Deck 47: Care of Patients with Cognitive Disorders

Question 1

Donepezil (Aricept)has been prescribed for a patient with Alzheimer disease (AD).Which statement indicates that the patient and spouse understand teaching about the medication?

A) "It is best to take the medication at bedtime."
B) "The medication will interact with dark leafy greens."
C) "Taking the medication with a citrus beverage should improve absorption."
D) "The medication should be taken with meals."

Answer 1

"The medication should be taken with meals."

Question 2

The nurse is aware that the older adult is at risk for drug-induced delirium.Which age-related change contributes to this risk?

A) Slower bowel motility
B) Reduced fluid intake
C) Overall reduced metabolism
D) Sedentary lifestyle

Answer 2

Overall reduced metabolism

Question 3

The nurse differentiates vascular dementia from Alzheimer dementia.Which causative factor is responsible for vascular dementia?

A) Cerebral atrophy
B) Global reduction of cognition
C) Hypertension
D) Emboli in cerebral vessels

Answer 3

Emboli in cerebral vessels

Question 4

The nurse is caring for a patient with acquired immune deficiency syndrome (AIDS)dementia complex (ADC).Which factor places this patient at particular risk for injury?

A) Manic behavior
B) Numbness and muscle weakness
C) Suicidal ideation
D) Difficulty concentrating

Question 5

The nurse is caring for a patient with Alzheimer disease (AD)who wakes up moaning and frightened in the middle of the night.She begs that her husband's coffin be removed from her room.How should the nurse respond?

A) Turn light on and say, "There is no coffin here. 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."

Question 6

The nurse notes that the newly admitted patient with Alzheimer disease (AD)has significant anomia.Which intervention is most appropriate for this problem?

A) Frequently reorient the patient to his room location.
B) Remind the patient about the names and uses for particular items.
C) Assist the patient with all meals.
D) Wait patiently for the patient to find the word he wants.

Question 7

The home health nurse is counseling a family who will be caring for a relative with moderate-stage Alzheimer disease (AD).Which information is most important to include?

A) Construct a consistent routine to provide structured environment.
B) Try to make each day different to enhance attention span.
C) Use multiple caregivers to decrease unhealthy attachment and prevent caregiver burnout.
D) Place bright scatter rugs, flower arrangements, and wall decorations around the room to stimulate sensory perception.

Question 8

The CNA approaches the older adult in the long-term care facility and says,"Oh,look! Your pretty dress is icky with food spots! Let's change your clothes,sweetie." The nurse identifies that the CNA is using which type of communication?

A) Instruction for personal hygiene
B) Encouragement for self-care
C) Simplistic "elderspeak"
D) Reorientation techniques

Question 9

The patient with Alzheimer's disease (AD)has been on donepezil (Aricept)for several weeks.In which situation would the nurse suspect an overdose?

A) The patient hungrily eats meals and often searches for snacks between meals.
B) The nurse assesses a radial pulse rate of 92 beats/min.
C) The patient's blood pressure is elevated after periods of exertion.
D) The patient fails to grasp a glass tightly enough to prevent dropping it.

Question 10

Postmortem brain examinations of Alzheimer disease (AD)patients reveal which type of finding(s)?

A) Tangled nerve cells
B) Abnormal buildup of proteins
C) Hemorrhagic areas
D) Occluded cerebral vessels
E) Reduced white matter

Question 11

An exhausted daughter is the sole caregiver to a patient with moderate Alzheimer disease (AD).She asks the nurse what respite care entails.Which statement indicates that the caregiver understands the nurse's response?

A) "My mom would stay in a long-term care facility for a short time while I rest."
B) "Home health aides would come to our home and help me with housework."
C) "A registered nurse would provide total care for my mom in 3 day intervals."
D) "I would be connected with a special support group to share stresses and communicate with other caregivers."

Question 12

How should the nurse speak when communicating with a patient with moderate Alzheimer dementia?

A) Slowly
B) Clearly
C) Loudly
D) Softly

Question 13

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

A) The nurse instructs the patient to apply the patch 12 hours after the last oral medication dosage.
B) The nurse instructs the patient to replace the patch every 36 hours.
C) The nurse explains that the sites of application will need to be rotated.
D) The nurse instructs the patient to avoid placing the patch on the trunk region of the body.

Question 14

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 is most therapeutic?

A) The nurse raises all of the side rails.
B) The nurse reassigns the patient to a room closer to the nurse's station.
C) The nurse obtains orders from the physician to apply restraints at night.
D) The nurse places the mattress on the floor.

Question 15

Which percentage of the population that is 85 years of age and older has some stage of Alzheimer disease (AD)?

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

Question 16

The nurse is assisting the patient with middle-stage Alzheimer's disease (AD)with dressing.Which action is most appropriate?

A) Select clothes and dress the patient.
B) Layout clothing and coach the patient to dress self.
C) Ask the patient what he wants to wear.
D) Open the closet and tell the patient to choose a shirt.

Question 17

An 85-year-old man is admitted to the hospital with gastroenteritis and dehydration.He receives 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.Which explanation best describes this behavior?

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 18

In which situation should the nurse document that the patient with AD exhibited agnosia?

A) The patient attempts to comb her hair with a fork.
B) The patient struggles to express herself verbally.
C) The patient appears unable to understand written language.
D) The patient cannot feed herself, despite having adequate motor function.

Question 19

Memory lapses seen in early stages of Alzheimer disease (AD)are related to the pathophysiology of which condition?

A) Frontal lobe atrophy
B) Overproduction of neurotransmitters
C) Pituitary disorders
D) Inadequate clearance of metabolic toxins

Question 20

The nurse is caring for a patient with moderate Alzheimer disease (AD)in a long-term care facility who "sundowns." The nurse understands that which action would be most beneficial for this patient?

A) Scheduling social interaction activities in the morning.
B) Darkening the bedroom to encourage sleep.
C) Administering sedatives to enhance sleep initiation.
D) Scheduling an exercise program after supper.

Question 21

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 22

Which strategy/strategies best benefit(s)a late-stage Alzheimer patient with global amnesia?

A) Reorientation sessions
B) Music therapy
C) Reminiscence therapy
D) Pet therapy
E) Looking at family scrapbooks

Question 23

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 24

The home health nurse assesses caregivers for a person with a cognitive deficit.Which finding(s)is/are characteristic of exhaustion?

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 above

Question 25

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 26

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)elirium

Question 27

The nurse is caring for a patient with memory deficits.The patient asks the nurse about foods that may help improve memory.Which food(s)is/are linked to enhanced memory?

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

Question 28

What does the Mini-Mental Status Exam (MMSE)assess? (select all that apply)

A) Orientation
B) Judgment
C) Memory
D) Insight
E) Ability to follow directions

Question 29

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 30

Which criteria must be established to assign a diagnosis of dementia?

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 above

Question 31

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