,NUR 255 Exam 4 | Concepts of Aging, Chronic &
Mental Health (2026/2027) PDF | Nursing | Galen
1. An older adult client presents with acute confusion and fluctuating attention.
Which condition is most likely?
A) Delirium
B) Alzheimer's disease
C) Depression
D) Dementia
Correct Answer: A) Delirium
Rationale: Delirium has an acute onset and fluctuating course, often caused by
an underlying medical condition. Alzheimer's disease and dementia are gradual
and progressive. Depression can cause cognitive changes but not acute
fluctuating confusion.
2. The nurse is assessing a client for depression using a tool designed for older
adults. Which tool is appropriate?
A) Beck Depression Inventory
B) Geriatric Depression Scale
C) Hamilton Depression Rating Scale
D) Patient Health Questionnaire-9
Correct Answer: B) Geriatric Depression Scale
,Rationale: The Geriatric Depression Scale is validated for older adults and
addresses symptoms common in this population. The other tools are used in
broader populations but are not specific to geriatric clients.
3. A client with Parkinson's disease is prescribed levodopa/carbidopa. Which
instruction should the nurse include?
A) Take with a high-protein meal
B) This medication may cause drowsiness
C) Avoid taking with vitamin B6
D) You can stop if you feel better
Correct Answer: C) Avoid taking with vitamin B6
Rationale: Vitamin B6 reduces levodopa effectiveness. High-protein meals
interfere with absorption, the drug should not be stopped abruptly, and
drowsiness is not a common effect.
4. A client with heart failure is prescribed furosemide. Which finding indicates
effectiveness?
A) Decreased blood pressure
B) Increased urine output
C) Decreased heart rate
D) Increased respiratory rate
Correct Answer: D) Increased urine output
, Rationale: Furosemide removes excess fluid, so increased urine output indicates
effectiveness. Decreased blood pressure may occur but is not the primary
indicator.
5. A client with COPD has ABG results: pH 7.30, PaCO2 55 mm Hg, HCO3 26
mEq/L. How should the nurse interpret these results?
A) Respiratory acidosis
B) Metabolic acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: A) Respiratory acidosis
Rationale: Low pH and high PaCO2 indicate respiratory acidosis. The normal
bicarbonate shows no metabolic compensation.
6. A client with diabetes is prescribed insulin lispro. When should the client eat?
A) Immediately before injection
B) Within 15 minutes of injection
C) 30 minutes after injection
D) 1 hour after injection
Correct Answer: B) Within 15 minutes of injection
Rationale: Lispro has onset about 15 minutes, so the client must eat within that
time to prevent hypoglycemia.
Mental Health (2026/2027) PDF | Nursing | Galen
1. An older adult client presents with acute confusion and fluctuating attention.
Which condition is most likely?
A) Delirium
B) Alzheimer's disease
C) Depression
D) Dementia
Correct Answer: A) Delirium
Rationale: Delirium has an acute onset and fluctuating course, often caused by
an underlying medical condition. Alzheimer's disease and dementia are gradual
and progressive. Depression can cause cognitive changes but not acute
fluctuating confusion.
2. The nurse is assessing a client for depression using a tool designed for older
adults. Which tool is appropriate?
A) Beck Depression Inventory
B) Geriatric Depression Scale
C) Hamilton Depression Rating Scale
D) Patient Health Questionnaire-9
Correct Answer: B) Geriatric Depression Scale
,Rationale: The Geriatric Depression Scale is validated for older adults and
addresses symptoms common in this population. The other tools are used in
broader populations but are not specific to geriatric clients.
3. A client with Parkinson's disease is prescribed levodopa/carbidopa. Which
instruction should the nurse include?
A) Take with a high-protein meal
B) This medication may cause drowsiness
C) Avoid taking with vitamin B6
D) You can stop if you feel better
Correct Answer: C) Avoid taking with vitamin B6
Rationale: Vitamin B6 reduces levodopa effectiveness. High-protein meals
interfere with absorption, the drug should not be stopped abruptly, and
drowsiness is not a common effect.
4. A client with heart failure is prescribed furosemide. Which finding indicates
effectiveness?
A) Decreased blood pressure
B) Increased urine output
C) Decreased heart rate
D) Increased respiratory rate
Correct Answer: D) Increased urine output
, Rationale: Furosemide removes excess fluid, so increased urine output indicates
effectiveness. Decreased blood pressure may occur but is not the primary
indicator.
5. A client with COPD has ABG results: pH 7.30, PaCO2 55 mm Hg, HCO3 26
mEq/L. How should the nurse interpret these results?
A) Respiratory acidosis
B) Metabolic acidosis
C) Metabolic alkalosis
D) Respiratory alkalosis
Correct Answer: A) Respiratory acidosis
Rationale: Low pH and high PaCO2 indicate respiratory acidosis. The normal
bicarbonate shows no metabolic compensation.
6. A client with diabetes is prescribed insulin lispro. When should the client eat?
A) Immediately before injection
B) Within 15 minutes of injection
C) 30 minutes after injection
D) 1 hour after injection
Correct Answer: B) Within 15 minutes of injection
Rationale: Lispro has onset about 15 minutes, so the client must eat within that
time to prevent hypoglycemia.
