BSN 375 Final Exam: Advanced Issues in Cognition
Updated and Verified Questions and Correct
Answers - Nightingale College (Version 1)
1. Which of the following is the hallmark clinical feature that distinguishes
delirium from dementia?
A. Acute onset and fluctuating course
B. Gradual decline in memory
C. Irreversible cognitive impairment
D. Intact level of consciousness
Correct Answer: A
Explanation: Delirium is characterized by an acute onset (hours to days) and a fluctuating
course of symptoms, whereas dementia involves a slow, progressive decline.
2. Which neurotransmitter deficiency is most significantly associated with the
cognitive symptoms of Alzheimer’s disease?
A. Acetylcholine
B. Serotonin
C. Dopamine
D. GABA
Correct Answer: A
Explanation: Alzheimer’s disease is primarily associated with a deficit in acetylcholine,
which is why cholinesterase inhibitors are used for treatment.
,3. A patient exhibits cognitive decline followed by motor symptoms and reports
vivid visual hallucinations. Which diagnosis is most likely?
A. Vascular Dementia
B. Frontotemporal Dementia
C. Huntington’s Disease
D. Dementia with Lewy Bodies
Correct Answer: D
Explanation: Dementia with Lewy Bodies is characterized by fluctuating cognition,
parkinsonism, and vivid visual hallucinations.
4. What is the mechanism of action for the medication Memantine (Namenda)?
A. Cholinesterase inhibition
B. Serotonin reuptake inhibition
C. Dopamine agonism
D. NMDA receptor antagonism
Correct Answer: D
Explanation: Memantine works as an NMDA receptor antagonist to regulate glutamate
activity, which can prevent neurotoxicity in Alzheimer’s disease.
5. Which screening tool is specifically designed to detect delirium in a clinical
setting?
A. Mini-Mental State Examination (MMSE)
B. Montreal Cognitive Assessment (MoCA)
C. Confusion Assessment Method (CAM)
D. Geriatric Depression Scale
Correct Answer: C
Explanation: The CAM is the gold standard tool for bedside screening of delirium based on
four features: acute onset, inattention, disorganized thinking, and altered level of
consciousness.
, 6. The ‘3 Ds’ of geriatric psychiatry often confused with each other are:
A. Dementia, Delirium, Depression
B. Dehydration, Diabetes, Delirium
C. Dysphasia, Dyspraxia, Dysphagia
D. Dementia, Decline, Debility
Correct Answer: A
Explanation: Dementia, delirium, and depression frequently overlap in older adults and
require careful differential diagnosis.
7. Which of the following describes ‘Apraxia’ in a patient with cognitive
impairment?
A. Inability to perform purposeful motor activities despite intact motor function
B. Inability to express language
C. Failure to recognize familiar objects
D. Impairment in social judgment
Correct Answer: A
Explanation: Apraxia is the loss of the ability to execute learned purposeful movements
despite having the physical desire and capacity to perform them.
8. In Vascular Dementia, the progression of cognitive decline is typically
described as:
A. Step-wise and unpredictable
B. Sudden and reversible
C. Slow and linear
D. Rapidly accelerating over weeks
Correct Answer: A
Explanation: Vascular dementia often shows a ‘step-wise’ progression, where cognitive
function drops after a cerebrovascular event and then stabilizes until the next event.
Updated and Verified Questions and Correct
Answers - Nightingale College (Version 1)
1. Which of the following is the hallmark clinical feature that distinguishes
delirium from dementia?
A. Acute onset and fluctuating course
B. Gradual decline in memory
C. Irreversible cognitive impairment
D. Intact level of consciousness
Correct Answer: A
Explanation: Delirium is characterized by an acute onset (hours to days) and a fluctuating
course of symptoms, whereas dementia involves a slow, progressive decline.
2. Which neurotransmitter deficiency is most significantly associated with the
cognitive symptoms of Alzheimer’s disease?
A. Acetylcholine
B. Serotonin
C. Dopamine
D. GABA
Correct Answer: A
Explanation: Alzheimer’s disease is primarily associated with a deficit in acetylcholine,
which is why cholinesterase inhibitors are used for treatment.
,3. A patient exhibits cognitive decline followed by motor symptoms and reports
vivid visual hallucinations. Which diagnosis is most likely?
A. Vascular Dementia
B. Frontotemporal Dementia
C. Huntington’s Disease
D. Dementia with Lewy Bodies
Correct Answer: D
Explanation: Dementia with Lewy Bodies is characterized by fluctuating cognition,
parkinsonism, and vivid visual hallucinations.
4. What is the mechanism of action for the medication Memantine (Namenda)?
A. Cholinesterase inhibition
B. Serotonin reuptake inhibition
C. Dopamine agonism
D. NMDA receptor antagonism
Correct Answer: D
Explanation: Memantine works as an NMDA receptor antagonist to regulate glutamate
activity, which can prevent neurotoxicity in Alzheimer’s disease.
5. Which screening tool is specifically designed to detect delirium in a clinical
setting?
A. Mini-Mental State Examination (MMSE)
B. Montreal Cognitive Assessment (MoCA)
C. Confusion Assessment Method (CAM)
D. Geriatric Depression Scale
Correct Answer: C
Explanation: The CAM is the gold standard tool for bedside screening of delirium based on
four features: acute onset, inattention, disorganized thinking, and altered level of
consciousness.
, 6. The ‘3 Ds’ of geriatric psychiatry often confused with each other are:
A. Dementia, Delirium, Depression
B. Dehydration, Diabetes, Delirium
C. Dysphasia, Dyspraxia, Dysphagia
D. Dementia, Decline, Debility
Correct Answer: A
Explanation: Dementia, delirium, and depression frequently overlap in older adults and
require careful differential diagnosis.
7. Which of the following describes ‘Apraxia’ in a patient with cognitive
impairment?
A. Inability to perform purposeful motor activities despite intact motor function
B. Inability to express language
C. Failure to recognize familiar objects
D. Impairment in social judgment
Correct Answer: A
Explanation: Apraxia is the loss of the ability to execute learned purposeful movements
despite having the physical desire and capacity to perform them.
8. In Vascular Dementia, the progression of cognitive decline is typically
described as:
A. Step-wise and unpredictable
B. Sudden and reversible
C. Slow and linear
D. Rapidly accelerating over weeks
Correct Answer: A
Explanation: Vascular dementia often shows a ‘step-wise’ progression, where cognitive
function drops after a cerebrovascular event and then stabilizes until the next event.
