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Dementia on the RCSI theory paper

Types of dementia, communication, person-centred care, responsive behaviours, capacity and safety.

22 multiple-choice questions, each with an explanation and the document it was checked against. Three questions are free; the pass opens the other 19 and every other topic. Wrong answers come back first the next time you practise, and a question counts as mastered after two correct answers in a row.

Sample questions from this topic

Question 1
A patient with dementia is admitted with a chest infection and is much more confused than her usual baseline. What should the nurse consider first?
1. AReferral for psychiatric assessment
2. BDelirium on dementia; screen with the 4AT
3. CAn inaccurate baseline from the family
4. DRapid progression of the dementia
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Answer: B. A sudden change from baseline in a person with dementia and an infection is most likely delirium superimposed on dementia. Screen with the 4AT, treat the infection and manage the delirium; dementia itself does not change over days.
Source: NICE CG103, 1.6.3
Question 2
A person with advanced dementia has stopped eating and drinking well. Which approach reflects person-centred, palliative-informed care?
1. AWithhold all food and fluids to avoid aspiration and chest infection
2. BCheck reversible causes, assist with preferred food and fluids
3. CInsert a nasogastric feeding tube as routine practice at this stage
4. DFeed at fixed meal times regardless of refusal
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Answer: B. NMBI Standard 4 asks for a palliative approach throughout a progressive illness, person-centred and guided by the person’s wishes, and its standards of quality list nutrition (including the use of feeding tubes) and hydration among the areas each service must have policy on. In practice that means: assess for reversible causes such as pain, mouth problems or constipation, offer preferred foods and fluids with assistance, and involve the family and team in goals of care. Careful hand feeding and comfort are the usual standard; artificial nutrition rarely benefits in advanced dementia (NICE NG97 1.10.6 to 1.10.8: encourage and support eating and drinking; do not routinely use enteral feeding in severe dementia).
Source: NMBI Working with Older People (2015), Standard 4 and standards of nursing quality (nutrition, hydration)
Question 3
A relative asks whether a person with dementia can still make decisions about their care. What is the correct answer under Irish law?
1. ANo; the diagnosis means decisions pass to the next of kin
2. BYes; capacity is presumed and assessed per decision
3. CYes, but a court order is needed for each decision
4. DNo; the treating doctor decides once dementia is diagnosed
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Answer: B. Assisted Decision-Making (Capacity) Act 2015: capacity is presumed and assessed decision by decision; the person is supported to decide, and only if they cannot do so even with support does a decision support arrangement apply. Dementia is not a blanket loss of capacity.
Source: HSE National Consent Policy (2024), Part One section 5

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Every fact was checked against the public document named on the answer. This topic draws on:

Dementia: RCSI aptitude test practice questions

Dementia on the RCSI theory paper

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