Deck 28: Cognitive Disorders

Question 1

What information should the nurse provide the family of a client diagnosed with normal-pressure hydrocephalus (NPH)?

A) It eventually develops into Pick disease
B) There is currently no treatment for this condition
C) Few clients regain cognitive abilities
D) The related dementia is potentially reversible

Answer 1

The related dementia is potentially reversible

Question 2

A nurse gives anticipatory guidance to the family of a patient diagnosed with stage 2 Alzheimer disease (AD). Which problem common to that stage should be addressed?

A) Violent outbursts
B) Emotional disinhibition
C) Communication deficits
D) Inability to feed or bathe self

Answer 2

Communication deficits

Question 3

What is the foundation of the cognitive process?

A) Reasoning and logic
B) Memory and learning
C) Orientation and speech
D) Perception and behavior

Answer 3

Memory and learning

Question 4

A patient diagnosed with vascular dementia does not remember family members' names. The family insistently reorients the patient, and the patient becomes more agitated. What is the most likely reason for the patient's reaction?

A) He or she is using agitation to distract the family from the cognitive deficits.
B) He or she is overstimulated by the reorientation and reacting negatively.
C) He or she is reliving family chaos that was previously unresolved.
D) He or she is experiencing guilt about the memory deficits.

Question 5

An older adult patient developed delirium secondary to diphenhydramine use. The patient usually took this drug for allergies but recently added a cough syrup that also contained the drug. What information is most important to teach the family?

A) Older adults are more prone to delirium.
B) The patient is now susceptible to progressive cognitive decline.
C) Toxic medication levels often occur because of slower metabolism in older adults.
D) The older adult brain has fewer neurotransmitters than the brain of a younger person.

Question 6

An older patient had a subtotal gastrectomy after being diagnosed with stomach cancer. What long-term mental health risk related to this procedure should the nurse discuss with the patient?

A) The increased risk of depression
B) The risk of vitamin B12-related dementia.
C) The risk of postsurgical delirium
D) The increased risk of Parkinson disease

Question 7

The nurse teaches a family who provides in-home care for a patient diagnosed with dementia. Which measure to facilitate environmental safety should the nurse include?

A) Install gates at the tops and bottoms of stairs.
B) Store medications in a clearly visible place.
C) Vary the daily schedule to provide variety and stimulation.
D) Include daily activities that call for use of higher cognitive functions.

Question 8

What is the nursing care priority for a patient diagnosed with stage 7 Alzheimer disease?

A) Nutrition and hydration
B) Promoting self-care activities
C) Supporting attempts to communicate
D) Preserving problem-solving abilities

Question 9

The family of a patient diagnosed with Alzheimer disease (AD) is concerned about the patient's occasional urinary incontinence. The nurse should give which suggestion?

A) Use adult diapers.
B) Put a sign on the bathroom door.
C) Limit fluid intake to 1000 mL daily.
D) Take the patient to the bathroom every 2 hours.

Question 10

An older adult patient diagnosed with delirium is anxious, agitated, and experiencing visual hallucinations. The nurse entering the room to assess vital signs should implement which intervention to best address this behavior?

A) Calmly announce yourself by name and title, and explain what is going to happening.
B) Limit talking with the client while taking the vital signs to minimize stimulation.
C) Ask the patient to identify place, person, and time to trigger memory.
D) Turn on all lights in the room to minimize misinterpretation of events.

Question 11

A patient diagnosed with delirium stares at the corner of the room, wrings hands, and says, "I'm scared those snakes will bite me." What term should the nurse use to best document this event?

A) Agnosia
B) Disorientation
C) Confabulation
D) Visual hallucinations

Question 12

What is the expected outcome for donepezil therapy prescribed for a client diagnosed with mild-to-moderate Alzheimer disease (AD)?

A) Better daily function than without treatment
B) Temporary interruption of disease process
C) Remissions of varying lengths of time
D) Marked decrease in memory impairment

Question 13

An older adult patient has fluctuating levels of awareness, anxiety, and appears to be picking things out of the air. The patient says, "I saw my granddaughter standing at the foot of the bed last night." The nurse should suspect which disorder?

A) Delirium
B) Dementia
C) Schizophrenia
D) Bipolar disorder

Question 14

A nurse assesses a newly admitted patient with possible delirium. Which aspect of the history provides by family members contributes to confirmation of the diagnosis?

A) "He became confused all of a sudden."
B) "He is always conscious and alert."
C) "He doesn't seem to understand jokes anymore."
D) "He is so distrustful of everyone now."

Question 15

A patient diagnosed with dementia is watching a crime story on television. Suddenly, the patient begins to yell, "Stop! He's got a gun." What is the nurse's best intervention?

A) Administer a PRN dose of an atypical antipsychotic medication.
B) Turn off the television and tell the patient, "You are safe."
C) Reassure the patient that there are no guns nearby.
D) Provide a snack, and put the patient in bed.

Question 16

Effective management of a client diagnosed with Huntington disease is best demonstrated by which documentation made by the nurse?

A) Bilateral lung sounds clear with no signs of dyspnea.
B) Client denies any visual hallucinations.
C) Disorientation noted only in the evenings.
D) Client denies any hearing limitations.

Question 17

An older adult patient is admitted with a diagnosis of delirium secondary to a urinary tract infection. The family asks whether or not the patient will recover. Select the nurse's best response.

A) "The health care provider is the best person to answer your question."
B) "The confusion will probably get better as we treat the infection."
C) "Unfortunately, delirium is a progressively disabling disorder."
D) "I will be glad to contact the chaplain to talk with you."

Question 18

A newly admitted patient diagnosed with Alzheimer disease (AD) has demonstrated apraxia. The nurse should assist the patient with which activity?

A) Grooming and hygiene
B) Reading written material
C) Word finding
D) Orientation

Question 19

An older adult presents with symptoms of delirium. The family says, "Everything was fine until yesterday." What is the most important assessment information the nurse should gather?

A) A list of medications the patient currently takes.
B) Whether or not the patient has experienced any recent losses.
C) Whether or not the patient has ingested aged or fermented foods.
D) The patient's recent personality characteristics and changes.

Question 20

The focus of nursing care for a patient diagnosed with dementia is best demonstrated by which nursing statement?

A) "The client's plan of care is individualized to meet his or her specific needs."
B) "I think that reminiscence therapy will help the client remember past events better."
C) "If we give the client enough time they can dress themselves appropriately each morning."
D) "The client was so proud when they talked about their war experiences."

Question 21

What assessment data suggest that a client is at risk for the development of vascular dementia? (Select all that apply.)

A) History of type 2 diabetes
B) Currently prescribed antihypertensive medication
C) Presents early signs/symptoms of Parkinson disease
D) Being treated for atrial fibrillation
E) 2 pack a day cigarette habit

Question 22

An older adult diagnosed with dementia is documented as demonstrating agnosia. Which client statements support this documentation? (Select all that apply.)

A) "My hands seem to shake all the time."
B) "I can't hold that cup without spilling the coffee."
C) "I signed my name with that thing that writes."
D) "I don't remember ever meeting you before."
E) "The water came out of that thing you turn."

Question 23

Which interventions are appropriate for inclusion into the plan of care for a client diagnosed with Parkinson disease? (Select all that apply.)

A) Speech therapy for language skills impairment
B) Falls risk precautions
C) Frequent depression screening
D) Monitoring for obsessive-compulsive disorder (OCD) tendencies
E) Education concerning risks associated with prescribed atypical antipsychotic medication therapy

Question 24

The care plan of an agitated patient diagnosed with dementia with Lewy body (DLB) should have which assessments as priorities? (Select all that apply.)

A) Level of consciousness
B) Presence of auditory or visual hallucinations
C) Signs of depression
D) Delusional thinking
E) Heart sounds

Question 25

Which vector is associated with transmission of variant Creutzfeldt-Jakob disease?

A) Dog ticks
B) Mosquito bites
C) Airborne particles
D) Contaminated meat

Question 26

Which nursing interventions are appropriate for the management of a client demonstrating the behaviors associated with dementia-related "sundowning"? (Select all that apply.)

A) Staff is trained to de-escalate an agitated client.
B) Frequent reorientation to time and place helps minimize the effects of sundowning.
C) Client is closely monitored during the late afternoon and evening hours.
D) The client is provided with a safe place to pace.
E) The client's family is educated to the fact that this behavior is a result of overstimulation.