NUR 255 Exam 3: Aging & Mental Health Nursing 2026 Galen College
1. A nurse is assessing an older adult client for delirium. Which characteristic
distinguishes delirium from dementia?
A. Sudden onset with fluctuating levels of consciousness
B. Irreversible cognitive impairment
C. Slow, progressive decline
D. Permanent memory loss
Answer: A
Rationale: Delirium is characterized by an acute, sudden onset and fluctuating levels of
consciousness, whereas dementia is slow and progressive.
2. The nurse is caring for a client with Alzheimer’s disease who is experiencing
‘sundowning.’ Which intervention is most appropriate?
A. Turn on the lights and increase stimulation in the evening
B. Restrict daytime naps to ensure the client sleeps at night
C. Provide a quiet, calm environment and adequate lighting during the late afternoon
D. Administer a sedative at the first sign of agitation
Answer: C
Rationale: Minimizing environmental stressors and providing adequate lighting can help
reduce confusion and agitation associated with sundowning.
,3. Which assessment finding in an elderly client is a hallmark sign of depression
rather than dementia (pseudodementia)?
A. Aphasia and agnosia
B. Attempts to hide cognitive deficits
C. Consistent disorientation to time and place
D. Rapid clinical progression of symptoms
Answer: D
Rationale: Pseudodementia (depression) usually has a rapid onset and the client often
complains about their memory loss, whereas dementia has a slow onset and the client may
try to hide deficits.
4. A client is prescribed Donepezil (Aricept) for Alzheimer’s disease. What
should the nurse include in the teaching?
A. This medication will cure the underlying cause of memory loss
B. Take the medication on an empty stomach for better absorption
C. Expect immediate improvement in memory within 24 hours
D. Report any symptoms of GI bleeding or slow heart rate
Answer: D
Rationale: Donepezil is a cholinesterase inhibitor that can cause side effects like
bradycardia and increased gastric acid secretion.
5. An older adult client is being evaluated for polypharmacy. Which factor
increases this client’s risk for adverse drug reactions?
A. Increased total body water
B. Improved hepatic metabolism
C. Increased serum albumin levels
D. Decreased glomerular filtration rate (GFR)
Answer: D
, Rationale: Aging leads to decreased renal function (GFR), which slows drug excretion and
increases the risk of toxicity.
6. A nurse identifies that an elderly client has a high score on the Geriatric
Depression Scale. What is the priority nursing action?
A. Notify the dietary department to increase caloric intake
B. Recommend an increase in physical activity
C. Assess the client for suicidal ideation
D. Encourage the family to visit more often
Answer: C
Rationale: The priority is always safety; any positive screening for depression in an elderly
client requires a thorough suicide risk assessment.
7. Which of the following is considered a ‘positive’ symptom of schizophrenia?
A. Auditory hallucinations
B. Apathy
C. Social withdrawal
D. Anhedonia
Answer: A
Rationale: Positive symptoms are additions to normal experiences, such as hallucinations
and delusions. Apathy and withdrawal are negative symptoms.
8. A client with schizophrenia states, ‘The government is tracking me through
my microwave.’ This is an example of:
A. A hallucination
B. An illusion
C. A delusion of persecution
D. Ideas of reference
Answer: C
1. A nurse is assessing an older adult client for delirium. Which characteristic
distinguishes delirium from dementia?
A. Sudden onset with fluctuating levels of consciousness
B. Irreversible cognitive impairment
C. Slow, progressive decline
D. Permanent memory loss
Answer: A
Rationale: Delirium is characterized by an acute, sudden onset and fluctuating levels of
consciousness, whereas dementia is slow and progressive.
2. The nurse is caring for a client with Alzheimer’s disease who is experiencing
‘sundowning.’ Which intervention is most appropriate?
A. Turn on the lights and increase stimulation in the evening
B. Restrict daytime naps to ensure the client sleeps at night
C. Provide a quiet, calm environment and adequate lighting during the late afternoon
D. Administer a sedative at the first sign of agitation
Answer: C
Rationale: Minimizing environmental stressors and providing adequate lighting can help
reduce confusion and agitation associated with sundowning.
,3. Which assessment finding in an elderly client is a hallmark sign of depression
rather than dementia (pseudodementia)?
A. Aphasia and agnosia
B. Attempts to hide cognitive deficits
C. Consistent disorientation to time and place
D. Rapid clinical progression of symptoms
Answer: D
Rationale: Pseudodementia (depression) usually has a rapid onset and the client often
complains about their memory loss, whereas dementia has a slow onset and the client may
try to hide deficits.
4. A client is prescribed Donepezil (Aricept) for Alzheimer’s disease. What
should the nurse include in the teaching?
A. This medication will cure the underlying cause of memory loss
B. Take the medication on an empty stomach for better absorption
C. Expect immediate improvement in memory within 24 hours
D. Report any symptoms of GI bleeding or slow heart rate
Answer: D
Rationale: Donepezil is a cholinesterase inhibitor that can cause side effects like
bradycardia and increased gastric acid secretion.
5. An older adult client is being evaluated for polypharmacy. Which factor
increases this client’s risk for adverse drug reactions?
A. Increased total body water
B. Improved hepatic metabolism
C. Increased serum albumin levels
D. Decreased glomerular filtration rate (GFR)
Answer: D
, Rationale: Aging leads to decreased renal function (GFR), which slows drug excretion and
increases the risk of toxicity.
6. A nurse identifies that an elderly client has a high score on the Geriatric
Depression Scale. What is the priority nursing action?
A. Notify the dietary department to increase caloric intake
B. Recommend an increase in physical activity
C. Assess the client for suicidal ideation
D. Encourage the family to visit more often
Answer: C
Rationale: The priority is always safety; any positive screening for depression in an elderly
client requires a thorough suicide risk assessment.
7. Which of the following is considered a ‘positive’ symptom of schizophrenia?
A. Auditory hallucinations
B. Apathy
C. Social withdrawal
D. Anhedonia
Answer: A
Rationale: Positive symptoms are additions to normal experiences, such as hallucinations
and delusions. Apathy and withdrawal are negative symptoms.
8. A client with schizophrenia states, ‘The government is tracking me through
my microwave.’ This is an example of:
A. A hallucination
B. An illusion
C. A delusion of persecution
D. Ideas of reference
Answer: C
