,NURS 6501 Final Exam Advanced PMHNP Care of Adults & Older
Adults Questions And Answers | 2026/2027 Capella University
Q1. Which component is essential when performing a
comprehensive psychiatric evaluation of an older adult?
A) Mental status examination, psychiatric history, medical history,
medication review, functional assessment, and collateral information when
appropriate
B) Psychiatric diagnosis based only on the chief complaint
C) Medication selection before completing the history
D) Assessment limited to current mood symptoms
Correct Answer: A) Mental status examination, psychiatric history, medical
history, medication review, functional assessment, and collateral information
when appropriate
Rationale: Older adults frequently have medical comorbidities,
polypharmacy, sensory changes, and functional concerns that affect
psychiatric presentation. A comprehensive evaluation integrates psychiatric,
medical, cognitive, medication, functional, and psychosocial information.
Q2. Which finding most strongly suggests delirium rather than a
chronic neurocognitive disorder?
A) Gradual memory decline over several years
B) Stable difficulty managing finances
C) Acute fluctuating attention and awareness
D) Longstanding word-finding difficulty
Correct Answer: C) Acute fluctuating attention and awareness
Rationale: Delirium is characterized by an acute disturbance in attention
and awareness with fluctuating severity. Dementia and other major
neurocognitive disorders generally develop more gradually and have a more
persistent course.
Q3. Which factor can make diagnosis of depression more difficult in
older adults?
A) Depression never occurs with cognitive symptoms.
B) Physical and cognitive complaints may predominate rather than an
explicit report of sadness.
C) Older adults cannot describe emotional symptoms.
D) Depression always presents with psychosis in older adults.
,Correct Answer: B) Physical and cognitive complaints may predominate
rather than an explicit report of sadness.
Rationale: Older adults may present with fatigue, sleep disturbance,
appetite changes, cognitive complaints, reduced activity, or somatic
symptoms rather than directly reporting depressed mood.
Q4. Which strategy best improves the accuracy of a psychiatric
medication history?
A) Review only medications prescribed by psychiatric providers.
B) Ask the patient to identify all prescription drugs, OTC products,
supplements, and actual dosing practices.
C) Rely only on the electronic medication list.
D) Ignore medications prescribed by other clinicians.
Correct Answer: B) Ask the patient to identify all prescription drugs, OTC
products, supplements, and actual dosing practices.
Rationale: Medication reconciliation should identify what the patient
actually takes, not just what the medical record lists. This helps detect
interactions, adverse effects, duplication, and adherence problems.
Q5. Which finding should prompt assessment for possible
medication-induced psychiatric symptoms?
A) New confusion after several medications were added
B) Stable depression predating all medications
C) Longstanding anxiety without medication changes
D) Chronic insomnia present since adolescence
Correct Answer: A) New confusion after several medications were added
Rationale: New psychiatric or cognitive symptoms after medication
initiation or dose escalation can represent adverse effects, interactions,
toxicity, or withdrawal. Medication timing should therefore be incorporated
into the differential diagnosis.
Q6. Which statement best describes the importance of collateral
information in older-adult psychiatric assessment?
A) It replaces the patient's account.
B) It is unnecessary when cognitive impairment is suspected.
C) It can help establish baseline functioning and identify changes that the
, patient may not recognize.
D) It should always be obtained without the patient's knowledge.
Correct Answer: C) It can help establish baseline functioning and identify
changes that the patient may not recognize.
Rationale: Family or caregiver information can help clarify cognitive and
functional decline, medication use, behavioral changes, and safety concerns.
It should complement, not automatically replace, direct patient assessment.
Q7. Which question best evaluates an older adult's functional
status?
A) "What is your favorite television program?"
B) "Have you had difficulty bathing, managing medications, preparing meals,
or paying bills?"
C) "Do you prefer morning appointments?"
D) "How many siblings do you have?"
Correct Answer: B) "Have you had difficulty bathing, managing medications,
preparing meals, or paying bills?"
Rationale: Activities of daily living and instrumental activities of daily living
provide important information about independence, cognition, mobility, and
safety.
Q8. Which factor should be considered before attributing new
confusion to dementia?
A) Possible infection, medication effects, metabolic problems, and delirium
B) The patient's chronological age alone
C) Family history alone
D) The patient's educational level alone
Correct Answer: A) Possible infection, medication effects, metabolic
problems, and delirium
Rationale: New confusion can have many reversible causes. Delirium,
medication toxicity, infection, metabolic abnormalities, and other medical
problems should be evaluated before assuming progressive neurocognitive
disease.
Q9. Which approach is most appropriate when an older adult has
hearing impairment during a psychiatric interview?
Adults Questions And Answers | 2026/2027 Capella University
Q1. Which component is essential when performing a
comprehensive psychiatric evaluation of an older adult?
A) Mental status examination, psychiatric history, medical history,
medication review, functional assessment, and collateral information when
appropriate
B) Psychiatric diagnosis based only on the chief complaint
C) Medication selection before completing the history
D) Assessment limited to current mood symptoms
Correct Answer: A) Mental status examination, psychiatric history, medical
history, medication review, functional assessment, and collateral information
when appropriate
Rationale: Older adults frequently have medical comorbidities,
polypharmacy, sensory changes, and functional concerns that affect
psychiatric presentation. A comprehensive evaluation integrates psychiatric,
medical, cognitive, medication, functional, and psychosocial information.
Q2. Which finding most strongly suggests delirium rather than a
chronic neurocognitive disorder?
A) Gradual memory decline over several years
B) Stable difficulty managing finances
C) Acute fluctuating attention and awareness
D) Longstanding word-finding difficulty
Correct Answer: C) Acute fluctuating attention and awareness
Rationale: Delirium is characterized by an acute disturbance in attention
and awareness with fluctuating severity. Dementia and other major
neurocognitive disorders generally develop more gradually and have a more
persistent course.
Q3. Which factor can make diagnosis of depression more difficult in
older adults?
A) Depression never occurs with cognitive symptoms.
B) Physical and cognitive complaints may predominate rather than an
explicit report of sadness.
C) Older adults cannot describe emotional symptoms.
D) Depression always presents with psychosis in older adults.
,Correct Answer: B) Physical and cognitive complaints may predominate
rather than an explicit report of sadness.
Rationale: Older adults may present with fatigue, sleep disturbance,
appetite changes, cognitive complaints, reduced activity, or somatic
symptoms rather than directly reporting depressed mood.
Q4. Which strategy best improves the accuracy of a psychiatric
medication history?
A) Review only medications prescribed by psychiatric providers.
B) Ask the patient to identify all prescription drugs, OTC products,
supplements, and actual dosing practices.
C) Rely only on the electronic medication list.
D) Ignore medications prescribed by other clinicians.
Correct Answer: B) Ask the patient to identify all prescription drugs, OTC
products, supplements, and actual dosing practices.
Rationale: Medication reconciliation should identify what the patient
actually takes, not just what the medical record lists. This helps detect
interactions, adverse effects, duplication, and adherence problems.
Q5. Which finding should prompt assessment for possible
medication-induced psychiatric symptoms?
A) New confusion after several medications were added
B) Stable depression predating all medications
C) Longstanding anxiety without medication changes
D) Chronic insomnia present since adolescence
Correct Answer: A) New confusion after several medications were added
Rationale: New psychiatric or cognitive symptoms after medication
initiation or dose escalation can represent adverse effects, interactions,
toxicity, or withdrawal. Medication timing should therefore be incorporated
into the differential diagnosis.
Q6. Which statement best describes the importance of collateral
information in older-adult psychiatric assessment?
A) It replaces the patient's account.
B) It is unnecessary when cognitive impairment is suspected.
C) It can help establish baseline functioning and identify changes that the
, patient may not recognize.
D) It should always be obtained without the patient's knowledge.
Correct Answer: C) It can help establish baseline functioning and identify
changes that the patient may not recognize.
Rationale: Family or caregiver information can help clarify cognitive and
functional decline, medication use, behavioral changes, and safety concerns.
It should complement, not automatically replace, direct patient assessment.
Q7. Which question best evaluates an older adult's functional
status?
A) "What is your favorite television program?"
B) "Have you had difficulty bathing, managing medications, preparing meals,
or paying bills?"
C) "Do you prefer morning appointments?"
D) "How many siblings do you have?"
Correct Answer: B) "Have you had difficulty bathing, managing medications,
preparing meals, or paying bills?"
Rationale: Activities of daily living and instrumental activities of daily living
provide important information about independence, cognition, mobility, and
safety.
Q8. Which factor should be considered before attributing new
confusion to dementia?
A) Possible infection, medication effects, metabolic problems, and delirium
B) The patient's chronological age alone
C) Family history alone
D) The patient's educational level alone
Correct Answer: A) Possible infection, medication effects, metabolic
problems, and delirium
Rationale: New confusion can have many reversible causes. Delirium,
medication toxicity, infection, metabolic abnormalities, and other medical
problems should be evaluated before assuming progressive neurocognitive
disease.
Q9. Which approach is most appropriate when an older adult has
hearing impairment during a psychiatric interview?
