Deck 23: Cognition and Caring for Persons with Cognitive Impairment

Question 1

The Mini-Mental State Exam (MMSE)is a tool used to:

A) diagnose Alzheimer's disease.
B) provide a baseline mental status measurement and track changes.
C) diagnose delirium in hospitalized older adults.
D) predict the progression of cognitive changes.

Answer 1

provide a baseline mental status measurement and track changes.

Question 2

An 87-year-old client is being discharged from the subacute facility to home with a sterile dressing on her right leg.You are her nurse and are responsible to teach her how to change the dressing.The following are important concepts to consider except:

A) assessing client readiness to learn.
B) teaching a family member because older adults are usually not able to learn new tasks.
C) providing enough time to respond because older adults' reaction times are often slower than younger adults.
D) using audio,visual,and tactile clues to reinforce learning.

Answer 2

teaching a family member because older adults are usually not able to learn new tasks.

Question 3

A 90-year-old client with dementia resides with his daughter in the community.When the home care nurse visits,the daughter tearfully tells the nurse that her father scratched her hand and cursed at her when she was attempting to feed him.She states,"I don't know why he hates me and wants to hurt me.I try so hard to take good care of him.I love him." What is the best response to the client's daughter?

A) "What have you done to anger your father?"
B) "Behavior is an expression of needs.Let's try to figure out what your father was trying to communicate."
C) "Scratching is usually a sign of untreated pain.Do you think your father is in pain?"
D) "Maybe you should not be providing direct care to your father,a home health aide might be more appropriate.

Answer 3

"Behavior is an expression of needs.Let's try to figure out what your father was trying to communicate."

Question 4

Interventions to manage wandering in clients in a long-term care facility include the following except:

A) environmental modifications such as camouflaging doorways and providing enclosed pathways.
B) close observation to identify the person's individual patterns.
C) engaging the person in social interactions.
D) using physical restraints to prevent wandering and maintain safety.

Question 5

A 75-year-old client was admitted to the hospital after having sustained a fall at home.She is diagnosed with a right hip fracture and is scheduled for surgery in the morning.At 2:30 AM she awakens from sleep with confusion about where she is.She insists that her daughter is in the other room and wants to see her.You attempt to reorient her to the surroundings with little success.She continues to insist that her daughter is in the next room.In reviewing the client's record,what data would be considered a source of her confusion?

A) Pain medication received
B) Death of the client's husband last month
C) The client's age
D) History of cardiac disease

Question 6

At the present time,the definitive diagnosis of Alzheimer's disease can be made:

A) by the neurofibrillary tangles and senile plaques in neural tissue upon microscopic examination during a brain biopsy or autopsy.
B) by clinical observation of progressive mental status changes.
C) whenever there is a loss of ability to read,write,calculate,and communicate intelligently in persons older than 65.
D) by the use of a positive emission tomography (PET)revealing decreased blood flow and metabolism of glucose and oxygen in the brain.

Question 7

In evaluating the plan of care for an older adult with the nursing diagnosis Risk for Injury related to delirium,which evaluative statement would best suggest that the problem is resolving?

A) Client attempted to climb over the side rails.
B) Client manipulated intravenous pump,stating "I can't get this transformer to work."
C) Client correctly stated year and month but not date.
D) Client stated,"If we don't hurry,I'll miss the bus."

Question 8

A major differentiation between delirium and dementia is that the course of delirium over a 24-hour period:

A) is fairly stable but may be exacerbated by stress.
B) fluctuates and is often worse at night.
C) is fairly stable but may be worse in the morning.
D) demonstrates a steady decline.

Question 9

You are caring for a client with delirium.Which assessment finding would be expected in this client throughout your shift?

A) Fluctuation in symptoms
B) Normal attention span
C) Unlimited duration
D) Unchanged sleep-wake cycle

Question 10

Drug therapy with cholinesterase inhibitors such as donepezil,rivastigmine,and galantamine:

A) reverses the neuronal decline that is seen in Alzheimer's disease.
B) is given in high doses to prevent the appearance of cognitive symptoms.
C) is given long term even if the client shows slight decline.
D) has no reported side effects.