam Actual Exam
b. Increased risk of dementia
c. Shorter length of stay in the hospital
d. Increased mortality
c. Shorter length of stay in the hospital
A 78-year-old male who resides at a nursing home has Lewy Body dementia,
frequent falls, visual hallucinations, and sleep disturbances. He is transferred to
your hospital with poor oral intake and confusion of 3 days duration. Physical
examination reveals a thin man with dry mucous membranes, tachypnea,
tachycardia, and confusion. To reliably identify delirium in this patient in a time-
efficient manner (<5 minutes), what will be your instrument of choice?
a. Folstein Mini-Mental State Examination (MMSE)
b. Confusion Assessment Method (CAM)
c. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)
d. Glasgow Coma Scale (GCS)
e. Delirium Rating Scale - Revised 1998 (DSR-R98)
b. Confusion Assessment Method (CAM)
An 84-year-old woman complains of nausea and vomiting for the past 3 days. She
has a history of multiple abdominal surgeries, adhesions, and recurrent
hospitalizations for partial small bowel obstruction. She has visual and hearing
impairment and is currently taking oxybutynin for neurogenic bladder. You
recognize she is high risk for development of delirium. Interventions that may
prevent the onset of delirium among older adult hospitalized patients include all
of the following except:
a. Early mobilization
b. Ensuring 6 hours of uninterrupted sleep per night
c. Treating volume depletion
d. Treating anxiety with lorazepam
e. Ensuring access to hearing and visual aids
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, NR 601 Final exam Actual Exam
d. Treating anxiety with lorazepam
A 78-year-old man with multiinfarct dementia, chronic kidney disease, congestive
heart failure, and uncontrolled hypertension was hospitalized with a heart failure
exacerbation. He was initially treated with diuretics and salt restriction and his
condition stabilized. On day 3 of his hospital stay, he developed confusion,
restlessness, and combativeness. Utilization of sitter, redirection, calming music,
and reassurance are unsuccessful. When safety of the patient and staff are in
jeopardy and nonpharmacologic approaches have failed, which of the
pharmacologic agents would be the best choice for treating the agitation
associated with his delirium?
a. Melatonin
b. Haloperidol
c. Diazepam
d. Gabapentin
e. Diphenhydramine
b. Haloperidol
A 69-year-old female presents to your office for routine primary care. Her elder
sister was recently diagnosed with Alzheimer disease, and she wonders what
steps she can take to reduce her own risk of developing dementia. Which of the
following statements about the prevention of dementia is true?
a. There is moderate quality evidence to support daily use of vitamin B12 and fish
oil to prevent risk of cognitive decline.
b. Risk of dementia is modulated by nonmodifiable risk factors, such as genetics,
family history, and educational attainment, and there are no behavioral
interventions that can be taken to reduce risk of developing dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
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, NR 601 Final exam Actual Exam
d. There is moderate to low quality evidence supporting cannabinoids may reduce
rates of progression from mild cognitive impairment to dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
A 78-year-old male was recently diagnosed with Alzheimer disease. He scored
23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical presentation
is consistent with mild disease. He returns to clinic with his family to discuss
possible initiation of pharmacotherapy. You consider beginning donepezil 5 mg
daily for 4 weeks, with a plan to increase to 10 mg daily if he tolerates the lower
dose. Which of the following is not a common side effect of donepezil?
a. Thrombocytopenia
b. Bradycardia
c. Vivid dreams
d. Gastrointestinal distress
a. Thrombocytopenia
The remission rate of depressed patients who are 65 years and older to initial
antidepressant treatment is:
a. 30%
b. 40%
c. 70%
d. 80%
a. 30%
Which of the following groups has the highest rate of suicide in older adults?
a. Asian males
b. Hispanic males
c. White males
d. Black males
4|Page
NR 601 FINAL EXAM ACTUAL EXAM 2025/2026 COMPLETE
200 QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED A+||BRAND NEW
VERSION!!
A 67-year-old female with a history of congestive heart failure and myocardial
infarction is admitted to the hospital because of increasing altered mental status
and decreased arousal over the last week. Physical examination reveals a confused
woman with right lower lobe crackles and a pulse oximetry of 86% on room air.
While you are interviewing the patient, she is irritable, paranoid, and inattentive,
which her family tells you is out of character. You notice waxing and waning in her
alertness and impaired short-term memory during your examination. Which one
of the following features present in this patient best distinguishes delirium from
depression or dementia?
a. Irritability
b. Inattentiveness
c. Paranoia
d. Aggressiveness
b. Inattentiveness
A 72-year-old man with colonic diverticulosis was admitted to the hospital with
gastrointestinal bleeding and abdominal pain. He underwent colonoscopy under
conscious sedation using fentanyl and midazolam. The following day, the patient
was positive on the Confusion Assessment Method performed by the geriatric
consultation services. Presence of delirium in this patient predisposes him to all of
the following except:
a. Higher risk of institutionalization
1|Page
, NR 601 Final exam Actual Exam
b. Increased risk of dementia
c. Shorter length of stay in the hospital
d. Increased mortality
c. Shorter length of stay in the hospital
A 78-year-old male who resides at a nursing home has Lewy Body dementia,
frequent falls, visual hallucinations, and sleep disturbances. He is transferred to
your hospital with poor oral intake and confusion of 3 days duration. Physical
examination reveals a thin man with dry mucous membranes, tachypnea,
tachycardia, and confusion. To reliably identify delirium in this patient in a time-
efficient manner (<5 minutes), what will be your instrument of choice?
a. Folstein Mini-Mental State Examination (MMSE)
b. Confusion Assessment Method (CAM)
c. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)
d. Glasgow Coma Scale (GCS)
e. Delirium Rating Scale - Revised 1998 (DSR-R98)
b. Confusion Assessment Method (CAM)
An 84-year-old woman complains of nausea and vomiting for the past 3 days. She
has a history of multiple abdominal surgeries, adhesions, and recurrent
hospitalizations for partial small bowel obstruction. She has visual and hearing
impairment and is currently taking oxybutynin for neurogenic bladder. You
recognize she is high risk for development of delirium. Interventions that may
prevent the onset of delirium among older adult hospitalized patients include all
of the following except:
a. Early mobilization
b. Ensuring 6 hours of uninterrupted sleep per night
c. Treating volume depletion
d. Treating anxiety with lorazepam
e. Ensuring access to hearing and visual aids
2|Page
, NR 601 Final exam Actual Exam
d. Treating anxiety with lorazepam
A 78-year-old man with multiinfarct dementia, chronic kidney disease, congestive
heart failure, and uncontrolled hypertension was hospitalized with a heart failure
exacerbation. He was initially treated with diuretics and salt restriction and his
condition stabilized. On day 3 of his hospital stay, he developed confusion,
restlessness, and combativeness. Utilization of sitter, redirection, calming music,
and reassurance are unsuccessful. When safety of the patient and staff are in
jeopardy and nonpharmacologic approaches have failed, which of the
pharmacologic agents would be the best choice for treating the agitation
associated with his delirium?
a. Melatonin
b. Haloperidol
c. Diazepam
d. Gabapentin
e. Diphenhydramine
b. Haloperidol
A 69-year-old female presents to your office for routine primary care. Her elder
sister was recently diagnosed with Alzheimer disease, and she wonders what
steps she can take to reduce her own risk of developing dementia. Which of the
following statements about the prevention of dementia is true?
a. There is moderate quality evidence to support daily use of vitamin B12 and fish
oil to prevent risk of cognitive decline.
b. Risk of dementia is modulated by nonmodifiable risk factors, such as genetics,
family history, and educational attainment, and there are no behavioral
interventions that can be taken to reduce risk of developing dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
3|Page
, NR 601 Final exam Actual Exam
d. There is moderate to low quality evidence supporting cannabinoids may reduce
rates of progression from mild cognitive impairment to dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and
metabolic risk factors, such as blood pressure, weight, and blood sugar, may
reduce risk of dementia.
A 78-year-old male was recently diagnosed with Alzheimer disease. He scored
23/30 on his Montreal Cognitive Assessment (MoCA) and his clinical presentation
is consistent with mild disease. He returns to clinic with his family to discuss
possible initiation of pharmacotherapy. You consider beginning donepezil 5 mg
daily for 4 weeks, with a plan to increase to 10 mg daily if he tolerates the lower
dose. Which of the following is not a common side effect of donepezil?
a. Thrombocytopenia
b. Bradycardia
c. Vivid dreams
d. Gastrointestinal distress
a. Thrombocytopenia
The remission rate of depressed patients who are 65 years and older to initial
antidepressant treatment is:
a. 30%
b. 40%
c. 70%
d. 80%
a. 30%
Which of the following groups has the highest rate of suicide in older adults?
a. Asian males
b. Hispanic males
c. White males
d. Black males
4|Page
