Deck 21: Cognitive Impairment

Question 1

When differentiating the characteristics of depression,delirium,and dementia,the nurse recognized which of the following as an indicator of delirium?

A) Sudden onset
B) Recent loss
C) Insidious
D) Life change

Answer 1

Sudden onset

Question 2

An older woman is recovering from a bowel resection in the intensive care unit but remains intubated and on a mechanical ventilator.Which of the following should the nurse implement to help prevent delirium in this woman?

A) Assess cognition with MMSE-2.
B) Provide uninterrupted periods of rest and sleep.
C) Maintain adequate sedation and pain management.
D) Cover the patient's eyes with protective ophthalmic ointment.

Answer 2

Provide uninterrupted periods of rest and sleep.

Question 3

The community health nurse is preparing for an educational session on AD for a group of seniors.Which modifiable risk factors should the nurse include?

A) Family history
B) Sex
C) Smoking
D) Obesity

Answer 3

Smoking
Obesity

Question 4

An older woman has a wound infection 5 days after a below-the-knee amputation brought about by diabetes mellitus.Which of the following is the nurse's priority intervention to prevent cognitive dysfunction and postoperative complications in this older adult?

A) Remove invasive devices as soon as possible.
B) Minimize the administration of opioid analgesics.
C) Allow for self-care and independent activities.
D) Administer short-acting benzodiazepines as needed.

Question 5

Which of the following approaches to hygienic care is beneficial for a patient with dementia?

A) Schedule the patient's full shower at 7 AM, three mornings every week.
B) Have a team give the bath with each member washing a different body area.
C) Wash the perineal region first to remove potentially infectious material.
D) Explain each step as you go, and keep the patient covered as much as possible while bathing.

Question 6

Which assessment parameter should the nurse use to differentiate between delirium and depression in an older adult?

A) Orientation
B) Activity
C) Course over the morning hours
D) Psychomotor activity

Question 7

The nurse recognizes which of the following displays may indicate hyperactive delirium?

A) Lethargy
B) Withdrawn behavior
C) Nonpurposeful repetitive movements
D) Decreased psychoactive activity

Question 8

Which of the following should the nurse use to assess a nonverbal older adult for delirium?

A) Cranial nerves XI and XII
B) Confusion Assessment Method
C) MMSE-2
D) Controlled Word Association Test

Question 9

A definitive diagnosis of Alzheimer disease (AD)can be made by detecting or using which one of the following methods?

A) Clinical observation of dementia
B) Inability to speak with relevance
C) Development of neurofibrillary tangles
D) Computed axial tomographic (CAT) scan

Question 10

A man who is 60 years of age and lives in the British Isles develops dementia.Which qualities of dementia does the nurse assess to prevent patient injury related to the type of dementia this man most likely has?

A) Visual hallucinations
B) Unilateral tremors
C) Visuospatial problems
D) Clumsy movements

Question 11

At 10 PM,an older male resident attempts to climb over the bedrails.Which intervention should the nurse implement first?

A) Talk to the resident about his behavior.
B) Call the physician, and ask for a sedative.
C) Apply a vest restraint on the resident.
D) Get a companion to keep him in the bed.

Question 12

The nurse working in a long-term care facility completes her morning assessment on a new postoperative patient and notes a change in cognitive status from the previous day? The nurse recognizes which of the following as a precipitating factor for delirium?

A) Major medical treatment
B) Poor sleep habits
C) Admission to long-term care
D) Pharmacological agents

Question 13

Which of the following statements is true about cognitive impairments in older adults?

A) Loss or interruption of sleep can lead to delirium.
B) Confusion is a normal and unavoidable consequence of aging.
C) Older patients who are agitated often have a lower cognitive status than those who are quietly sitting.
D) The Mini-Mental State Examination-2nd edition (MMSE-2) should be administered on admission to detect delirium.

Question 14

Which of the following is(are)the risk factors for vascular dementia (VaD)after a stroke?

A) Smoking
B) Male sex
C) Hypertension
D) Advancing age
E) Hyperlipidemia
F)African American

Question 15

Which types of exercise programs are better for older adults with AD for improving mood and function?

A) Balance
B) Walking
C) Self-paced
D) Endurance
E) Muscle strength
F)Lasting 16 weeks or longer

Question 16

Which medication administered for delirium under a controlled environment can reduce the duration and severity of delirium for high-risk patients?

A) Haloperidol (Haldol)
B) Thioridazine (Mellaril)
C) Fluphenazine (Prolixin)
D) Chlorpromazine (Thorazine)