NUR255 Exam 2 V3 | Aging &
Mental Health Nursing Q&A with
Rationale | Galen College of
Nursing
1. An older adult patient is experiencing a sudden onset of confusion and fluctuating levels of
consciousness. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Major Depressive Disorder
C. Delirium
D. Vascular Dementia
Correct Answer: C
Expert Explanation: Delirium is characterized by a rapid, acute onset of cognitive
impairment and changes in consciousness. It is often reversible once the underlying
physiological cause, such as an infection or electrolyte imbalance, is addressed. In contrast,
dementia involves a slow, progressive decline in memory and function.
2. A nurse is teaching a family about the ‘sundowning’ phenomenon in a patient with
dementia. Which statement should the nurse include?
A. Confusion and agitation often worsen as daylight fades.
,B. The patient will be most alert during the late evening hours.
C. This is a sign that the patient’s condition is improving.
D. Symptoms are usually best managed with heavy sedation at night.
Correct Answer: A
Expert Explanation: Sundowning refers to the increased confusion, restlessness, and
agitation that many dementia patients experience in the late afternoon or evening. It can be
triggered by fatigue, low lighting, or disruptions in the circadian rhythm. Management
involves maintaining a consistent routine and providing a calm, well-lit environment.
3. Which of the following is a primary nursing priority when caring for a patient in an acute
manic phase of Bipolar Disorder?
A. Encouraging participation in group therapy sessions
B. Providing high-calorie finger foods and fluids
C. Administering long-acting antidepressants
D. Initiating deep-tissue massage for relaxation
Correct Answer: B
Expert Explanation: Patients in acute mania are often too hyperactive to sit down for full
meals, putting them at risk for nutritional deficits and exhaustion. High-calorie finger foods
allow the patient to eat while moving, ensuring they receive necessary energy. Safety and
physical stability are the highest priorities during this phase of the illness.
, 4. An older adult is prescribed a new SSRI for depression. Which side effect is the nurse most
concerned about in this population?
A. Weight gain
B. Hyponatremia
C. Increased salivation
D. Hypertension
Correct Answer: B
Expert Explanation: Older adults taking Selective Serotonin Reuptake Inhibitors (SSRIs)
are at an increased risk for developing hyponatremia, often due to SIADH. Symptoms may
include nausea, headache, and further confusion, which can be mistaken for aging or
dementia. Monitoring serum sodium levels is a critical nursing intervention for these
patients.
5. When assessing an older adult for depression, which symptom might the patient display
that differs from a younger adult?
A. Overt expressions of sadness and crying
B. Rapid, pressured speech patterns
C. Intense feelings of grandiosity
D. Somatic complaints such as pain or fatigue
Correct Answer: D
Mental Health Nursing Q&A with
Rationale | Galen College of
Nursing
1. An older adult patient is experiencing a sudden onset of confusion and fluctuating levels of
consciousness. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Major Depressive Disorder
C. Delirium
D. Vascular Dementia
Correct Answer: C
Expert Explanation: Delirium is characterized by a rapid, acute onset of cognitive
impairment and changes in consciousness. It is often reversible once the underlying
physiological cause, such as an infection or electrolyte imbalance, is addressed. In contrast,
dementia involves a slow, progressive decline in memory and function.
2. A nurse is teaching a family about the ‘sundowning’ phenomenon in a patient with
dementia. Which statement should the nurse include?
A. Confusion and agitation often worsen as daylight fades.
,B. The patient will be most alert during the late evening hours.
C. This is a sign that the patient’s condition is improving.
D. Symptoms are usually best managed with heavy sedation at night.
Correct Answer: A
Expert Explanation: Sundowning refers to the increased confusion, restlessness, and
agitation that many dementia patients experience in the late afternoon or evening. It can be
triggered by fatigue, low lighting, or disruptions in the circadian rhythm. Management
involves maintaining a consistent routine and providing a calm, well-lit environment.
3. Which of the following is a primary nursing priority when caring for a patient in an acute
manic phase of Bipolar Disorder?
A. Encouraging participation in group therapy sessions
B. Providing high-calorie finger foods and fluids
C. Administering long-acting antidepressants
D. Initiating deep-tissue massage for relaxation
Correct Answer: B
Expert Explanation: Patients in acute mania are often too hyperactive to sit down for full
meals, putting them at risk for nutritional deficits and exhaustion. High-calorie finger foods
allow the patient to eat while moving, ensuring they receive necessary energy. Safety and
physical stability are the highest priorities during this phase of the illness.
, 4. An older adult is prescribed a new SSRI for depression. Which side effect is the nurse most
concerned about in this population?
A. Weight gain
B. Hyponatremia
C. Increased salivation
D. Hypertension
Correct Answer: B
Expert Explanation: Older adults taking Selective Serotonin Reuptake Inhibitors (SSRIs)
are at an increased risk for developing hyponatremia, often due to SIADH. Symptoms may
include nausea, headache, and further confusion, which can be mistaken for aging or
dementia. Monitoring serum sodium levels is a critical nursing intervention for these
patients.
5. When assessing an older adult for depression, which symptom might the patient display
that differs from a younger adult?
A. Overt expressions of sadness and crying
B. Rapid, pressured speech patterns
C. Intense feelings of grandiosity
D. Somatic complaints such as pain or fatigue
Correct Answer: D
