Deck 27: Cognitive and Neurologic Function

Question 1

An older adult has a medical condition that has required hospitalization at a facility far from home and family.To best minimize the patient's risk for depression,the nurse:

A)keeps the patient informed of the expected discharge date.
B)offers to help the patient telephone family members each evening.
C)reassures the patient that early discharge is a nursing goal.
D)encourages the patient to place family photographs around the room.

Answer 1

offers to help the patient telephone family members each evening.

Question 2

An older adult is experiencing age-related postural hypotension and he fears "something is really wrong" because he is the only one in his social group experiencing the problems.The nurse responds:

A)"Don't be concerned;just be very careful about your risk for falling."
B)"You have had very thorough testing,so don't worry about it being serious."
C)"It's just a matter of time before they too have to watch not to get up too quickly."
D)"You just don't have the compensating mechanisms of your friends."

Answer 2

"You just don't have the compensating mechanisms of your friends."

Question 3

Which of the following statements,when made by family members caring for an older patient with dementia,indicates peaceful acceptance of the situation?

A)"I'm so pleased that Mother had a good day today.I'm really very hopeful."
B)"The hospice nurses are so helpful when I need time for myself."
C)"I promised Mother I would take care of her and I'll never leave her."
D)"It's the least I can do for Mother since she cared for us all these years."

Answer 3

"The hospice nurses are so helpful when I need time for myself."

Question 4

An older adult has been recently diagnosed with type 2 diabetes and mild retinal deterioration.To best address the patient's potential for developing situation depression,the nurse:

A)assesses the patient's coping skills.
B)Encourages the patient to participate in a depression support group.
C)assesses the patient's ability to manage the symptoms.
D)educates the family on early signs of depression.

Question 5

An 80-year-old patient is exhibiting signs of dementia representative of Alzheimer disease (AD).The nurse supports that possibility when determining that the patient:

A)experienced a gastric resection several years ago.
B)traveled often to third world countries.
C)was employed as a steelworker for 40 years.
D)has a history of viral encephalitis.

Question 6

An 89-year-old diagnosed with dementia was until recently responding well to cognitive cueing techniques.The nurse shows an understanding of dementia when sharing with staff that:

A)"We will implement new interventions that address the disease's progression."
B)"It's important that we frequently recue the patient to improve her quality of life."
C)"The patient's family needs to be made aware of this decline."
D)"This poor response to cueing is likely a result of advanced aging."

Question 7

The son of a patient with possible Alzheimer disease (AD)asks the nurse if there is a diagnostic test that can confirm the diagnosis.The nurse responds that:

A)an electroencephalogram is often very useful in diagnosing AD.
B)a positron emission tomography (PET)scan is a cheap but dependable tool.
C)magnetic resonance imaging (MRI)is often ordered for that purpose.
D)postmortem autopsy is the only definitive diagnostic tool.

Question 8

A nurse is caring for an older patient diagnosed with acute depression.What action by the nurse is most important to help prevent delirium in this patient?

A)Reorienting the patient to the day,time and place frequently
B)Being physically present to help the patient with eating meals
C)Providing the patient with opportunities to discuss depression
D)Administering antidepressive medication as prescribed

Question 9

An 80-year-old patient who is experiencing symptoms of depression and anxiety is reluctant to comply with the prescribed treatment plan.The nurse initially addresses the issue with the patient by asking:

A)"How do you feel about how others view your mental health problem?"
B)"Are you concerned about paying for your psychiatric medications?"
C)"Did you know that depression is common among people your age?"
D)"Do you have any questions about your the mental health treatment plan?"

Question 10

An older adult patient being treated for chronic obstructive pulmonary disease (COPD)is exhibiting signs of memory loss and confusion.In planning his care,the nurse should give priority to:

A)obtaining an order for a pulmonary function test (PFT).
B)determining the potential of a possible adverse drug reaction.
C)reorienting the patient to time,place,and person frequently.
D)assessing for a family history of dementia.

Question 11

The nurse is conducting an admission assessment on a mildly confused older patient.The nurse best assures an accurate history by first:

A)scoring the client's cognitive responses.
B)focusing on the client to respond.
C)directing the questions to both patient and family.
D)arranging a Mini-Mental State Examination (MMSE).

Question 12

To best advocate for an older adult patient being prescribed medication to control newly observed signs of confusion and aggressive behavior,the nurse:

A)initiates an assessment to determine possible underlying causes of the behavior.
B)contacts family to inform them of the new medication therapy being planned.
C)discusses possible nonpharmaceutical treatments with the physician.
D)documents a detailed description of the behaviors before administering the drugs.

Question 13

The nurse caring for an older adult patient recovering from cardiac surgery recognizes that it is most appropriate to assess this patient for mental health problems because:

A)cardiac surgery often results in anxiety-related issues.
B)untreated depression can contribute to the patient's morbidity risks.
C)many in this age cohort have undiagnosed depression.
D)hospitalization is both anxiety and depression inducing.

Question 14

When planning care for the older adult being treated for depression,the nurse addresses the patient's tertiary intervention needs best by:

A)helping the patient to identify the early symptoms of depression.
B)helping the patient deal with the physical symptoms of depression.
C)discussing with the patient how to implement new coping skills.
D)educating the patient about the importance of being drug compliant.

Question 15

What education by the nurse is most important to address age-related changes to the senses?

A)Installing auditory smoke alarms
B)Having regular eye checkups
C)Being aware that hearing acuity decreases with age
D)Checking the expiration dates on foods such as dairy

Question 16

An older patient is anxious about an upcoming diagnostic test and requests something to calm the nerves.To best address the patient's need,the nurse prepares to administer a PRN dose of:

A)clonazepam (Klonopin).
B)diazepam (Valium).
C)chlordiazepoxide (Librium).
D)lorazepam (Ativan).

Question 17

While collecting a health history for an older adult patient,the nurse learns that the patient had been prescribed Elavil 3 weeks ago and wants to stop taking it because "It didn't make me feel any better." In response to this information,the nurse shares with the patient that:

A)sudden withdrawal is likely to cause a hypertensive crisis.
B)depression seldom improves without medication.
C)realistically it will take longer for the patient to feel an improvement.
D)in time,people adjust to the side effects.

Question 18

When assessing an older patient displaying symptoms of delirium,the nurse focuses the assessment on:

A)the degree and duration of the symptoms.
B)the amount of self-care deficiency the symptoms cause.
C)identifying processes that commonly result in the symptoms.
D)physiologic dysfunction resulting from the symptoms.

Question 19

A 73-year-old patient diagnosed with vascular dementia is admitted for exacerbation of asthma.The patient has been treated for 2 years with benzodiazepines to manage her increasingly aggressive behavior.The nurse's initial response is to:

A)identify the patient as being at high risk for falls.
B)monitor the patient for signs of benzodiazepine withdrawal.
C)notify the admitting physician immediately.
D)place the patient on strict intake and output.

Question 20

When planning care for the older adult with advanced dementia,the nurse recognizes that the best way to implement reality orientation is to:

A)place printed labels on important items,such as the telephone.
B)place a clock and calendar in the patient's immediate environment.
C)use hand gestures instead of verbal communications to demonstrate meaning.
D)show the patient a picture of a toothbrush when it is time for oral hygiene.

Question 21

An older adult is hospitalized for treatment of a mental health disorder and is prescribed clomipramine (Anafranil).The nurse documents that the medication is having the desired effect when the patient:

A)begins sleeping 8 hours per night.
B)engages in fewer ritualistic behaviors.
C)reports fewer episodes of nervousness.
D)exhibits no delusionary thinking.

Question 22

To help manage the potential side effects of prescribed antipsychotic medications,amantadine (Symmetrel)may be prescribed.Which statement best indicates that the nurse understands the appropriateness of this medication for the older adult patient?

A)"This medication produces few anticholinergic effects."
B)"Symmetrel is an effective dopamine agonist."
C)"Extrapyramidal symptoms are best controlled by Symmetrel."
D)"Older patients seem to have the fewest side effects on this medication."

Question 23

A 78-year-old patient was admitted with dehydration.The nurse assesses and documents observations that support a finding of dementia.Which of the following observations are related to dementia? (Select all that apply. )

A)Forgetting what she ate for lunch today
B)Crying frequently when alone
C)Inability to find her way back to her room from the dayroom
D)Being impatient with the nursing staff for not closing her door
E)Repeatedly asking to call her son

Question 24

A 72-year-old is prescribed lithium.The nurse educates the patient on the importance of biannual evaluation of which of the following? (Select all that apply. )

A)Renal function
B)Serum glucose level
C)Liver function
D)Thyroid function
E)Red blood cell count

Question 25

The nurse familiar with the old adult population recognizes that the patient who has the greatest potential for successfully committing suicide is the:

A)63-year-old Asian female.
B)86-year-old Caucasian male.
C)76-year-old Hispanic female.
D)67-year-old African-American male.

Question 26

The nurse is caring for an older adult patient admitted to the hospital.What assessment findings place the patient at risk for developing delirium during the hospitalization? (Select all that apply. )

A)The patent takes medications to manage several chronic illnesses.
B)The patent has a history of urinary tract infections.
C)The patent is in cancer remission.
D)The patent has recently been eating poorly.
E)The patent experienced a mild heart attack 2 years ago.

Question 27

The nurse is caring for a severely depressed older patient.To best effect change in the patient's emotional state,the nurse's initial goal is to:

A)plan interventions that will enhance the patient's self-esteem.
B)introduce the patient to new coping skills.
C)assess the patient's potential to self-harm.
D)develop a therapeutic nurse-patient relationship.

Question 28

A home care nurse is visiting a patient with moderate cognitive impairment from Alzheimer disease.The patient's partner expresses concern about difficulty getting the patient "to eat properly." The nurse suggests which of the following? (Select all that apply. )

A)Serving meals at the same time each day
B)Offering liquids in place of solid foods when possible
C)Offering a calorie-dense snack at bedtime
D)Cutting food into bite-sized pieces that will fit into the patient's hand
E)Asking the patent to identify favorite foods

Question 29

A 65-year-old adult who recently lost his spouse is admitted to the hospital after a failed suicide attempt.He presents with a sad affect and is reluctant to interact within the milieu.The nursing diagnosis with priority is:

A)ineffective coping related to recent loss.
B)hopelessness related to death of spouse.
C)risk for loneliness related to loss of spouse.
D)risk for self-directed violence related to depression.