NURS 317 Final Exam Practice Questions and
Answers with Rationale | New Update 2026/27 |
Graded A+
Which patient is exhibiting signs of delirium?
A. A patient at home unable to solve a puzzle
B. A patient in the ICU acting erratic and drowsy
C. A patient in an assisted living facility having difficulty speaking
Correct Answer: B. A patient in the ICU acting erratic and drowsy
Rationale: Delirium is characterized by an acute, fluctuating disturbance in
consciousness, attention, and cognition. The key features include erratic lucidity
and somnolence (drowsiness), along with disturbances in behavior, orientation,
and perception. It is most commonly seen in ICU settings (ICU psychosis) due to
factors like sleep deprivation, sensory overload/deprivation, and metabolic
disturbances. Options A and C could be indicative of other conditions like
dementia or aphasia but do not specifically point to the hallmark features of
delirium.
A patient with dementia has cognitive deficits manifested by which conditions?
A. Amnesia, aphagia, apraxia, agnosia
B. Amnesia, aphasia, apraxia, analgesia
,C. Amnesia, aphasia, apraxia, agnosia
D. Amnesia, abstract thinking, apraxia, aphasia
Correct Answer: C. Amnesia, aphasia, apraxia, agnosia
Rationale: The "4 A's" of dementia represent the core cognitive deficits: Amnesia
(memory loss), Aphasia (language disturbance), Apraxia (inability to perform
motor tasks despite intact motor function), and Agnosia (inability to recognize
objects or people). Abstract thinking is also commonly impaired, but not part of
the classic 4 A's framework. Aphagia (inability to swallow) and analgesia (absence
of pain) are not cognitive deficits associated with dementia.
A patient showing signs of agnosia and apraxia would most look like:
A. Have difficulty remembering what they were going to do
B. Have difficulty speaking and swallowing
C. Have difficulty knowing what utensils to use to eat and have difficulty speaking
D. Have difficulty knowing what utensils to use to eat and unable to easily pick up
the utensils
Correct Answer: D. Have difficulty knowing what utensils to use to eat and unable
to easily pick up the utensils
Rationale: Agnosia is the inability to recognize familiar objects, people, or sounds.
The patient would not know what a utensil is for. Apraxia is the inability to
perform learned motor movements, despite having the physical ability. The
patient would be unable to use the utensil properly. Option A describes memory
,loss (amnesia), and Option B describes aspects of aphasia (speech) and dysphagia
(swallowing), not agnosia/apraxia.
Depression in older adults can be seen with all of the following EXCEPT:
A. Sleeping in until noon
B. Anxiety & irritability
C. Unexplained aches & pains
D. Neglecting personal care
Correct Answer: A. Sleeping in until noon
Rationale: While hypersomnia (excessive sleeping) can be a sign of depression in
younger adults, older adults more often present with less typical symptoms. These
include anxiety, irritability, unexplained somatic complaints (aches and pains), and
neglect of personal care (hygiene, nutrition). Sleeping until noon is more
characteristic of depression in younger populations, not the classic presentation in
older adults.
All of the following brain changes are seen in the development of Alzheimer's
EXCEPT:
A. Amyloid plaques & neurofibrillary tangles
B. Dysfunction & gliosis of neuronal cells in the frontal and temporal lobes
C. Reduction in neurotransmitters like acetylcholine
D. Reduction in brain size & weight
, Correct Answer: B. Dysfunction & gliosis of neuronal cells in the frontal and
temporal lobes
Rationale: The hallmark pathological changes in Alzheimer's disease (AD) are
amyloid plaques and neurofibrillary tangles, a reduction in neurotransmitters
(especially acetylcholine), and generalized brain atrophy (reduced size/weight).
Dysfunction and gliosis (inflammation) of neuronal cells specifically in the frontal
and temporal lobes is a characteristic finding of frontotemporal dementia (FTD),
not AD.
What would you expect from a patient who is in the moderate stage of
Alzheimer's?
A. MMSE score > 21
B. Having difficulty meal planning and managing their finances
C. Needing 24-hour care and full assistance with ADL's
D. Experiencing incontinence with a MMSE score of 14
Correct Answer: D. Experiencing incontinence with a MMSE score of 14
Rationale: The moderate stage of Alzheimer's is characterized by a Mini-Mental
State Exam (MMSE) score of 10-20. A score of 14 falls within this range.
Incontinence often begins around this stage. Option A (MMSE >21) is mild stage.
Option B describes difficulty with instrumental ADLs (IADLs), which is seen in early
stages. Option C (24-hour care, full ADL assistance) is characteristic of the severe
stage.
Answers with Rationale | New Update 2026/27 |
Graded A+
Which patient is exhibiting signs of delirium?
A. A patient at home unable to solve a puzzle
B. A patient in the ICU acting erratic and drowsy
C. A patient in an assisted living facility having difficulty speaking
Correct Answer: B. A patient in the ICU acting erratic and drowsy
Rationale: Delirium is characterized by an acute, fluctuating disturbance in
consciousness, attention, and cognition. The key features include erratic lucidity
and somnolence (drowsiness), along with disturbances in behavior, orientation,
and perception. It is most commonly seen in ICU settings (ICU psychosis) due to
factors like sleep deprivation, sensory overload/deprivation, and metabolic
disturbances. Options A and C could be indicative of other conditions like
dementia or aphasia but do not specifically point to the hallmark features of
delirium.
A patient with dementia has cognitive deficits manifested by which conditions?
A. Amnesia, aphagia, apraxia, agnosia
B. Amnesia, aphasia, apraxia, analgesia
,C. Amnesia, aphasia, apraxia, agnosia
D. Amnesia, abstract thinking, apraxia, aphasia
Correct Answer: C. Amnesia, aphasia, apraxia, agnosia
Rationale: The "4 A's" of dementia represent the core cognitive deficits: Amnesia
(memory loss), Aphasia (language disturbance), Apraxia (inability to perform
motor tasks despite intact motor function), and Agnosia (inability to recognize
objects or people). Abstract thinking is also commonly impaired, but not part of
the classic 4 A's framework. Aphagia (inability to swallow) and analgesia (absence
of pain) are not cognitive deficits associated with dementia.
A patient showing signs of agnosia and apraxia would most look like:
A. Have difficulty remembering what they were going to do
B. Have difficulty speaking and swallowing
C. Have difficulty knowing what utensils to use to eat and have difficulty speaking
D. Have difficulty knowing what utensils to use to eat and unable to easily pick up
the utensils
Correct Answer: D. Have difficulty knowing what utensils to use to eat and unable
to easily pick up the utensils
Rationale: Agnosia is the inability to recognize familiar objects, people, or sounds.
The patient would not know what a utensil is for. Apraxia is the inability to
perform learned motor movements, despite having the physical ability. The
patient would be unable to use the utensil properly. Option A describes memory
,loss (amnesia), and Option B describes aspects of aphasia (speech) and dysphagia
(swallowing), not agnosia/apraxia.
Depression in older adults can be seen with all of the following EXCEPT:
A. Sleeping in until noon
B. Anxiety & irritability
C. Unexplained aches & pains
D. Neglecting personal care
Correct Answer: A. Sleeping in until noon
Rationale: While hypersomnia (excessive sleeping) can be a sign of depression in
younger adults, older adults more often present with less typical symptoms. These
include anxiety, irritability, unexplained somatic complaints (aches and pains), and
neglect of personal care (hygiene, nutrition). Sleeping until noon is more
characteristic of depression in younger populations, not the classic presentation in
older adults.
All of the following brain changes are seen in the development of Alzheimer's
EXCEPT:
A. Amyloid plaques & neurofibrillary tangles
B. Dysfunction & gliosis of neuronal cells in the frontal and temporal lobes
C. Reduction in neurotransmitters like acetylcholine
D. Reduction in brain size & weight
, Correct Answer: B. Dysfunction & gliosis of neuronal cells in the frontal and
temporal lobes
Rationale: The hallmark pathological changes in Alzheimer's disease (AD) are
amyloid plaques and neurofibrillary tangles, a reduction in neurotransmitters
(especially acetylcholine), and generalized brain atrophy (reduced size/weight).
Dysfunction and gliosis (inflammation) of neuronal cells specifically in the frontal
and temporal lobes is a characteristic finding of frontotemporal dementia (FTD),
not AD.
What would you expect from a patient who is in the moderate stage of
Alzheimer's?
A. MMSE score > 21
B. Having difficulty meal planning and managing their finances
C. Needing 24-hour care and full assistance with ADL's
D. Experiencing incontinence with a MMSE score of 14
Correct Answer: D. Experiencing incontinence with a MMSE score of 14
Rationale: The moderate stage of Alzheimer's is characterized by a Mini-Mental
State Exam (MMSE) score of 10-20. A score of 14 falls within this range.
Incontinence often begins around this stage. Option A (MMSE >21) is mild stage.
Option B describes difficulty with instrumental ADLs (IADLs), which is seen in early
stages. Option C (24-hour care, full ADL assistance) is characteristic of the severe
stage.
