Deck 48: Care of Patients With Cognitive Disorders

Question 1

The exhausted caregiver to a patient with moderate Alzheimer's disease asks what respite care entails.The nurse replies that respite care is:

A)placing the patient in a long-term care facility for a short period of time for the caregiver to rest.
B)bringing in home health aides to do housework to lighten duties of the caregiver.
C)accompanying patient to a long-term care facility and staying there while the facility staff do physical care.
D)attending a support group to ventilate feelings and communicate with other caregivers.

Answer 1

placing the patient in a long-term care facility for a short period of time for the caregiver to rest.

Question 2

When assisting the patient with middle-stage Alzheimer's disease (AD)to dress,the nurse should:

A)select clothes and dress him.
B)lay out clothing and coach patient to dress self.
C)ask patient what he wants to wear.
D)open closet and say, "Get a shirt."

Answer 2

lay out clothing and coach patient to dress self.

Question 3

The nurse explains that postmortem brain examinations of people with Alzheimer's disease have revealed that there are: (Select all that apply.)

A)tangled nerve cells.
B)abnormal buildup of proteins.
C)hemorrhagic areas.
D)occluded cerebral vessels.
E)reduced white matter.

Answer 3

tangled nerve cells.
abnormal buildup of proteins.

Question 4

The nurse is aware that the memory lapses seen in early stages of Alzheimer's disease (AD)are related to the pathophysiology of:

A)frontal lobe atrophy.
B)overproduction of neurotransmitters.
C)pituitary disorders.
D)inadequate clearance of metabolic toxins.

Question 5

The nurse notes that the newly admitted patient with Alzheimer's disease has significant anomia.An appropriate intervention for this problem would be to:

A)frequently reorient him to his room location.
B)remind him what a particular item is and what its use is.
C)help him feed himself.
D)wait for the patient to find the word he wants.

Question 6

An 85-year-old man is admitted to the hospital with gastroenteritis and dehydration after a hiking trip to Mexico.He is given a dose of meclizine hydrochloride,an anticholinergic,for vomiting.He begins to hallucinate and talk to his wife,who has been dead for 10 years.The nurse assesses this behavior to be:

A)dementia related to advanced age.
B)delirium related to dehydration.
C)dementia related to early Alzheimer's disease (AD).
D)delirium related to side effect of anticholinergic.

Question 7

When communicating with a patient with moderate Alzheimer's dementia,the nurse should speak:

A)slowly.
B)clearly.
C)loudly.
D)softly.

Question 8

The patient with Alzheimer's disease has been on donepezil (Aricept)for several weeks.The nurse suspects an overdose when the patient:

A)eats hungrily at each meal and looks for snacks between meals.
B)exhibits a consistent heart rate of 80 beats/min.
C)has an elevation in blood pressure after each exercise period.
D)is unable to grasp a glass tightly enough to prevent dropping it.

Question 9

The percentage of the population that is 85 years of age and older who have some stage of Alzheimer's disease is _____%.

A)10
B)20
C)35
D)50

Question 10

The patient with Alzheimer's wakes up at 2:00 AM moaning and frightened and begs that her husband's coffin be removed from her room.The nurse should:

A)turn light on and say, "There is no coffin here, Mrs. Smith. This is the dresser."
B)leave the light off and shine a flashlight on the dresser and say, "See! No coffin!"
C)turn the light on, assist patient to the bathroom, and say, "This is your dresser."
D)leave the light off and say, "You are in your room, Mrs. Smith."

Question 11

The nurse takes into consideration that the patient with AIDS dementia complex (ADC)is at risk for injury due to:

A)manic behavior.
B)numbness and muscle weakness.
C)suicidal ideation.
D)difficulty concentrating.

Question 12

The nurse is aware the older adult is at risk for drug-induced delirium because of:

A)slower bowel motility.
B)reduced fluid intake.
C)overall reduced metabolism.
D)sedentary lifestyle.

Question 13

The nurse is caring for a patient who has dementia and has been getting up out of bed at night.What action by the nurse will be most therapeutic?

A)The nurse places all of the side rails in the up position.
B)The nurse raises the bed to a tall position to reduce the patient's ability to get out of bed.
C)The nurse obtains orders from the physician to apply restraints at night.
D)The nurse places the mattress on the floor.

Question 14

The nurse takes into consideration that the patient with moderate Alzheimer's disease in a long-term care facility who "sundowns" would benefit from:

A)social interaction activities in the morning.
B)darkened bedroom to encourage sleep.
C)sedative to enhance initiating sleep.
D)exercise program after supper.

Question 15

The CNA approaches the older adult in the long-term care facility and says,"Oh,look at your pretty dress.It is all icky with food spots! Come with me,sweetie,we'll put on that special party dress so you will look cute." The CNA is using:

A)instruction for personal hygiene.
B)encouragement for self-care.
C)simplistic "elderspeak."
D)reorientation techniques.

Question 16

The nurse will record that the patient with Alzheimer's disease exhibited agnosia when the patient:

A)attempted to comb her hair with a spoon.
B)had difficulty expressing herself verbally.
C)was unable to understand written language.
D)could not feed herself, although she had adequate motor function to do so.

Question 17

Donepezil (Aricept)has been prescribed for a patient with Alzheimer's disease.Which statement by the patient and spouse indicates an understanding of the medication?

A)"It is best for me to take the medication at bedtime."
B)"The medication will be most effective if taken on an empty stomach."
C)"Absorption of the medication will be improved if taken with a citrus beverage."
D)"The medication should be taken with meals."

Question 18

The nurse differentiates vascular dementia from Alzheimer's dementia in that vascular dementia is related to:

A)cerebral atrophy.
B)global reduction of cognition.
C)hypertension.
D)emboli in cerebral vessels.

Question 19

A recently licensed nurse is orienting to the Alzheimer's disease care unit.The nurse is caring for a patient who is transitioning from oral rivastigmine (Exelon)to the medication patch.Which action observed by the nurse's preceptor indicates an understanding of the medication?

A)The patient is instructed to put on the patch 12 hours after the last oral medication dosage.
B)The nurse reports that the patient will need to replace the patch every 36 hours.
C)The nurse explains to the patient and family that the sites of application will need to be rotated.
D)The nurse explains to the patient that the patch should not be placed on the trunk region of the body.

Question 20

The home health nurse counseling a family who will be caring for a relative with moderate-stage Alzheimer's disease will stress the need for:

A)a consistent routine to provide structured environment.
B)making each day different to enhance attention span.
C)using several caregivers to increase social skills.
D)placing bright scatter rugs, flower arrangements, and wall decorations to stimulate sensory perception.

Question 21

Matching
The nurse clarifies terminology related to cognitive disorders.Match the options to the expected characteristics.(Options may be used more than once.)

Results from cerebrovascular accident

A)Cognition
B)Dementia
C)Delirium

Question 22

Matching
The nurse clarifies terminology related to cognitive disorders.Match the options to the expected characteristics.(Options may be used more than once.)

Experiences an illusion

A)Cognition
B)Dementia
C)Delirium

Question 23

Matching
The nurse clarifies terminology related to cognitive disorders.Match the options to the expected characteristics.(Options may be used more than once.)

Processes of perception,memory,and judgment

A)Cognition
B)Dementia
C)Delirium

Question 24

The nurse uses the Mini-Mental Status Exam (MMSE)frequently to assess: (Select all that apply.)

A)orientation.
B)judgment.
C)memory.
D)insight.
E)ability to follow directions.

Question 25

Matching
The nurse clarifies terminology related to cognitive disorders.Match the options to the expected characteristics.(Options may be used more than once.)

Characterized by slow onset

A)Cognition
B)Dementia
C)Delirium

Question 26

A patient who has been experiencing memory deficits questions the nurse about foods that are associated with better memory.What selections are linked to enhanced memory? (Select all that apply.)

A)Salmon
B)Red meat
C)Pork loin
D)Leafy green vegetables
E)Fruits

Question 27

Matching
The nurse clarifies terminology related to cognitive disorders.Match the options to the expected characteristics.(Options may be used more than once.)

Uses confabulation to cover memory gaps

A)Cognition
B)Dementia
C)Delirium

Question 28

The home health nurse assesses a family who is caring for a person with a cognitive deficit for responses that indicates exhaustion,which include: (Select all that apply.)

A)irritability with other family members and the patient.
B)report of sleep disturbances.
C)anger at patient and self.
D)depression.
E)fatigue.
F)None of the above.

Question 29

Matching
The nurse clarifies terminology related to cognitive disorders.Match the options to the expected characteristics.(Options may be used more than once.)

An acute alteration in cognition

A)Cognition
B)Dementia
C)Delirium

Question 30

Criteria established for the diagnosis of dementia include: (Select all that apply.)

A)evidence of cognitive deficits.
B)evidence of aphasia, apraxia, or agnosia.
C)impairment in social function.
D)impairments of occupational function.
E)neurologic signs and symptoms, such as ataxic gait.
F)None of the above.

Question 31

The nurse is aware the resident with global amnesia in the late stage of Alzheimer's disease will benefit from: (Select all that apply.)

A)reorientation sessions.
B)music therapy.
C)reminiscence therapy.
D)pet therapy.
E)looking at family scrapbooks.