NUR 185 Exam 2 - (Hondros) Complete Questions, correct
Answers and Detailed Explanations - Latest Update 2026/2027
| 100% Guaranteed Pass || Graded A+
1. A nurse is caring for a patient who has developed an acute change in mental
status, disorientation, and fluctuating attention over several hours. Which
condition should the nurse suspect first?
A. Dementia
B. Delirium
C. Depression
D. Schizophrenia
Correct Answer: B. Delirium
Explanation: Delirium is characterized by an acute and usually fluctuating
disturbance in attention, awareness, and cognition. It often develops over
hours to days and may be caused by infection, medications, metabolic
abnormalities, dehydration, hypoxia, or other acute illnesses. Dementia
generally develops gradually over months or years and does not typically
produce the rapid fluctuations characteristic of delirium.
2. An older adult becomes increasingly confused after admission to the
hospital and is attempting to climb out of bed. Which nursing intervention is
the priority?
A. Place the patient in a dark room
B. Assess for potentially reversible causes of the acute confusion
C. Encourage the patient to remain in bed without explanation
D. Administer a sedative immediately
Correct Answer: B. Assess for potentially reversible causes of the acute
confusion
Explanation: Acute confusion should prompt assessment for reversible
causes, including infection, hypoxia, dehydration, electrolyte abnormalities,
pain, urinary retention, constipation, and medication effects. Identifying and
pg. 1
,treating the underlying cause is more important than simply suppressing the
patient's behavior.
3. A patient with dementia becomes increasingly agitated in the evening and
repeatedly asks where they are. Which nursing intervention is most
appropriate?
A. Frequently change the patient's environment
B. Provide a calm, structured, familiar environment
C. Correct the patient each time they make a mistake
D. Encourage multiple visitors simultaneously
Correct Answer: B. Provide a calm, structured, familiar environment
Explanation: Patients with dementia often benefit from consistency,
familiar surroundings, predictable routines, and reduced environmental
stimulation. Repeatedly correcting the patient can increase frustration and
anxiety. A calm environment can reduce agitation and improve orientation.
4. A patient is experiencing anxiety and begins breathing rapidly. The patient
reports numbness around the mouth and tingling in the hands. Which nursing
intervention is most appropriate initially?
A. Encourage slow, controlled breathing
B. Have the patient hold their breath for several minutes
C. Encourage vigorous exercise
D. Leave the patient alone
Correct Answer: A. Encourage slow, controlled breathing
Explanation: Hyperventilation associated with acute anxiety can decrease
carbon dioxide levels and produce perioral and extremity tingling,
dizziness, and lightheadedness. The nurse should remain with the patient
and encourage slow, controlled breathing while assessing the patient for other
potential causes of the symptoms.
pg. 2
,5. A patient states, “I don't want to live anymore.” What should the nurse do
first?
A. Change the subject
B. Ask directly whether the patient has a suicide plan
C. Tell the patient that life will improve
D. Leave the patient alone to calm down
Correct Answer: B. Ask directly whether the patient has a suicide plan
Explanation: Any expression of suicidal thoughts requires direct
assessment of suicide risk. The nurse should ask about suicidal thoughts,
intent, plan, access to means, previous attempts, and protective factors.
Asking directly about suicide does not cause suicidal behavior and is an
essential component of safety assessment.
6. A patient with major depressive disorder reports having no energy and
difficulty completing activities of daily living. Which nursing intervention is
most appropriate?
A. Encourage the patient to complete all activities independently
B. Break activities into small, manageable steps
C. Avoid setting any expectations
D. Require participation in multiple activities each day
Correct Answer: B. Break activities into small, manageable steps
Explanation: Depression can cause fatigue, decreased motivation,
impaired concentration, and psychomotor slowing. Breaking tasks into
manageable steps reduces feelings of being overwhelmed while encouraging
gradual participation and independence.
7. A patient taking a selective serotonin reuptake inhibitor develops agitation,
sweating, tremor, diarrhea, and hyperreflexia. Which condition should the
nurse suspect?
pg. 3
, A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Lithium toxicity
Correct Answer: B. Serotonin syndrome
Explanation: Serotonin syndrome results from excessive serotonergic
activity and may include agitation, diaphoresis, diarrhea, tremor,
hyperreflexia, clonus, fever, and autonomic instability. Severe cases can
become life-threatening and require prompt medical intervention.
8. A patient taking an antipsychotic medication develops severe muscle
rigidity, high fever, altered mental status, and autonomic instability. Which
condition is most concerning?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. Extrapyramidal symptoms only
Correct Answer: B. Neuroleptic malignant syndrome
Explanation: Neuroleptic malignant syndrome is a potentially life-
threatening reaction to dopamine-blocking medications, particularly
antipsychotics. Classic manifestations include severe rigidity, hyperthermia,
altered mental status, and autonomic instability. Immediate medical
evaluation and discontinuation of the causative medication are typically
required.
9. A patient receiving an antipsychotic develops involuntary facial movements
and repetitive tongue movements after long-term therapy. Which adverse
effect should the nurse suspect?
A. Tardive dyskinesia
B. Acute dystonia
pg. 4
Answers and Detailed Explanations - Latest Update 2026/2027
| 100% Guaranteed Pass || Graded A+
1. A nurse is caring for a patient who has developed an acute change in mental
status, disorientation, and fluctuating attention over several hours. Which
condition should the nurse suspect first?
A. Dementia
B. Delirium
C. Depression
D. Schizophrenia
Correct Answer: B. Delirium
Explanation: Delirium is characterized by an acute and usually fluctuating
disturbance in attention, awareness, and cognition. It often develops over
hours to days and may be caused by infection, medications, metabolic
abnormalities, dehydration, hypoxia, or other acute illnesses. Dementia
generally develops gradually over months or years and does not typically
produce the rapid fluctuations characteristic of delirium.
2. An older adult becomes increasingly confused after admission to the
hospital and is attempting to climb out of bed. Which nursing intervention is
the priority?
A. Place the patient in a dark room
B. Assess for potentially reversible causes of the acute confusion
C. Encourage the patient to remain in bed without explanation
D. Administer a sedative immediately
Correct Answer: B. Assess for potentially reversible causes of the acute
confusion
Explanation: Acute confusion should prompt assessment for reversible
causes, including infection, hypoxia, dehydration, electrolyte abnormalities,
pain, urinary retention, constipation, and medication effects. Identifying and
pg. 1
,treating the underlying cause is more important than simply suppressing the
patient's behavior.
3. A patient with dementia becomes increasingly agitated in the evening and
repeatedly asks where they are. Which nursing intervention is most
appropriate?
A. Frequently change the patient's environment
B. Provide a calm, structured, familiar environment
C. Correct the patient each time they make a mistake
D. Encourage multiple visitors simultaneously
Correct Answer: B. Provide a calm, structured, familiar environment
Explanation: Patients with dementia often benefit from consistency,
familiar surroundings, predictable routines, and reduced environmental
stimulation. Repeatedly correcting the patient can increase frustration and
anxiety. A calm environment can reduce agitation and improve orientation.
4. A patient is experiencing anxiety and begins breathing rapidly. The patient
reports numbness around the mouth and tingling in the hands. Which nursing
intervention is most appropriate initially?
A. Encourage slow, controlled breathing
B. Have the patient hold their breath for several minutes
C. Encourage vigorous exercise
D. Leave the patient alone
Correct Answer: A. Encourage slow, controlled breathing
Explanation: Hyperventilation associated with acute anxiety can decrease
carbon dioxide levels and produce perioral and extremity tingling,
dizziness, and lightheadedness. The nurse should remain with the patient
and encourage slow, controlled breathing while assessing the patient for other
potential causes of the symptoms.
pg. 2
,5. A patient states, “I don't want to live anymore.” What should the nurse do
first?
A. Change the subject
B. Ask directly whether the patient has a suicide plan
C. Tell the patient that life will improve
D. Leave the patient alone to calm down
Correct Answer: B. Ask directly whether the patient has a suicide plan
Explanation: Any expression of suicidal thoughts requires direct
assessment of suicide risk. The nurse should ask about suicidal thoughts,
intent, plan, access to means, previous attempts, and protective factors.
Asking directly about suicide does not cause suicidal behavior and is an
essential component of safety assessment.
6. A patient with major depressive disorder reports having no energy and
difficulty completing activities of daily living. Which nursing intervention is
most appropriate?
A. Encourage the patient to complete all activities independently
B. Break activities into small, manageable steps
C. Avoid setting any expectations
D. Require participation in multiple activities each day
Correct Answer: B. Break activities into small, manageable steps
Explanation: Depression can cause fatigue, decreased motivation,
impaired concentration, and psychomotor slowing. Breaking tasks into
manageable steps reduces feelings of being overwhelmed while encouraging
gradual participation and independence.
7. A patient taking a selective serotonin reuptake inhibitor develops agitation,
sweating, tremor, diarrhea, and hyperreflexia. Which condition should the
nurse suspect?
pg. 3
, A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Anticholinergic toxicity
D. Lithium toxicity
Correct Answer: B. Serotonin syndrome
Explanation: Serotonin syndrome results from excessive serotonergic
activity and may include agitation, diaphoresis, diarrhea, tremor,
hyperreflexia, clonus, fever, and autonomic instability. Severe cases can
become life-threatening and require prompt medical intervention.
8. A patient taking an antipsychotic medication develops severe muscle
rigidity, high fever, altered mental status, and autonomic instability. Which
condition is most concerning?
A. Serotonin syndrome
B. Neuroleptic malignant syndrome
C. Panic disorder
D. Extrapyramidal symptoms only
Correct Answer: B. Neuroleptic malignant syndrome
Explanation: Neuroleptic malignant syndrome is a potentially life-
threatening reaction to dopamine-blocking medications, particularly
antipsychotics. Classic manifestations include severe rigidity, hyperthermia,
altered mental status, and autonomic instability. Immediate medical
evaluation and discontinuation of the causative medication are typically
required.
9. A patient receiving an antipsychotic develops involuntary facial movements
and repetitive tongue movements after long-term therapy. Which adverse
effect should the nurse suspect?
A. Tardive dyskinesia
B. Acute dystonia
pg. 4
