Question 1

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

Accepted Answer

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." B

Question 2

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

Accepted Answer

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. D

Question 3

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

Accepted Answer

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 A

Question 4

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. )

Accepted Answer

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 5

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

Accepted Answer

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

Question 6

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." What information does the nurse share with the patient?

Accepted Answer

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 better.
D)  In time,people adjust to the side effects.

Question 7

A home care nurse is visiting a patient with moderate cognitive impairment from Alzheimer's 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. )

Accepted Answer

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 8

An older patient is anxious about an upcoming diagnostic test and requests something to calm the nerves.What medication does the nurse prepare to administer?

Accepted Answer

A)  Clonazepam
B)  Diazepam
C)  Chlordiazepoxide
D)  Lorazepam

Question 9

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

Accepted Answer

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 10

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

Accepted Answer

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 11

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

Accepted Answer

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 12

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

Accepted Answer

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 13

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. )

Accepted Answer

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 14

The son of a patient with possible Alzheimer's disease (AD)asks the nurse if there is a diagnostic test that can confirm the diagnosis.Which response by the nurse is best?

Accepted Answer

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 15

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

Accepted Answer

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 16

An older adult patient being treated for chronic obstructive pulmonary disease (COPD)is exhibiting signs of memory loss and confusion.What is the priority for the nurse when planning care for this patient?

Accepted Answer

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 17

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

Accepted Answer

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 (MMS
E)  .

Question 18

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?

Accepted Answer

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 19

An 89-year-old patient diagnosed with dementia was until recently responding well to cognitive cueing techniques.What statement by the nurse to the care team shows an understanding of dementia?

Accepted Answer

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 20

An older adult has been recently diagnosed with type 2 diabetes and mild retinal deterioration.What action by the nurse is best in order to address the patient's potential for developing situation depression?

Accepted Answer

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.

Exam 24: Cognitive and Neurologic Function