NR547 Final Exam Practice Questions
MCQ Options, Correct Answers, and Expert Rationales
1. A client was diagnosed with major neurocognitive disorder due to Alzheimer’s disease.
What pharmacologic therapy would be anticipated?
Options:
A. Memantine
B. Methylphenidate
C. Buspirone
D. Disulfiram
Correct Answer:
A. Memantine
Expert Rationale:
Memantine is an NMDA receptor antagonist used for moderate-to-severe Alzheimer
disease and may help cognition and function. Stimulants, anxiolytics, and alcohol-use
medications do not target Alzheimer-related neurocognitive decline.
2. An 89-year-old presents with symptoms of dementia. Which diagnostic test should be
performed initially to rule out treatable causes of symptoms?
Options:
A. Electroencephalogram
B. Serum ammonia level
C. Lumbar puncture
D. Cobalamin level
Correct Answer:
D. Cobalamin level
Expert Rationale:
Vitamin B12 deficiency can cause cognitive changes that mimic dementia and is treatable.
Initial workup for cognitive decline commonly includes labs to identify reversible metabolic
or nutritional causes.
3. What information can assist the clinician in differentiate dementia from depression?
Options:
A. A patient with dementia has symptoms for a long time before seeking medical help.
B. A patient with depression always denies memory problems.
C. Dementia usually begins suddenly after a stressful event.
D. Depression is confirmed by abnormal neuroimaging.
,Correct Answer:
A. A patient with dementia has symptoms for a long time before seeking medical help.
Expert Rationale:
Dementia usually has an insidious onset and progressive course, often noticed by family
before the patient seeks care. Depressive cognitive symptoms often have a more
noticeable onset and the patient may emphasize distress about impairment.
4. A client presents with concerns about difficulties at work. He states that he has trouble
speaking up when things aren’t going well because he is afraid that others won’t like him or
will think he is stupid. He is not in a relationship because he can’t imagine anyone wanting
to be with him. The clients symptoms are consistent with which disorder?
Options:
A. Schizoid personality disorder
B. Avoidant personality disorder
C. Narcissistic personality disorder
D. Obsessive-compulsive personality disorder
Correct Answer:
B. Avoidant personality disorder
Expert Rationale:
Avoidant personality disorder is marked by social inhibition, feelings of inadequacy, and
hypersensitivity to criticism or rejection. The client wants connection but avoids it because
of fear of negative evaluation.
5. A client presents with ataxia, short-term memory loss, and nystagmus. The client has a
history of prolonged, heavy alcohol use. What is the most likely diagnosis?
Options:
A. Alcohol intoxication
B. Wernicke Encephalopathy
C. Hepatic encephalopathy
D. Korsakoff syndrome
Correct Answer:
B. Wernicke Encephalopathy
Expert Rationale:
Wernicke encephalopathy is associated with thiamine deficiency and classically presents
with confusion, ataxia, and ocular findings such as nystagmus. Heavy alcohol use is a
major risk factor.
6. A client who has been diagnosed with mild neurocognitive disorder asks what he can do
to improve his prognosis. What is the best response?
, Options:
A. Begin a regular exercise program
B. Avoid all cognitively stimulating activities
C. Use benzodiazepines for sleep nightly
D. Stop all social activities to reduce stress
Correct Answer:
A. Begin a regular exercise program
Expert Rationale:
Regular physical activity is associated with better cognitive and functional outcomes and
supports cardiovascular and brain health. Sedatives and social isolation can worsen
cognition and function.
7. A 50-year-old client presents with fatigue and poor motivation to the point that she is
avoiding work. She reports that for the past several weeks she has a poor appetite and
sleeps over 14 hours per day. She notesthat last month,she felt “much better” had lots of
energy and didn’t need much sleep. She went on several shopping sprees that caused her
checking account to be overdrawn. Which diagnosis is most consistent with the
client’ssymptoms?
Options:
A. Major depressive disorder
B. Bipolar I disorder
C. Cyclothymic disorder
D. Persistent depressive disorder
Correct Answer:
B. Bipolar I disorder
Expert Rationale:
The history suggests a depressive episode plus a prior manic episode, shown by increased
energy, decreased need for sleep, and risky spending with impairment. A manic episode
supports bipolar I disorder.
8. Inattention and a variable level of consciousness are the hallmark symptoms of which
condition?
Options:
A. Delirium
B. Major depressive disorder
C. Schizoid personality disorder
D. Mild neurocognitive disorder
Correct Answer:
A. Delirium
MCQ Options, Correct Answers, and Expert Rationales
1. A client was diagnosed with major neurocognitive disorder due to Alzheimer’s disease.
What pharmacologic therapy would be anticipated?
Options:
A. Memantine
B. Methylphenidate
C. Buspirone
D. Disulfiram
Correct Answer:
A. Memantine
Expert Rationale:
Memantine is an NMDA receptor antagonist used for moderate-to-severe Alzheimer
disease and may help cognition and function. Stimulants, anxiolytics, and alcohol-use
medications do not target Alzheimer-related neurocognitive decline.
2. An 89-year-old presents with symptoms of dementia. Which diagnostic test should be
performed initially to rule out treatable causes of symptoms?
Options:
A. Electroencephalogram
B. Serum ammonia level
C. Lumbar puncture
D. Cobalamin level
Correct Answer:
D. Cobalamin level
Expert Rationale:
Vitamin B12 deficiency can cause cognitive changes that mimic dementia and is treatable.
Initial workup for cognitive decline commonly includes labs to identify reversible metabolic
or nutritional causes.
3. What information can assist the clinician in differentiate dementia from depression?
Options:
A. A patient with dementia has symptoms for a long time before seeking medical help.
B. A patient with depression always denies memory problems.
C. Dementia usually begins suddenly after a stressful event.
D. Depression is confirmed by abnormal neuroimaging.
,Correct Answer:
A. A patient with dementia has symptoms for a long time before seeking medical help.
Expert Rationale:
Dementia usually has an insidious onset and progressive course, often noticed by family
before the patient seeks care. Depressive cognitive symptoms often have a more
noticeable onset and the patient may emphasize distress about impairment.
4. A client presents with concerns about difficulties at work. He states that he has trouble
speaking up when things aren’t going well because he is afraid that others won’t like him or
will think he is stupid. He is not in a relationship because he can’t imagine anyone wanting
to be with him. The clients symptoms are consistent with which disorder?
Options:
A. Schizoid personality disorder
B. Avoidant personality disorder
C. Narcissistic personality disorder
D. Obsessive-compulsive personality disorder
Correct Answer:
B. Avoidant personality disorder
Expert Rationale:
Avoidant personality disorder is marked by social inhibition, feelings of inadequacy, and
hypersensitivity to criticism or rejection. The client wants connection but avoids it because
of fear of negative evaluation.
5. A client presents with ataxia, short-term memory loss, and nystagmus. The client has a
history of prolonged, heavy alcohol use. What is the most likely diagnosis?
Options:
A. Alcohol intoxication
B. Wernicke Encephalopathy
C. Hepatic encephalopathy
D. Korsakoff syndrome
Correct Answer:
B. Wernicke Encephalopathy
Expert Rationale:
Wernicke encephalopathy is associated with thiamine deficiency and classically presents
with confusion, ataxia, and ocular findings such as nystagmus. Heavy alcohol use is a
major risk factor.
6. A client who has been diagnosed with mild neurocognitive disorder asks what he can do
to improve his prognosis. What is the best response?
, Options:
A. Begin a regular exercise program
B. Avoid all cognitively stimulating activities
C. Use benzodiazepines for sleep nightly
D. Stop all social activities to reduce stress
Correct Answer:
A. Begin a regular exercise program
Expert Rationale:
Regular physical activity is associated with better cognitive and functional outcomes and
supports cardiovascular and brain health. Sedatives and social isolation can worsen
cognition and function.
7. A 50-year-old client presents with fatigue and poor motivation to the point that she is
avoiding work. She reports that for the past several weeks she has a poor appetite and
sleeps over 14 hours per day. She notesthat last month,she felt “much better” had lots of
energy and didn’t need much sleep. She went on several shopping sprees that caused her
checking account to be overdrawn. Which diagnosis is most consistent with the
client’ssymptoms?
Options:
A. Major depressive disorder
B. Bipolar I disorder
C. Cyclothymic disorder
D. Persistent depressive disorder
Correct Answer:
B. Bipolar I disorder
Expert Rationale:
The history suggests a depressive episode plus a prior manic episode, shown by increased
energy, decreased need for sleep, and risky spending with impairment. A manic episode
supports bipolar I disorder.
8. Inattention and a variable level of consciousness are the hallmark symptoms of which
condition?
Options:
A. Delirium
B. Major depressive disorder
C. Schizoid personality disorder
D. Mild neurocognitive disorder
Correct Answer:
A. Delirium
