Deck 22: Neurocognitive Disorders

Question 1

The nurse identifies which symptoms differentiate clients diagnosed with NCD from clients with pseudodementia (depression)?

A)Altered sleep
B)Impaired attention and concentration
C)Altered task performance
D)Impaired psychomotor activity

Answer 1

Altered task performance

Question 2

A nursing instructor is teaching about donepezil (Aricept).A student asks,"How does this work? Will this cure Alzheimer's disease (AD)?" Which is the appropriate instructor reply?

A)"Donepezil (Aricept)delays the destruction of acetylcholine,a chemical in the brain necessary for memory processes.Although most effective in the early stages,it serves to delay,but not stop,the progression of the disease."
B)"Donepezil (Aricept)encourages production of acetylcholine,a chemical in the brain necessary for memory processes.It delays the progression of the disease."
C)"Donepezil (Aricept)delays the destruction of dopamine,a chemical in the brain necessary for memory processes.Although most effective in the early stages,it serves to delay,but not stop,the progression of the disease."
D)"Donepezil (Aricept)encourages production of dopamine,a chemical in the brain necessary for memory processes.It delays the progression of the disease."

Answer 2

"Donepezil (Aricept)delays the destruction of acetylcholine,a chemical in the brain necessary for memory processes.Although most effective in the early stages,it serves to delay,but not stop,the progression of the disease."

Question 3

A client is in the late stage of Alzheimer's disease.To address the client's symptoms,which nursing intervention should take priority?

A)Improve cognitive status by encouraging involvement in social activities.
B)Decrease social isolation by providing group therapies.
C)Promote dignity by providing comfort,safety,and self-care measures.
D)Facilitate communication by providing assistive devices.

Answer 3

Promote dignity by providing comfort,safety,and self-care measures.

Question 4

A 36-year old female is admitted to the emergency department at 2:20 a.m.with a severe laceration to her forehead,with incoherent speech.Paramedics report that they picked up the patient at a local bar,and the bartender on site said,"She seemed just fine when she came in.She must have had a lot to drink before she came here." Witness reports onsite confirmed that the woman fell off a bar stool and hit her head on the bar rail.Based on the information provided,a blood alcohol test was administered with a result of a 0.01 blood alcohol level.The woman's weight was recorded at 145 pounds.Incoherent speech is most likely attributed to which of the following?

A)Alcohol intoxication
B)Intoxication and fatigue due to late hour
C)A primary NCD
D)A secondary NCD

Question 5

A client is experiencing progressive changes in memory that have interfered with personal,social,and occupational functioning.The client exhibits poor judgment and has a short attention span.The nurse recognizes these as classic signs of which condition?

A)Mania
B)Delirium
C)NCD
D)Parkinsonism

Question 6

A female client was admitted to the hospital after being treated in the emergency room for seizures following a head trauma.Within a few minutes of arriving on the floor,the admitting nurse noticed that the client had a difficult time sustaining attention and did not know where she was.What is the most likely reason for the abnormal behavior?

A)The client likely has a systemic illness.
B)The client is experiencing delirium.
C)The client is experiencing a metabolic imbalance from dehydration.
D)The client likely has a major NCD.

Question 7

After 1 week of continuous mental confusion,an elderly African American client is admitted with a preliminary diagnosis of Major NCD due to Alzheimer's disease.Which of the following would cause the nurse to question this diagnosis?

A)Neurocognitive disorder does not typically occur in African American clients.
B)The symptoms presented are more indicative of Parkinsonism.
C)NCD does not develop suddenly.
D)There has been no T3 or T4 level evaluation ordered.

Question 8

The nurse notices that Martha,the primary caregiver for her husband with Alzheimer's disease,seems distracted and she asked how Martha was doing."I'm doing okay," said Martha."I'm just so overwhelmed.I can't seem to get anything done.Just when I think I'm handling everything,something else comes up.Hopefully things will settle down soon and I can get a break." Which of the following would most help Martha cope with the caregiver strain she's expressing?

A)Teaching about symptoms of Alzheimer's disease
B)Information about the management of Alzheimer's disease
C)Referrals to support services for Alzheimer's disease
D)Recommending an Alzheimer's-friendly residence facility

Question 9

The nurse identifies which symptoms differentiate clients diagnosed with NCDs from clients diagnosed with amnestic disorders.

A)NCDs involve disorientation that develops suddenly,whereas amnestic disorders develop more slowly.
B)NCDs involve impairment of abstract thinking and judgment,whereas amnestic disorders do not.
C)NCDs include the symptom of confabulation,whereas amnestic disorders do not.
D)Both NCDs and profound amnesia typically share the symptom of disorientation to place,time,and self.

Question 10

A client with a history of cerebrovascular accident (CVA)is brought to an emergency department experiencing memory problems,confusion,and disorientation.Based on this client's assessment data,which diagnosis would the nurse expect the physician to assign?

A)Medication-induced delirium
B)VNCD
C)Altered thought processes
D)Alzheimer's disease

Question 11

A client diagnosed with NCD due to Alzheimer's disease can no longer ambulate,does not recognize family members,and communicates with agitated behaviors and incoherent verbalizations.The nurse recognizes that these symptoms indicate which stage of the illness?

A)Confabulation stage
B)Early stage
C)Middle stage
D)Late stage

Question 12

A client diagnosed with NCD due to Alzheimer's disease has impairments of memory and judgment and is incapable of performing ADLs.Which intervention is the nurse's priority?

A)Present evidence of objective reality to improve cognition.
B)Design a bulletin board to represent the current season.
C)Label the client's room with name and number.
D)Assist the client with bathing and toileting.

Question 13

At what time during a 24-hour period should a nurse expect clients with Alzheimer's disease to exhibit more pronounced symptoms?

A)When they first awaken
B)In the middle of the night
C)At twilight
D)After taking medications

Question 14

A client diagnosed with NCD due to Alzheimer's disease is disoriented,ataxic,and wanders.Which is the priority nursing diagnosis?

A)Disturbed thought processes
B)Self-care deficit
C)Risk for injury
D)Altered health-care maintenance

Question 15

A geriatric nurse is teaching student nurses about the risk factors for development of delirium in older adults.Which student statement indicates that learning has occurred?

A)"Taking multiple medications may lead to adverse interactions or toxicity."
B)"Age-related cognitive changes may lead to alterations in mental status."
C)"Lack of rigorous exercise may lead to decreased cerebral blood flow."
D)"Decreased social interaction may lead to profound isolation and psychosis."

Question 16

A client diagnosed with Lewy Body Dementia has been prescribed an antipsychotic medication to manage a decline in mental capacities.Why should the nurse question this prescription?

A)Antipsychotic medications can cause Lewy body dementia to become a permanent condition.
B)Lewy body syndrome does not affect cognitive functioning.
C)Clients with Lewy body dementia are highly sensitive to extrapyramidal effects of antipsychotic medications.
D)Lewy body syndrome causes an increase in acetylcholinesterase concentrations,which makes antipsychotic medications contraindicated.

Question 17

An elderly client recently moved to a nursing home.The client is having trouble concentrating and is isolating from others.A physician believes the client would benefit from medication therapy.Which medication should the nurse expect the physician to prescribe?

A)Haloperidol (Haldol)
B)Donepezil (Aricept)
C)Diazepam (Valium)
D)Sertraline (Zoloft)

Question 18

A client diagnosed with Vascular Dementia is discharged to home under the care of his wife.Which information causes the nurse to question the client's safety?

A)His wife works from home in telecommunication.
B)The client has worked the night shift his entire career.
C)His wife has minimal family support.
D)The client smokes one pack of cigarettes per day.

Question 19

A client diagnosed with NCD has progressive memory loss,diminished cognitive functioning,verbal aggression,and is experiencing frustration.Which nursing intervention is most appropriate?

A)Schedule structured daily routines.
B)Minimize environmental lighting.
C)Organize a group activity to present reality.
D)Explain the consequences for aggressive behaviors.

Question 20

A client diagnosed with a NCD is exhibiting behavioral problems every day.At change of shift,the client's behavior escalates from pacing to screaming and flailing.Which action should the nurse implement first?

A)Consult the psychologist regarding behavior-modification techniques.
B)Medicate the client with prn antianxiety medications.
C)Assess environmental triggers and potential unmet needs.
D)Anticipate the behavior and restrain when pacing begins.

Question 21

Martha is the primary caregiver for her husband,Norman,who has progressed to Stage 5 of Alzheimer's disease.Which of the following teaching topics should the nurse focus on for a caregiver of a patient with Stage 5 Alzheimer's disease? Select all that apply.

A)How to assist with some ADLs such as hygiene,dressing and grooming
B)How to care for decubitus ulcers resulting from immobility
C)How to apply medications to compromised skin resulting from bowel and bladder incontinence
D)Tools to help re-orientate Norman to time and place

Question 22

_________________________________ is defined as a "change in the amount or patterning of incoming stimuli accompanied by a diminished,exaggerated,distorted,or impaired response to such stimuli."

Question 23

________________ is the inability to carry out motor activities despite intact motor function.

Question 24

What is the most appropriate nursing diagnosis for a client who is unable to identify objects,confabulation,screaming,and demanding verbalizations?

A)Impaired verbal communication
B)Disturbed sensory perception
C)Situational low self-esteem;Grieving
D)Disturbed thought processes;Impaired memory

Question 25

A client with pseudodementia presents with ______________ attention and concentration.

Question 26

Which of the following nursing interventions would be used for a client with a nursing diagnosis of risk of trauma related to impairments in cognitive and psychomotor functioning?

A)Store frequently used items within easy access.
B)Keep cigarettes and lighters out of reach of the client.
C)Keep the side rails up when client is in bed.
D)Keep a dim light on at night.