Deck 29: Care of Individuals with Neurocognitive Disorders

Question 1

Which intervention best addresses the principle that is the basis for communicating with a client experiencing postsurgical delirium?

A) Reminding the client that delirium is generally acute and reversible
B) Assuming that the client's statements are an attempt to express needs
C) Allowing the client sufficient time to formulate an answer to questions
D) Using nonverbal communication techniques to communicate with the client

Answer 1

Assuming that the client's statements are an attempt to express needs

Question 2

An older client diagnosed with dementia resides with his daughter. When the homecare 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." How will the nurse respond to the client's daughter?

A) "Let's think about what you may have done to anger your father?"
B) "Let's try to figure out what your father was trying to say with his behavior."
C) "Scratching is usually a sign of untreated pain. Do you think your father is in pain?"
D) "Maybe you should consider having a home health care provider take over responsibility for your father's physical care."

Answer 2

"Let's try to figure out what your father was trying to say with his behavior."

Question 3

Which intervention to manage wandering in clients in a long-term care facility should be implemented? (Select all that apply.)

A) Camouflaging doorways
B) Close observation to identify the person's individual patterns
C) Engaging the person in social interactions
D) Using physical restraints to prevent wandering to maintain safety
E) Providing enclosed pathways for walking

Answer 3

Camouflaging doorways
Close observation to identify the person's individual patterns
Engaging the person in social interactions
Providing enclosed pathways for walking

Question 4

A nurse is caring for a patient with a diagnosis of delirium. Which of the following is an expected assessment finding for this patient?

A) Normal attention span
B) Fluctuation in symptoms
C) Normal sleep cycle
D) Increased appetite

Question 5

Which information will the nurse manager include when discussing the major differentiation between delirium and dementia with novice nurses? (Select all that apply.)

A) The delirious client learns to make up answers to hide his or her confusion.
B) Delirium requires increased monitoring at night.
C) The client diagnosed with dementia generally looks frightened.
D) Dementia results in a steady decline in cognitive abilities.
E) Delirium is characterized by fluctuations in alertness.

Question 6

A nurse is assessing an older patient with new onset confusion using the Confusion Assessment Method (CAM). The nurse understands that in order to have a diagnosis of delirium when using the CAM, the patient must exhibit which of the following? (Select all that apply.)

A) Acute onset of symptoms or fluctuating course
B) Inattention
C) Disorganized thinking
D) Altered level of consciousness
E) Alteration in level of physical activity

Question 7

The nurse is caring for an older client who experienced a hip replacement surgery 10 hours ago. Which intervention will help minimize this client's risk of developing delirium?

A) Requesting that staff offer fluids each time they interact with the client
B) Medicating the client to best facilitate restorative sleep
C) Encouraging the client to remain still and thus minimize pain
D) Suggesting that visitors are limited to family members only

Question 8

A nurse in a long term care facility is concerned that a 94-year-old resident with dementia is losing weight. Upon assessment, the nurse notes that the resident, who is able to feed herself independently, consumes less than 50% of each of her meal trays. Which of the following strategies can the nurse utilize to improve this resident's intake? (Select all that apply.)

A) Assign a nursing assistant to feed the resident.
B) Assign a nursing assistant to sit with the resident as the resident eats.
C) Serve the resident finger foods.
D) Serve the resident one dish at a time.
E) Alter the dining ambience to reduce distractions.

Question 9

An older client admitted to the hospital after having sustained a fall at home is diagnosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium?

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

Question 10

A nurse is caring for a 92-year-old female patient who was admitted to the hospital 1 day after she had outpatient cataract surgery. The patient who lives in an assisted living facility became very confused and agitated and was found wandering in the lobby of the building in her nightgown. She refused to return to her room and stated that there were "bad men" in her room. The patient has a history of dementia, diabetes, heart failure, and is on seven different medications. She was widowed 1 year ago. The nurse suspects that she has delirium. What are the patient's risk factors for delirium? (Select all that apply.)

A) Age of 92
B) Residing in an assisted living facility
C) History of dementia
D) Female gender
E) Recent cataract surgery