Deck 13: Neurocognitive Disorders

Question 1

The client diagnosed with neurocognitive disorder (NCD) is disoriented and ataxic and wanders. Which is the priority nursing diagnosis?

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

Answer 1

Risk for trauma

Question 2

A client is diagnosed in stage 7 of Alzheimer's disease (AD). 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 2

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

Question 3

A client diagnosed with major neurocognitive disorder (NCD) is exhibiting behavioral problems on a daily basis. At change of shift, the client's behavior escalates from pacing to screaming and flailing. Which action should be a nursing priority?

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.

Answer 3

Medicate the client with prn antianxiety medications.

Question 4

The geriatric nurse is teaching the client's family about the possible cause of delirium. Which information should the nurse include in the teaching session?

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 5

Which information would the nurse include in a staff teaching session about the differences between mild neurocognitive disorder (NCD) and major NCD?

A) Major NCD involves disorientation that develops suddenly, whereas mild NCD develops more slowly.
B) Major NCD involves impairment of abstract thinking and judgment, whereas mild NCD does not.
C) Major NCD criteria requires substantial cognitive decline from a previous level of performance, and mild NCD requires modest decline.
D) Major NCD criteria requires decline from a previous level of performance in three of the listed domains, and mild NCD requires only one.

Question 6

Which conditions have been known to precipitate delirium in some individuals? (Select all that apply.)

A) Febrile illness
B) Seizures
C) Migraine headaches
D) Gallstones
E) Temporomandibular joint syndrome

Question 7

A client diagnosed with Alzheimer's disease (AD) can no longer ambulate, does not recognize family members, and communicates with agitated behaviors and incoherent moaning. The nurse recognizes these symptoms as indicative of which stage of the illness?

A) Stage 4: Moderate Cognitive Decline
B) Stage 5: Moderately Severe Cognitive Decline
C) Stage 6: Severe Cognitive Decline
D) Stage 7: Very Severe Cognitive Decline

Question 8

A male client diagnosed with vascular neurocognitive disorder (NCD) is discharged to home under the care of his wife. Which information should cause the nurse to question the client's safety?

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

Question 9

Which medications have been known to precipitate delirium in clients? (Select all that apply.)

A) Antineoplastic agents
B) H₂-receptor antagonists
C) Antihypertensives
D) Corticosteroids
E) Lipid-lowering agents

Question 10

Major neurocognitive disorder (NCD) constitutes what was previously described as ______ in the DSM-IV-TR.

Question 11

A client diagnosed recently with Alzheimer's disease (AD) is prescribed donepezil (Aricept). The client's spouse inquires, "How does this work? Will this cure him?" Which response by the nurse is appropriate?

A) "This medication 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) "This medication encourages production of acetylcholine, a chemical in the brain necessary for memory processes. It delays the progression of the disease."
C) "This medication 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) "This medication encourages production of dopamine, a chemical in the brain necessary for memory processes. It delays the progression of the disease."

Question 12

A client with a history of cerebrovascular accident is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client's assessment data, on which medical diagnosis would the nurse focus the plan of care?

A) Delirium due to adverse effects of cardiac medications
B) Vascular neurocognitive disorder
C) Neurocognitive disorder due to Huntington's disease
D) Alzheimer's disease

Question 13

The nurse attended a seminar about neurocognitive disorders (NCD). Which information from the nurse indicates a correct understanding of the differences between NCD and pseudodementia (depression)?

A) NCD has a rapid onset, whereas pseudodementia does not.
B) NCD symptoms include disorientation to time and place, and pseudodementia does not.
C) NCD symptoms improve as the day progresses, but symptoms of pseudodementia worsen.
D) NCD causes decreased appetite, whereas pseudodementia does not.

Question 14

A client diagnosed with Alzheimer's disease (AD) exhibits diminished cognitive functioning, verbal aggression upon experiencing frustration, and has a nursing diagnosis of inability to provide self-care. Which nursing intervention is most appropriate?

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

Question 15

A client diagnosed with Alzheimer's disease (AD) has impairments of memory and judgment and is incapable of performing activities of daily living. Which nursing intervention should take 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 with bathing and toileting.

Question 16

After one week of continuous mental confusion, an older African American client is admitted with a preliminary diagnosis of Alzheimer's disease (AD). What should cause the nurse to question this diagnosis?

A) AD does not typically occur in African American clients.
B) The symptoms presented are more indicative of Parkinsonism.
C) AD does not develop suddenly.
D) There have been no liver function studies ordered.

Question 17

The nurse is asked why there seems to be more people diagnosed with neurocognitive disorders (NCD). Which rationale would the nurse offer?

A) Increased numbers of neurotransmitters have been implicated in the proliferation of NCD.
B) Similar symptoms of NCD and depression lead to misdiagnoses, increasing numbers of NCD.
C) Societal stress contributes to the increase in this diagnosis.
D) More people now survive into the high-risk period for neurocognitive disorders.

Question 18

An older client has recently moved to a nursing home. The client has a sad affect, trouble concentrating and socially isolates. A physician believes the client would benefit from medication therapy. Which medication would the nurse most likely administer to the client?

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