NURS 6540 Final Exam Study Guide
2025/2026 – Advanced Practice Care of Frail
Elders – Walden University | 100+ Verified
Answers | A+ Prep Guide
Domain: Cognitive Decline
Question 1
An 82-year-old patient reports memory lapses and difficulty finding words. What is the priority
assessment tool for cognitive decline?
A: Mini-Mental State Examination (MMSE)
B: Geriatric Depression Scale (GDS)
C: Activities of Daily Living (ADL) Scale
D: Pain Assessment in Advanced Dementia (PAINAD)
A: Mini-Mental State Examination (MMSE)
Rationale: MMSE screens for cognitive impairment, assessing memory, orientation, and
language. B screens for depression. C evaluates functional status. D assesses pain in dementia.
Question 2
A patient with suspected dementia exhibits agitation. What is the first nursing intervention?
A: Assess for reversible causes (e.g., infection, pain)
B: Administer a benzodiazepine
C: Restrict patient movement
D: Increase social activities
A: Assess for reversible causes (e.g., infection, pain)
Rationale: Agitation in dementia may stem from reversible causes like infection or pain, which
should be ruled out first. B risks worsening confusion. C is unethical. D is secondary.
Question 3
Which condition is most likely to mimic dementia in older adults?
A: Delirium
B: Depression
C: Hypothyroidism
D: All of the above
A: Delirium
Rationale: Delirium, with acute onset and fluctuating symptoms, often mimics dementia but is
reversible with treatment. B and C can contribute but are less acute. D is too broad.
, Question 4
A 78-year-old with mild cognitive impairment (MCI) asks about slowing progression. What is
the best recommendation?
A: Engage in regular physical and cognitive activities
B: Increase dietary fat intake
C: Limit social interactions
D: Take high-dose vitamin E
A: Engage in regular physical and cognitive activities
Rationale: Physical exercise and cognitive stimulation slow MCI progression. B is unrelated. C
worsens isolation. D lacks evidence for MCI.
Question 5
What is a hallmark feature of Alzheimer’s disease?
A: Progressive memory loss
B: Sudden personality changes
C: Visual hallucinations
D: Tremors at rest
A: Progressive memory loss
Rationale: Alzheimer’s is characterized by gradual memory decline. B is less specific. C is more
common in Lewy body dementia. D suggests Parkinson’s.
Question 6
A patient with dementia has difficulty sleeping. What is a non-pharmacologic intervention?
A: Establish a consistent bedtime routine
B: Administer zolpidem
C: Increase daytime napping
D: Use physical restraints
A: Establish a consistent bedtime routine
Rationale: Consistent routines promote sleep in dementia without medication risks. B increases
fall risk. C disrupts sleep cycles. D is unsafe.
Question 7
What is a key risk factor for cognitive decline in frail elders?
A: Multimorbidity
B: High physical activity
C: Low medication use
D: Young age
A: Multimorbidity
Rationale: Multiple chronic conditions increase cognitive decline risk. B and C are protective. D
is irrelevant.
Question 8
A nurse practitioner suspects vascular dementia. What diagnostic finding supports this?
A: Stepwise cognitive decline
B: Gradual memory loss
C: Early personality changes
2025/2026 – Advanced Practice Care of Frail
Elders – Walden University | 100+ Verified
Answers | A+ Prep Guide
Domain: Cognitive Decline
Question 1
An 82-year-old patient reports memory lapses and difficulty finding words. What is the priority
assessment tool for cognitive decline?
A: Mini-Mental State Examination (MMSE)
B: Geriatric Depression Scale (GDS)
C: Activities of Daily Living (ADL) Scale
D: Pain Assessment in Advanced Dementia (PAINAD)
A: Mini-Mental State Examination (MMSE)
Rationale: MMSE screens for cognitive impairment, assessing memory, orientation, and
language. B screens for depression. C evaluates functional status. D assesses pain in dementia.
Question 2
A patient with suspected dementia exhibits agitation. What is the first nursing intervention?
A: Assess for reversible causes (e.g., infection, pain)
B: Administer a benzodiazepine
C: Restrict patient movement
D: Increase social activities
A: Assess for reversible causes (e.g., infection, pain)
Rationale: Agitation in dementia may stem from reversible causes like infection or pain, which
should be ruled out first. B risks worsening confusion. C is unethical. D is secondary.
Question 3
Which condition is most likely to mimic dementia in older adults?
A: Delirium
B: Depression
C: Hypothyroidism
D: All of the above
A: Delirium
Rationale: Delirium, with acute onset and fluctuating symptoms, often mimics dementia but is
reversible with treatment. B and C can contribute but are less acute. D is too broad.
, Question 4
A 78-year-old with mild cognitive impairment (MCI) asks about slowing progression. What is
the best recommendation?
A: Engage in regular physical and cognitive activities
B: Increase dietary fat intake
C: Limit social interactions
D: Take high-dose vitamin E
A: Engage in regular physical and cognitive activities
Rationale: Physical exercise and cognitive stimulation slow MCI progression. B is unrelated. C
worsens isolation. D lacks evidence for MCI.
Question 5
What is a hallmark feature of Alzheimer’s disease?
A: Progressive memory loss
B: Sudden personality changes
C: Visual hallucinations
D: Tremors at rest
A: Progressive memory loss
Rationale: Alzheimer’s is characterized by gradual memory decline. B is less specific. C is more
common in Lewy body dementia. D suggests Parkinson’s.
Question 6
A patient with dementia has difficulty sleeping. What is a non-pharmacologic intervention?
A: Establish a consistent bedtime routine
B: Administer zolpidem
C: Increase daytime napping
D: Use physical restraints
A: Establish a consistent bedtime routine
Rationale: Consistent routines promote sleep in dementia without medication risks. B increases
fall risk. C disrupts sleep cycles. D is unsafe.
Question 7
What is a key risk factor for cognitive decline in frail elders?
A: Multimorbidity
B: High physical activity
C: Low medication use
D: Young age
A: Multimorbidity
Rationale: Multiple chronic conditions increase cognitive decline risk. B and C are protective. D
is irrelevant.
Question 8
A nurse practitioner suspects vascular dementia. What diagnostic finding supports this?
A: Stepwise cognitive decline
B: Gradual memory loss
C: Early personality changes
