NUR 255 Exam 3: Units 6–8 Aging & Mental Health Nursing 2026
Galen Nursing
1. A 78-year-old patient exhibits a sudden onset of confusion, agitation, and
fluctuating levels of consciousness. Which condition is the most likely cause?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Major Depressive Disorder
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in consciousness and attention, unlike the gradual decline seen in dementia.
2. Which assessment tool is specifically used by nurses to identify the presence
of delirium in hospitalized patients?
A. Mini-Mental State Exam (MMSE)
B. The Confusion Assessment Method (CAM)
C. Geriatric Depression Scale (GDS)
D. The CAGE Questionnaire
Answer: B
Rationale: The CAM is the gold standard nursing assessment tool for identifying delirium
based on four features: acute onset, inattention, disorganized thinking, and altered level of
consciousness.
,3. In the middle stage of Alzheimer’s Disease, a patient begins ‘confabulating.’
What is the nurse’s understanding of this behavior?
A. The patient is intentionally lying to manipulate the staff.
B. The patient is demonstrating a side effect of cholinesterase inhibitors.
C. The patient is experiencing visual hallucinations.
D. The patient is creating stories to fill in memory gaps to maintain self-esteem.
Answer: D
Rationale: Confabulation is a defense mechanism where a patient with memory loss
creates stories to fill gaps, often to avoid embarrassment or maintain self-esteem.
4. An elderly patient is prescribed Donepezil (Aricept) for Alzheimer’s. Which
side effect is a priority for the nurse to monitor?
A. Hypertension
B. Constipation
C. Bradycardia and syncope
D. Tinnitus
Answer: C
Rationale: Donepezil is a cholinesterase inhibitor that can cause increased
parasympathetic activity, leading to bradycardia, which increases the risk of falls and
syncope in the elderly.
5. When communicating with a patient who has advanced dementia and is
experiencing a ‘sundowning’ episode, which nursing intervention is most
appropriate?
A. Minimize noise and use a calm, reassuring voice.
B. Provide a complex activity to distract the patient.
C. Turn on bright lights to improve visibility.
D. Place the patient in soft wrist restraints for safety.
Answer: A
, Rationale: Reducing environmental stimuli (noise, bright light) and providing a calm
presence helps decrease the agitation associated with sundowning.
6. Which of the following is considered a ‘normal’ physiological change of aging
rather than a pathology?
A. Loss of short-term memory
B. Urinary incontinence
C. Increased sensitivity to glare
D. Development of pressure ulcers
Answer: C
Rationale: Changes in the lens of the eye (presbyopia) and increased sensitivity to glare
are normal parts of aging. Memory loss and incontinence are pathological.
7. A nurse is assessing a patient with a diagnosis of Generalized Anxiety
Disorder (GAD). Which symptom is characteristic of this diagnosis?
A. Sudden episodes of intense fear and impending doom
B. Persistent, excessive worry about various things for at least 6 months
C. Reliving a traumatic event through flashbacks
D. Fear of being in open spaces or crowds
Answer: B
Rationale: GAD is defined as chronic, excessive anxiety or worry about multiple events or
activities for a period of at least 6 months.
8. A patient arrives at the ER experiencing a severe panic attack. What is the
priority nursing action?
A. Stay with the patient and provide short, simple instructions.
B. Teach the patient a new relaxation technique immediately.
C. Encourage the patient to explore the source of their anxiety.
D. Administer a high dose of an antidepressant.
Answer: A
Galen Nursing
1. A 78-year-old patient exhibits a sudden onset of confusion, agitation, and
fluctuating levels of consciousness. Which condition is the most likely cause?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Major Depressive Disorder
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in consciousness and attention, unlike the gradual decline seen in dementia.
2. Which assessment tool is specifically used by nurses to identify the presence
of delirium in hospitalized patients?
A. Mini-Mental State Exam (MMSE)
B. The Confusion Assessment Method (CAM)
C. Geriatric Depression Scale (GDS)
D. The CAGE Questionnaire
Answer: B
Rationale: The CAM is the gold standard nursing assessment tool for identifying delirium
based on four features: acute onset, inattention, disorganized thinking, and altered level of
consciousness.
,3. In the middle stage of Alzheimer’s Disease, a patient begins ‘confabulating.’
What is the nurse’s understanding of this behavior?
A. The patient is intentionally lying to manipulate the staff.
B. The patient is demonstrating a side effect of cholinesterase inhibitors.
C. The patient is experiencing visual hallucinations.
D. The patient is creating stories to fill in memory gaps to maintain self-esteem.
Answer: D
Rationale: Confabulation is a defense mechanism where a patient with memory loss
creates stories to fill gaps, often to avoid embarrassment or maintain self-esteem.
4. An elderly patient is prescribed Donepezil (Aricept) for Alzheimer’s. Which
side effect is a priority for the nurse to monitor?
A. Hypertension
B. Constipation
C. Bradycardia and syncope
D. Tinnitus
Answer: C
Rationale: Donepezil is a cholinesterase inhibitor that can cause increased
parasympathetic activity, leading to bradycardia, which increases the risk of falls and
syncope in the elderly.
5. When communicating with a patient who has advanced dementia and is
experiencing a ‘sundowning’ episode, which nursing intervention is most
appropriate?
A. Minimize noise and use a calm, reassuring voice.
B. Provide a complex activity to distract the patient.
C. Turn on bright lights to improve visibility.
D. Place the patient in soft wrist restraints for safety.
Answer: A
, Rationale: Reducing environmental stimuli (noise, bright light) and providing a calm
presence helps decrease the agitation associated with sundowning.
6. Which of the following is considered a ‘normal’ physiological change of aging
rather than a pathology?
A. Loss of short-term memory
B. Urinary incontinence
C. Increased sensitivity to glare
D. Development of pressure ulcers
Answer: C
Rationale: Changes in the lens of the eye (presbyopia) and increased sensitivity to glare
are normal parts of aging. Memory loss and incontinence are pathological.
7. A nurse is assessing a patient with a diagnosis of Generalized Anxiety
Disorder (GAD). Which symptom is characteristic of this diagnosis?
A. Sudden episodes of intense fear and impending doom
B. Persistent, excessive worry about various things for at least 6 months
C. Reliving a traumatic event through flashbacks
D. Fear of being in open spaces or crowds
Answer: B
Rationale: GAD is defined as chronic, excessive anxiety or worry about multiple events or
activities for a period of at least 6 months.
8. A patient arrives at the ER experiencing a severe panic attack. What is the
priority nursing action?
A. Stay with the patient and provide short, simple instructions.
B. Teach the patient a new relaxation technique immediately.
C. Encourage the patient to explore the source of their anxiety.
D. Administer a high dose of an antidepressant.
Answer: A
