RASMUSSEN UNIVERSITY NUR 2459
Mental and
Behavioral Health S ECTIONS
Nursing Neurocognitive (12)
Exam 2
Comprehensive examination covering neurocognitive
disorders, schizophrenia spectrum disorders, mood
Schizophrenia (12)
Mood Disorders (10)
disorders, psychopharmacology, therapeutic Psychopharmacology (12)
communication, and integrated clinical scenarios aligned Communication (8)
with 2026-2027 Rasmussen University NUR 2459 Integrated NGN (6)
curriculum.
60 Questions with Verified Answers
All Correct & A+ Graded Rationales
2026-2027 Rasmussen Curriculum Aligned
R A S M US S EN UN I V ER S I T Y S CHO O L O F N UR S I N G CER T I FI CAT I O N
EX A M I N AT I O N
,Section 1: Neurocognitive Disorders (Q1-Q12)
Q1: A nurse is assessing a 72-year-old client who is being evaluated for possible Alzheimer's disease. The
client's family reports that the client forgets recent conversations but can recall events from 20 years ago
in vivid detail. Which stage of Alzheimer's disease does this presentation most closely correspond to?
A. Stage 1: No apparent symptoms
B. Stage 2: Forgetfulness with short-term memory loss [CORRECT]
C. Stage 4: Mild to moderate decline with confabulation
D. Stage 6: Moderate to severe decline with incontinence
Correct Answer: B
Rationale: Stage 2 of Alzheimer's disease is characterized by subjective memory complaints, particularly losses in short-term
memory such as forgetting names and recent events, while long-term memory remains relatively intact. This distinguishes it
from Stage 4, where confabulation occurs, and Stage 6, where incontinence and severe disorientation are present.
Q2: A client with Alzheimer's disease is brought to the clinic by their daughter. The nurse observes that
the client fills in memory gaps with fabricated stories about recent events. The daughter reports the client
forgets significant recent events but remains oriented to their own identity. Which stage of Alzheimer's
disease is this client most likely experiencing?
A. Stage 3: Mild cognitive decline
B. Stage 4: Mild to moderate decline with confabulation [CORRECT]
C. Stage 5: Moderate decline with ADL dependence
D. Stage 7: Severe decline with aphasia
Correct Answer: B
Rationale: Confabulation, defined as creating imaginary events to fill memory gaps, is a hallmark of Stage 4 Alzheimer's
disease. At this stage, the client forgets significant events but maintains awareness of their own identity, differentiating it from
Stage 5 (ADL dependence) and Stage 7 (aphasia and inability to recognize family).
Q3: A nurse is caring for a client in Stage 6 of Alzheimer's disease. Which of the following manifestations
would the nurse expect to observe?
A. Occasional word-finding difficulty and mild forgetfulness noticeable to family
B. Disorientation to day, season, and year; inability to manage ADLs without assistance; urinary and fecal
incontinence; and wandering with agitation [CORRECT]
C. Complete inability to recognize family members, being bedfast, and development of decubiti
D. No apparent symptoms with normal cognitive function on clinical assessment
Correct Answer: B
Rationale: Stage 6 of Alzheimer's disease is characterized by moderate to severe decline including disorientation to
surroundings (day, season, year), inability to manage ADLs without assistance, urinary and fecal incontinence, wandering,
agitation, aggression, and sundowning (symptoms worsening in late afternoon and evening).
Q4: A nurse is developing a short-term goal for a client with early-stage Alzheimer's disease who has been
experiencing weight loss. Which short-term goal is most appropriate for this client?
A. The client will demonstrate improved short-term memory within 1 week
B. The client will maintain adequate nutritional intake by completing at least 75% of each meal within 3
days [CORRECT]
, C. The client will independently perform all ADLs within 2 weeks
D. The client will verbalize understanding of their diagnosis within 1 day
Correct Answer: B
Rationale: For clients with Alzheimer's disease, short-term goals should focus on manageable, functional outcomes. Nutritional
intake is a priority short-term goal because weight loss and feeding difficulties are common. Goals focused on memory
improvement are unrealistic given the progressive nature of the disease.
Q5: A nurse is providing education to the family of a client newly diagnosed with Alzheimer's disease.
Which physiological changes should the nurse explain as underlying the client's symptoms?
A. Increased dopamine production in the substantia nigra and depletion of serotonin
B. Brain atrophy with an overabundance of amyloid beta plaques and tau protein tangles [CORRECT]
C. Hyperactivity of the hippocampus and excessive neurogenesis in the cerebral cortex
D. Inflammation of the meninges and increased cerebrospinal fluid pressure
Correct Answer: B
Rationale: The primary pathological changes in Alzheimer's disease include brain atrophy, an overabundance of amyloid beta
plaques that disrupt neuronal communication, and neurofibrillary tangles composed of hyperphosphorylated tau protein that
impair intracellular transport. These changes lead to progressive neuronal death and cognitive decline.
Q6: An 80-year-old client is admitted to the hospital with acute confusion, fluctuating level of
consciousness, and inattention that developed over the past 24 hours. The client has a history of mild
dementia. The nurse recognizes that this presentation is most consistent with which condition?
A. Worsening of the underlying dementia
B. Delirium superimposed on dementia [CORRECT]
C. New-onset Alzheimer's disease
D. Schizophrenia with late-onset presentation
Correct Answer: B
Rationale: Delirium is characterized by acute onset, fluctuating course, and inattention, distinguishing it from dementia which is
chronic and progressive. The key differentiator here is the acute 24-hour onset and fluctuating consciousness. Delirium is
potentially reversible, whereas dementia is not. A client with preexisting dementia is at heightened risk for delirium.
Q7: A nurse is caring for a client with Alzheimer's disease who exhibits increased agitation, pacing, and
confusion beginning in the late afternoon and continuing into the evening. The nurse documents this
behavior using which term?
A. Confabulation
B. Sundowning [CORRECT]
C. Delirium
D. Echolalia
Correct Answer: B
Rationale: Sundowning refers to the phenomenon where symptoms of Alzheimer's disease worsen in the late afternoon and
evening hours. It is characterized by increased agitation, confusion, pacing, and restlessness. This is distinct from confabulation
(creating false memories) and delirium (acute confusional state).
Q8: A nurse is conducting a mental status examination on a client suspected of having delirium. Which
finding would most strongly support a diagnosis of delirium rather than dementia?
A. Gradual onset of memory impairment over 6 months
B. Acute onset with fluctuating level of consciousness and inattention [CORRECT]
Mental and
Behavioral Health S ECTIONS
Nursing Neurocognitive (12)
Exam 2
Comprehensive examination covering neurocognitive
disorders, schizophrenia spectrum disorders, mood
Schizophrenia (12)
Mood Disorders (10)
disorders, psychopharmacology, therapeutic Psychopharmacology (12)
communication, and integrated clinical scenarios aligned Communication (8)
with 2026-2027 Rasmussen University NUR 2459 Integrated NGN (6)
curriculum.
60 Questions with Verified Answers
All Correct & A+ Graded Rationales
2026-2027 Rasmussen Curriculum Aligned
R A S M US S EN UN I V ER S I T Y S CHO O L O F N UR S I N G CER T I FI CAT I O N
EX A M I N AT I O N
,Section 1: Neurocognitive Disorders (Q1-Q12)
Q1: A nurse is assessing a 72-year-old client who is being evaluated for possible Alzheimer's disease. The
client's family reports that the client forgets recent conversations but can recall events from 20 years ago
in vivid detail. Which stage of Alzheimer's disease does this presentation most closely correspond to?
A. Stage 1: No apparent symptoms
B. Stage 2: Forgetfulness with short-term memory loss [CORRECT]
C. Stage 4: Mild to moderate decline with confabulation
D. Stage 6: Moderate to severe decline with incontinence
Correct Answer: B
Rationale: Stage 2 of Alzheimer's disease is characterized by subjective memory complaints, particularly losses in short-term
memory such as forgetting names and recent events, while long-term memory remains relatively intact. This distinguishes it
from Stage 4, where confabulation occurs, and Stage 6, where incontinence and severe disorientation are present.
Q2: A client with Alzheimer's disease is brought to the clinic by their daughter. The nurse observes that
the client fills in memory gaps with fabricated stories about recent events. The daughter reports the client
forgets significant recent events but remains oriented to their own identity. Which stage of Alzheimer's
disease is this client most likely experiencing?
A. Stage 3: Mild cognitive decline
B. Stage 4: Mild to moderate decline with confabulation [CORRECT]
C. Stage 5: Moderate decline with ADL dependence
D. Stage 7: Severe decline with aphasia
Correct Answer: B
Rationale: Confabulation, defined as creating imaginary events to fill memory gaps, is a hallmark of Stage 4 Alzheimer's
disease. At this stage, the client forgets significant events but maintains awareness of their own identity, differentiating it from
Stage 5 (ADL dependence) and Stage 7 (aphasia and inability to recognize family).
Q3: A nurse is caring for a client in Stage 6 of Alzheimer's disease. Which of the following manifestations
would the nurse expect to observe?
A. Occasional word-finding difficulty and mild forgetfulness noticeable to family
B. Disorientation to day, season, and year; inability to manage ADLs without assistance; urinary and fecal
incontinence; and wandering with agitation [CORRECT]
C. Complete inability to recognize family members, being bedfast, and development of decubiti
D. No apparent symptoms with normal cognitive function on clinical assessment
Correct Answer: B
Rationale: Stage 6 of Alzheimer's disease is characterized by moderate to severe decline including disorientation to
surroundings (day, season, year), inability to manage ADLs without assistance, urinary and fecal incontinence, wandering,
agitation, aggression, and sundowning (symptoms worsening in late afternoon and evening).
Q4: A nurse is developing a short-term goal for a client with early-stage Alzheimer's disease who has been
experiencing weight loss. Which short-term goal is most appropriate for this client?
A. The client will demonstrate improved short-term memory within 1 week
B. The client will maintain adequate nutritional intake by completing at least 75% of each meal within 3
days [CORRECT]
, C. The client will independently perform all ADLs within 2 weeks
D. The client will verbalize understanding of their diagnosis within 1 day
Correct Answer: B
Rationale: For clients with Alzheimer's disease, short-term goals should focus on manageable, functional outcomes. Nutritional
intake is a priority short-term goal because weight loss and feeding difficulties are common. Goals focused on memory
improvement are unrealistic given the progressive nature of the disease.
Q5: A nurse is providing education to the family of a client newly diagnosed with Alzheimer's disease.
Which physiological changes should the nurse explain as underlying the client's symptoms?
A. Increased dopamine production in the substantia nigra and depletion of serotonin
B. Brain atrophy with an overabundance of amyloid beta plaques and tau protein tangles [CORRECT]
C. Hyperactivity of the hippocampus and excessive neurogenesis in the cerebral cortex
D. Inflammation of the meninges and increased cerebrospinal fluid pressure
Correct Answer: B
Rationale: The primary pathological changes in Alzheimer's disease include brain atrophy, an overabundance of amyloid beta
plaques that disrupt neuronal communication, and neurofibrillary tangles composed of hyperphosphorylated tau protein that
impair intracellular transport. These changes lead to progressive neuronal death and cognitive decline.
Q6: An 80-year-old client is admitted to the hospital with acute confusion, fluctuating level of
consciousness, and inattention that developed over the past 24 hours. The client has a history of mild
dementia. The nurse recognizes that this presentation is most consistent with which condition?
A. Worsening of the underlying dementia
B. Delirium superimposed on dementia [CORRECT]
C. New-onset Alzheimer's disease
D. Schizophrenia with late-onset presentation
Correct Answer: B
Rationale: Delirium is characterized by acute onset, fluctuating course, and inattention, distinguishing it from dementia which is
chronic and progressive. The key differentiator here is the acute 24-hour onset and fluctuating consciousness. Delirium is
potentially reversible, whereas dementia is not. A client with preexisting dementia is at heightened risk for delirium.
Q7: A nurse is caring for a client with Alzheimer's disease who exhibits increased agitation, pacing, and
confusion beginning in the late afternoon and continuing into the evening. The nurse documents this
behavior using which term?
A. Confabulation
B. Sundowning [CORRECT]
C. Delirium
D. Echolalia
Correct Answer: B
Rationale: Sundowning refers to the phenomenon where symptoms of Alzheimer's disease worsen in the late afternoon and
evening hours. It is characterized by increased agitation, confusion, pacing, and restlessness. This is distinct from confabulation
(creating false memories) and delirium (acute confusional state).
Q8: A nurse is conducting a mental status examination on a client suspected of having delirium. Which
finding would most strongly support a diagnosis of delirium rather than dementia?
A. Gradual onset of memory impairment over 6 months
B. Acute onset with fluctuating level of consciousness and inattention [CORRECT]
