NUR 2214 Week 4 Quiz V3 | NUR 2214
Nursing Care of the Older Adult | Actual
Q&A with Rationale (NUR2214 Week 4
Quiz) | Rasmussen University
1. A nurse is assessing an 82-year-old client who has suddenly become confused, agitated,
and is hallucinating. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Rationale: Delirium is characterized by an acute onset of confusion and changes in
cognition that often include hallucinations or agitation. Unlike dementia, which is a slow,
progressive decline, delirium is often reversible once the underlying cause, such as an
infection or medication reaction, is treated. It is considered a medical emergency in the
geriatric population.
2. When distinguishing between dementia and depression in an older adult, which finding is
more characteristic of depression (pseudodementia)?
A. Rapid onset of symptoms and ‘I don’t know’ answers to questions
,B. Slow, insidious decline in short-term memory
C. Consistently poor performance on cognitive tasks
D. Attempts to hide cognitive deficits from others
Answer: A
Rationale: Depression in older adults can mimic dementia, a condition often called
pseudodementia. Clients with depression typically complain of memory loss and frequently
respond with ‘I don’t know’ during assessments, whereas those with dementia often try to
cover up their deficits. The onset of depression-related cognitive impairment is usually
more rapid than the progression of true dementia.
3. Which medication should the nurse identify as a ‘potentially inappropriate medication’ for
an older adult according to the Beers Criteria?
A. Acetaminophen
B. Lisinopril
C. Diphenhydramine
D. Metformin
Answer: C
Rationale: Diphenhydramine is an anticholinergic medication that significantly increases
the risk of falls, confusion, and urinary retention in older adults. The Beers Criteria advises
, avoiding its use in this population due to these high risks. Nurses should always screen for
over-the-counter sleep aids or allergy medications containing this ingredient.
4. A client with moderate-stage Alzheimer’s disease becomes increasingly restless and
agitated in the late afternoon. Which intervention is most appropriate?
A. Administer a PRN dose of a sedative
B. Insist the client stay in their room until morning
C. Place the client in physical restraints for safety
D. Reduce environmental stimuli and provide a quiet activity
Answer: D
Rationale: This behavior, known as sundowning, is common in patients with dementia and
occurs late in the day. The nurse should first attempt non-pharmacological interventions
like reducing noise, dimming lights, and engaging the client in calming activities. Sedatives
and restraints should be avoided as they often exacerbate confusion and increase fall risks.
5. The nurse is using the Confusion Assessment Method (CAM) tool. What is the primary
purpose of this tool?
A. To stage the severity of Alzheimer’s disease
B. To screen for geriatric depression
C. To identify the presence of delirium
D. To assess for risk of elder abuse
Nursing Care of the Older Adult | Actual
Q&A with Rationale (NUR2214 Week 4
Quiz) | Rasmussen University
1. A nurse is assessing an 82-year-old client who has suddenly become confused, agitated,
and is hallucinating. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Delirium
C. Major Depressive Disorder
D. Vascular Dementia
Answer: B
Rationale: Delirium is characterized by an acute onset of confusion and changes in
cognition that often include hallucinations or agitation. Unlike dementia, which is a slow,
progressive decline, delirium is often reversible once the underlying cause, such as an
infection or medication reaction, is treated. It is considered a medical emergency in the
geriatric population.
2. When distinguishing between dementia and depression in an older adult, which finding is
more characteristic of depression (pseudodementia)?
A. Rapid onset of symptoms and ‘I don’t know’ answers to questions
,B. Slow, insidious decline in short-term memory
C. Consistently poor performance on cognitive tasks
D. Attempts to hide cognitive deficits from others
Answer: A
Rationale: Depression in older adults can mimic dementia, a condition often called
pseudodementia. Clients with depression typically complain of memory loss and frequently
respond with ‘I don’t know’ during assessments, whereas those with dementia often try to
cover up their deficits. The onset of depression-related cognitive impairment is usually
more rapid than the progression of true dementia.
3. Which medication should the nurse identify as a ‘potentially inappropriate medication’ for
an older adult according to the Beers Criteria?
A. Acetaminophen
B. Lisinopril
C. Diphenhydramine
D. Metformin
Answer: C
Rationale: Diphenhydramine is an anticholinergic medication that significantly increases
the risk of falls, confusion, and urinary retention in older adults. The Beers Criteria advises
, avoiding its use in this population due to these high risks. Nurses should always screen for
over-the-counter sleep aids or allergy medications containing this ingredient.
4. A client with moderate-stage Alzheimer’s disease becomes increasingly restless and
agitated in the late afternoon. Which intervention is most appropriate?
A. Administer a PRN dose of a sedative
B. Insist the client stay in their room until morning
C. Place the client in physical restraints for safety
D. Reduce environmental stimuli and provide a quiet activity
Answer: D
Rationale: This behavior, known as sundowning, is common in patients with dementia and
occurs late in the day. The nurse should first attempt non-pharmacological interventions
like reducing noise, dimming lights, and engaging the client in calming activities. Sedatives
and restraints should be avoided as they often exacerbate confusion and increase fall risks.
5. The nurse is using the Confusion Assessment Method (CAM) tool. What is the primary
purpose of this tool?
A. To stage the severity of Alzheimer’s disease
B. To screen for geriatric depression
C. To identify the presence of delirium
D. To assess for risk of elder abuse
