Question 1

Which of the following should the nurse use to assess a nonverbal older adult for delirium?

Accepted Answer

A)  Cranial nerves XI and XII 
B)  Confusion Assessment Method 
C)  MMSE-2 
D)  Controlled Word Association Test 
A)  Cranial nerves XI and XII 
B)  Confusion Assessment Method 
C)  MMSE-2 
D)  Controlled Word Association Test B

Question 2

An older woman is recovering from a bowel resection in the intensive care unit but remains intubated and on a mechanical ventilator.Which of the following should the nurse implement to help prevent delirium in this woman?

Accepted Answer

A)  Assess cognition with MMSE-2. 
B)  Provide uninterrupted periods of rest and sleep. 
C)  Maintain adequate sedation and pain management. 
D)  Cover the patient's eyes with protective ophthalmic ointment. 
A)  Assess cognition with MMSE-2. 
B)  Provide uninterrupted periods of rest and sleep. 
C)  Maintain adequate sedation and pain management. 
D)  Cover the patient's eyes with protective ophthalmic ointment. B

Question 3

The nurse recognizes which of the following displays may indicate hyperactive delirium?

Accepted Answer

A)  Lethargy 
B)  Withdrawn behavior 
C)  Nonpurposeful repetitive movements 
D)  Decreased psychoactive activity 
A)  Lethargy 
B)  Withdrawn behavior 
C)  Nonpurposeful repetitive movements 
D)  Decreased psychoactive activity C

Question 4

Which medication administered for delirium under a controlled environment can reduce the duration and severity of delirium for high-risk patients?

Accepted Answer

A)  Haloperidol (Haldol) 
B)  Thioridazine (Mellaril) 
C)  Fluphenazine (Prolixin) 
D)  Chlorpromazine (Thorazine) 
A)  Haloperidol (Haldol) 
B)  Thioridazine (Mellaril) 
C)  Fluphenazine (Prolixin) 
D)  Chlorpromazine (Thorazine)

Question 5

Which assessment parameter should the nurse use to differentiate between delirium and depression in an older adult?

Accepted Answer

A)  Orientation 
B)  Activity 
C)  Course over the morning hours 
D)  Psychomotor activity 
A)  Orientation 
B)  Activity 
C)  Course over the morning hours 
D)  Psychomotor activity

Question 6

Which of the following is(are)the risk factors for vascular dementia (VaD)after a stroke?

Accepted Answer

A)  Smoking 
B)  Male sex 
C)  Hypertension 
D)  Advancing age 
E)  Hyperlipidemia
F)African American 
A)  Smoking 
B)  Male sex 
C)  Hypertension 
D)  Advancing age 
E)  Hyperlipidemia
F)African American

Question 7

A definitive diagnosis of Alzheimer disease (AD)can be made by detecting or using which one of the following methods?

Accepted Answer

A)  Clinical observation of dementia 
B)  Inability to speak with relevance 
C)  Development of neurofibrillary tangles 
D)  Computed axial tomographic (CAT) scan 
A)  Clinical observation of dementia 
B)  Inability to speak with relevance 
C)  Development of neurofibrillary tangles 
D)  Computed axial tomographic (CAT) scan

Question 8

At 10 PM,an older male resident attempts to climb over the bedrails.Which intervention should the nurse implement first?

Accepted Answer

A)  Talk to the resident about his behavior. 
B)  Call the physician, and ask for a sedative. 
C)  Apply a vest restraint on the resident. 
D)  Get a companion to keep him in the bed. 
A)  Talk to the resident about his behavior. 
B)  Call the physician, and ask for a sedative. 
C)  Apply a vest restraint on the resident. 
D)  Get a companion to keep him in the bed.

Question 9

An older woman has a wound infection 5 days after a below-the-knee amputation brought about by diabetes mellitus.Which of the following is the nurse's priority intervention to prevent cognitive dysfunction and postoperative complications in this older adult?

Accepted Answer

A)  Remove invasive devices as soon as possible. 
B)  Minimize the administration of opioid analgesics. 
C)  Allow for self-care and independent activities. 
D)  Administer short-acting benzodiazepines as needed. 
A)  Remove invasive devices as soon as possible. 
B)  Minimize the administration of opioid analgesics. 
C)  Allow for self-care and independent activities. 
D)  Administer short-acting benzodiazepines as needed.

Question 10

Which of the following statements is true about cognitive impairments in older adults?

Accepted Answer

A)  Loss or interruption of sleep can lead to delirium. 
B)  Confusion is a normal and unavoidable consequence of aging. 
C)  Older patients who are agitated often have a lower cognitive status than those who are quietly sitting. 
D)  The Mini-Mental State Examination-2nd edition (MMSE-2) should be administered on admission to detect delirium. 
A)  Loss or interruption of sleep can lead to delirium. 
B)  Confusion is a normal and unavoidable consequence of aging. 
C)  Older patients who are agitated often have a lower cognitive status than those who are quietly sitting. 
D)  The Mini-Mental State Examination-2nd edition (MMSE-2) should be administered on admission to detect delirium.

Question 11

The nurse working in a long-term care facility completes her morning assessment on a new postoperative patient and notes a change in cognitive status from the previous day? The nurse recognizes which of the following as a precipitating factor for delirium?

Accepted Answer

A)  Major medical treatment 
B)  Poor sleep habits 
C)  Admission to long-term care 
D)  Pharmacological agents 
A)  Major medical treatment 
B)  Poor sleep habits 
C)  Admission to long-term care 
D)  Pharmacological agents

Question 12

The community health nurse is preparing for an educational session on AD for a group of seniors.Which modifiable risk factors should the nurse include?

Accepted Answer

A)  Family history 
B)  Sex 
C)  Smoking 
D)  Obesity 
A)  Family history 
B)  Sex 
C)  Smoking 
D)  Obesity

Question 13

Which of the following approaches to hygienic care is beneficial for a patient with dementia?

Accepted Answer

A)  Schedule the patient's full shower at 7 AM, three mornings every week. 
B)  Have a team give the bath with each member washing a different body area. 
C)  Wash the perineal region first to remove potentially infectious material. 
D)  Explain each step as you go, and keep the patient covered as much as possible while bathing. 
A)  Schedule the patient's full shower at 7 AM, three mornings every week. 
B)  Have a team give the bath with each member washing a different body area. 
C)  Wash the perineal region first to remove potentially infectious material. 
D)  Explain each step as you go, and keep the patient covered as much as possible while bathing.

Question 14

Which types of exercise programs are better for older adults with AD for improving mood and function?

Accepted Answer

A)  Balance 
B)  Walking 
C)  Self-paced 
D)  Endurance 
E)  Muscle strength
F)Lasting 16 weeks or longer 
A)  Balance 
B)  Walking 
C)  Self-paced 
D)  Endurance 
E)  Muscle strength
F)Lasting 16 weeks or longer

Question 15

A man who is 60 years of age and lives in the British Isles develops dementia.Which qualities of dementia does the nurse assess to prevent patient injury related to the type of dementia this man most likely has?

Accepted Answer

A)  Visual hallucinations 
B)  Unilateral tremors 
C)  Visuospatial problems 
D)  Clumsy movements 
A)  Visual hallucinations 
B)  Unilateral tremors 
C)  Visuospatial problems 
D)  Clumsy movements

Question 16

When differentiating the characteristics of depression,delirium,and dementia,the nurse recognized which of the following as an indicator of delirium?

Accepted Answer

A)  Sudden onset 
B)  Recent loss 
C)  Insidious 
D)  Life change 
A)  Sudden onset 
B)  Recent loss 
C)  Insidious 
D)  Life change

Exam 21: Cognitive Impairment

Which of the following should the nurse use to assess a nonverbal older adult for delirium?

An older woman is recovering from a bowel resection in the intensive care unit but remains intubated and on a mechanical ventilator.Which of the following should the nurse implement to help prevent delirium in this woman?

The nurse recognizes which of the following displays may indicate hyperactive delirium?

Which medication administered for delirium under a controlled environment can reduce the duration and severity of delirium for high-risk patients?

Which assessment parameter should the nurse use to differentiate between delirium and depression in an older adult?

Which of the following is(are)the risk factors for vascular dementia (VaD)after a stroke?

A definitive diagnosis of Alzheimer disease (AD)can be made by detecting or using which one of the following methods?

At 10 PM,an older male resident attempts to climb over the bedrails.Which intervention should the nurse implement first?

An older woman has a wound infection 5 days after a below-the-knee amputation brought about by diabetes mellitus.Which of the following is the nurse's priority intervention to prevent cognitive dysfunction and postoperative complications in this older adult?

Which of the following statements is true about cognitive impairments in older adults?

The nurse working in a long-term care facility completes her morning assessment on a new postoperative patient and notes a change in cognitive status from the previous day? The nurse recognizes which of the following as a precipitating factor for delirium?

The community health nurse is preparing for an educational session on AD for a group of seniors.Which modifiable risk factors should the nurse include?

Which of the following approaches to hygienic care is beneficial for a patient with dementia?

Which types of exercise programs are better for older adults with AD for improving mood and function?

A man who is 60 years of age and lives in the British Isles develops dementia.Which qualities of dementia does the nurse assess to prevent patient injury related to the type of dementia this man most likely has?

When differentiating the characteristics of depression,delirium,and dementia,the nurse recognized which of the following as an indicator of delirium?

Introduction to Healthy Aging

Gerontological Nursing History, Education, and Roles

Care Across the Continuum

Culture and Aging

Theories of Aging and Physical Changes

Social, Psychological, Spiritual, and Cognitive Aspects of Aging

Assessment and Documentation for Optimal Care

Safe Medication Use

Nutrition and Hydration

Elimination

Rest, Sleep, and Activity

Promoting Healthy Skin and Feet

Promoting Safety

Living With Chronic Illness

Pain and Comfort

Diseases Affecting Vision and Hearing

Metabolic Disorders

Bone and Joint Problems

Cardiovascular and Respiratory Disorders

Neurological Disorders

Mental Health

Economic and Legal Issues

Relationships, Roles, and Transitions

Loss, Death, and Palliative Care

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