1
NCLEX PN Exam Bank Behavioral Management
in Dementia and Cognitive Decline
Table of Contents
Subtopic 1: Early Identification and Assessment of Cognitive Decline ............................... 2
Subtopic 2: Communication Strategies with Patients Experiencing Cognitive Decline ...... 10
Subtopic 3: Behavioral Symptoms and Non-Pharmacologic Interventions in Dementia .... 19
Subtopic 4: Pharmacologic Interventions and Medication Safety in Dementia Care ......... 28
Subtopic 5: Therapeutic Communication and Patient-Centered Language Techniques .... 36
Subtopic 6: Environmental Modifications and Sensory Stimulation Interventions ............ 45
Subtopic 7: Family Education, Support, and Caregiver Role in Dementia Management
(Questions 121–140) ................................................................................................... 53
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Subtopic 1: Early Identification and Assessment of
Cognitive Decline
(Questions 1–20)
Question 1
Which of the following is an early sign of Alzheimer’s disease?
A. Inability to walk without assistance
B. Frequently misplacing items and difficulty retracing steps
C. Loss of bladder control
D. Complete memory loss
Correct Answer: B. Frequently misplacing items and difficulty retracing steps
Rationale: In early Alzheimer's, individuals often misplace things and have trouble retracing
their steps. This differs from normal forgetfulness and is a key early sign.
Question 2
A nurse is assessing a patient suspected of early-stage dementia. What cognitive screening
tool is most commonly used?
A. Apgar Score
B. GAD-7
C. Mini-Mental State Examination (MMSE)
D. Morse Fall Scale
Correct Answer: C. Mini-Mental State Examination (MMSE)
Rationale: The MMSE is widely used to evaluate cognitive function and screen for
dementia. It assesses memory, attention, language, and orientation.
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Question 3
Which of the following patient statements indicates the need for further evaluation of
cognitive decline?
A. “I forgot where I put my keys but found them in my purse.”
B. “Sometimes I forget names, but they come back later.”
C. “I got lost driving to the grocery store I’ve gone to for years.”
D. “I once called my son by my brother’s name.”
Correct Answer: C. “I got lost driving to the grocery store I’ve gone to for years.”
Rationale: Getting lost in familiar places is a significant red flag indicating potential
cognitive impairment.
Question 4
Which vitamin deficiency can mimic dementia-like symptoms and should be ruled out
during assessment?
A. Vitamin C
B. Vitamin D
C. Vitamin B12
D. Vitamin K
Correct Answer: C. Vitamin B12
Rationale: Vitamin B12 deficiency can lead to symptoms such as memory loss and
confusion, often mistaken for dementia.
Question 5
What is the priority nursing intervention when a client scores low on the MMSE?
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A. Initiate full restraints
B. Provide sedatives
C. Notify the healthcare provider for further evaluation
D. Place in hospice care
Correct Answer: C. Notify the healthcare provider for further evaluation
Rationale: A low MMSE score warrants medical follow-up and possibly diagnostic imaging
to confirm dementia or rule out other causes.
Question 6
A patient’s family is concerned about increasing forgetfulness. What is the best nursing
action?
A. Reassure the family it’s just aging
B. Encourage formal cognitive screening
C. Suggest more rest
D. Recommend over-the-counter supplements
Correct Answer: B. Encourage formal cognitive screening
Rationale: Cognitive screening allows early detection and intervention. Dismissing
concerns can delay diagnosis and management.
Question 7
Which factor increases the risk of developing dementia?
A. Low cholesterol
B. History of traumatic brain injury (TBI)
C. Vegetarian diet
D. Daily exercise
NCLEX PN Exam Bank Behavioral Management
in Dementia and Cognitive Decline
Table of Contents
Subtopic 1: Early Identification and Assessment of Cognitive Decline ............................... 2
Subtopic 2: Communication Strategies with Patients Experiencing Cognitive Decline ...... 10
Subtopic 3: Behavioral Symptoms and Non-Pharmacologic Interventions in Dementia .... 19
Subtopic 4: Pharmacologic Interventions and Medication Safety in Dementia Care ......... 28
Subtopic 5: Therapeutic Communication and Patient-Centered Language Techniques .... 36
Subtopic 6: Environmental Modifications and Sensory Stimulation Interventions ............ 45
Subtopic 7: Family Education, Support, and Caregiver Role in Dementia Management
(Questions 121–140) ................................................................................................... 53
, 2
Subtopic 1: Early Identification and Assessment of
Cognitive Decline
(Questions 1–20)
Question 1
Which of the following is an early sign of Alzheimer’s disease?
A. Inability to walk without assistance
B. Frequently misplacing items and difficulty retracing steps
C. Loss of bladder control
D. Complete memory loss
Correct Answer: B. Frequently misplacing items and difficulty retracing steps
Rationale: In early Alzheimer's, individuals often misplace things and have trouble retracing
their steps. This differs from normal forgetfulness and is a key early sign.
Question 2
A nurse is assessing a patient suspected of early-stage dementia. What cognitive screening
tool is most commonly used?
A. Apgar Score
B. GAD-7
C. Mini-Mental State Examination (MMSE)
D. Morse Fall Scale
Correct Answer: C. Mini-Mental State Examination (MMSE)
Rationale: The MMSE is widely used to evaluate cognitive function and screen for
dementia. It assesses memory, attention, language, and orientation.
, 3
Question 3
Which of the following patient statements indicates the need for further evaluation of
cognitive decline?
A. “I forgot where I put my keys but found them in my purse.”
B. “Sometimes I forget names, but they come back later.”
C. “I got lost driving to the grocery store I’ve gone to for years.”
D. “I once called my son by my brother’s name.”
Correct Answer: C. “I got lost driving to the grocery store I’ve gone to for years.”
Rationale: Getting lost in familiar places is a significant red flag indicating potential
cognitive impairment.
Question 4
Which vitamin deficiency can mimic dementia-like symptoms and should be ruled out
during assessment?
A. Vitamin C
B. Vitamin D
C. Vitamin B12
D. Vitamin K
Correct Answer: C. Vitamin B12
Rationale: Vitamin B12 deficiency can lead to symptoms such as memory loss and
confusion, often mistaken for dementia.
Question 5
What is the priority nursing intervention when a client scores low on the MMSE?
, 4
A. Initiate full restraints
B. Provide sedatives
C. Notify the healthcare provider for further evaluation
D. Place in hospice care
Correct Answer: C. Notify the healthcare provider for further evaluation
Rationale: A low MMSE score warrants medical follow-up and possibly diagnostic imaging
to confirm dementia or rule out other causes.
Question 6
A patient’s family is concerned about increasing forgetfulness. What is the best nursing
action?
A. Reassure the family it’s just aging
B. Encourage formal cognitive screening
C. Suggest more rest
D. Recommend over-the-counter supplements
Correct Answer: B. Encourage formal cognitive screening
Rationale: Cognitive screening allows early detection and intervention. Dismissing
concerns can delay diagnosis and management.
Question 7
Which factor increases the risk of developing dementia?
A. Low cholesterol
B. History of traumatic brain injury (TBI)
C. Vegetarian diet
D. Daily exercise
