Deck 14: Neurocognitive Disorders

Question 1

The large majority of older people ____ have substantial cognitive problems.

A) do
B) often
C) do not
D) never

Answer 1

do not

Question 2

When people who were previously cognitively normal have had some major medical event like surgery or have a high fever and they seem severely confused and have trouble staying awake, they may be experiencing

A) delusions.
B) delirium.
C) dementia.
D) decorticate functioning.

Answer 2

delirium.

Question 3

Cognitive changes that are massive, often irreversible, and significantly interfere with daily functioning are characteristic of advanced

A) dementia.
B) delirium.
C) amnesia.
D) aphasia.

Answer 3

dementia.

Question 4

When a dementia diagnosis is apparent, the individual's cognitive deficits

A) are sudden, irreversible, and chronic.
B) are gradual, chronic, progressive, and usually irreversible.
C) need clarification, can be serious, and are irreversible.
D) are intermittent, somewhat chronic, and pervasive.

Question 5

An important characteristic of delirium is that the symptoms

A) start out marginal and then escalate to psychosis.
B) are less apparent if the person isn't upset.
C) are quite unpredictable and seldom repeat.
D) fluctuate over hours and days.

Question 6

Carter just had heart surgery is waking up from the anesthesia. As per hospital protocol, the nurse asks him his name and where he is, and, while he remembers his name, he believes that he is in an airport and is quite concerned about getting to his plane on time. Later that day, he mistakes his adult daughter for his long-deceased sister. Within a day, however, he seems to be back to his usual self, knows who his family members are, and recalls that he has just had major surgery. Carter has likely experienced

A) delirium.
B) dementia.
C) Alzheimer's disease.
D) Korsakoff's syndrome.

Question 7

How is delirium different from dementia?

A) Dementia involves a progressive course.
B) Delirium involves chronic deficits for long periods.
C) Dementia involves conditions that are usually reversible.
D) Delirium involves gradual onset of deficits.

Question 8

In order to diagnose the presence of delirium, evidence of ____ is needed.

A) brain damage on neuroimaging studies
B) a change from baseline cognitive functioning
C) the disturbance is a direct physiological consequence of another medical condition.
D) brain damage on neuroimaging studies and of a change from baseline cognitive functioning

Question 9

Many people in a state of delirium slip in and out of

A) sleep or conscious awareness.
B) work or depression.
C) rehab or institutionalization.
D) self-injury or depression.

Question 10

Cognitive deficits involving problems with memory, attention, language, concentration, judgment, and problem-solving that progressively worsen occur in

A) delirium.
B) dementia.
C) stroke.
D) mood disorders.

Question 11

Which individual has presenile dementia resulting in major neurocognitive disorder?

A) Ellie, who is 43, can't figure out how to turn her stove on, and hasn't been paying her bills because it is too confusing.
B) Jack, who is 43, sometimes feels confused, and takes longer to figure things out, but is still cooking meals and paying bills just fine.
C) Mandy, who is 68, can't use the toilet without assistance any longer, and cannot figure out how to get dressed and undressed.
D) Zachary, who is 93, is sharp as a tack, but feels slower in getting around the house.

Question 12

Age-associated cognitive changes may relate to alterations in the brain areas that are most responsible for memory, particularly the

A) prefrontal cortex.
B) thalamus and occipital lobe.
C) hippocampus and frontal lobes.
D) amygdala and thalamus.

Question 13

As we enter our 30s and 40s, slightly greater problems start to occur with respect to

A) long-term memory.
B) intermittent memory.
C) sensory memory.
D) short-term memory.

Question 14

Delirium is commonly associated with a person having difficulty remembering personal information, where he is, or even what time it is. This difficulty is referred to as

A) misrepresentation.
B) disorientation.
C) disrepresentation.
D) time and space continuum.

Question 15

The best known and most prominent form of dementia is

A) senior dementia.
B) Korsakoff's syndrome.
C) Alzheimer's disease.
D) vascular dementia.

Question 16

Which disorder that can be associated with changes in cognition has, by definition, an acute onset rather than one that is insidious or variable?

A) depression
B) dementia
C) schizophrenia
D) delirium

Question 17

Delirium is usually caused by

A) general medical conditions or substance intoxication and withdrawal.
B) age-related changes in cerebral blood flow.
C) poor socialization skills.
D) misdiagnosis of a psychological condition.

Question 18

Chantal knows she went into the bedroom for some reason, but now that she is there, cannot remember what it is. She feels like she knows what it is, but just cannot retrieve the memory. This happened the other day when she was telling her sister about a problem with her refrigerator, but could not remember the word "refrigerator" to save her life! These experiences of knowing something without being able to retrieve it are examples of

A) anterograde amnesia.
B) disorientation.
C) delirium tremens.
D) the tip-of-the-tongue phenomenon.

Question 19

Cognitive deficits that are chronic, develop slowly, show a progressive course, and are usually irreversible characterize which condition?

A) delirium
B) dementia
C) stroke
D) mood disorders

Question 20

When a person with delirium struggles to remember personal information, where he/she is, or even a basic understanding of time, he/she is experiencing

A) disequilibrium.
B) homeostatic disruption.
C) disorientation.
D) pervasive confusion.

Question 21

People with Parkinson's disease often display ____ dementia, meaning their primary cognitive problems include slowed thinking and difficulty using newly acquired knowledge and retrieving information from memory.

A) cortical
B) subcortical
C) infratentorial
D) ventricular

Question 22

Dan is visiting his folks for Christmas and having a grand time. Suddenly, in the middle of singing a Christmas carol, Dan's dad seems to change abruptly. His speech starts slurring, and he loses control of the right side of his body. He appears very confused, although this comes and goes, and at times, he is completely alert and aware. After some testing at the emergency room, Dan and his mom are likely going to be informed that his dad has had

A) a stroke.
B) Alzheimer's disease.
C) Pick's disease.
D) Korsakoff's syndrome.

Question 23

A common form of dementia that may be associated with a stroke is called

A) senile dementia.
B) Korsakoff's syndrome.
C) Alzheimer's disease.
D) vascular dementia.

Question 24

Which disorder is characterized by acute onset, fluctuating course, impaired level of consciousness, inattention and poor memory, hallucinations that are usually visual, fleeting, and fragmented delusions?

A) delirium
B) dementia
C) depression
D) schizophrenia

Question 25

People with Parkinson's disease show less of the classic characteristics of ____ dementia found in people with Alzheimer's disease.

A) subcortical
B) infratentorial
C) cortical
D) ventricular

Question 26

A progressive neurological disorder marked by abnormal movements such as rigidity, bradykinesia, hypokinesia, and hypomimia, as well as significant cognitive changes, is

A) Alzheimer's.
B) Pick's.
C) Parkinson's.
D) amnestic disorder.

Question 27

Which disorder is characterized by variable onset, variable course, exacerbations, poor attention, hallucinations that are usually auditory, and frequent complex often paranoid delusions?

A) delirium
B) dementia
C) depression
D) schizophrenia

Question 28

People with vascular dementia often have

A) a history of stroke and faster onset of dementia systems.
B) better retention of overall cognitive functioning and stepwise deterioration.
C) focal neurological signs and patchy distribution of deficit.
D) all of these choices.

Question 29

Blood clots that block a key artery to the brain produce a(n) ____ stroke.

A) dementing
B) hemorrhagic
C) ischemic
D) clotted

Question 30

Impaired ability to recognize people for common objects, as when a person fails to recognize loved ones or basic items, such as a spoon, is called

A) apraxia.
B) agnosia.
C) aphasia.
D) executive functioning deficit.

Question 31

Rosetta has demonstrated difficulty understanding what others say to her as well as difficulty speaking and maintaining a conversation with her children. She is most likely experiencing

A) apraxia.
B) agnosia.
C) aphasia.
D) executive functioning deficit.

Question 32

The form of dementia caused by problems with blood vessels that supply the brain with oxygen and other nutrients is called

A) blood vessel dementia.
B) anoxia dementia.
C) hypoxia dementia.
D) vascular dementia.

Question 33

Which disorder is characterized by insidious onset, often progressive course that is not usually reversible, clear consciousness until late stages, poor memory, possible visual or auditory hallucinations, and often fixed paranoid delusions?

A) delirium
B) dementia
C) depression
D) schizophrenia

Question 34

A stroke with uncontrolled bleeding is also called a(n)

A) ischemic stroke.
B) dementing stroke.
C) hemorrhagic stroke.
D) Alzheimer's stroke.

Question 35

Impaired ability to plan or organize daily activities, to engage in abstract thinking, or to understand sequences of events are examples of

A) apraxias.
B) agnosias.
C) aphasias.
D) executive functioning deficits.

Question 36

What type of dementia is extremely similar to Alzheimer's disease and includes most of its key features but may also include visual and auditory hallucinations, muscle tremors, and a more fluctuating course of symptoms?

A) new variant CJD
B) atypical Alzheimer's
C) dementia with fluctuation
D) Lewy body disease.

Question 37

The rate of dementia ____.

A) decreases with less stressors, especially after age 60.
B) increases with more stressors, especially after age 60.
C) decreases with age, especially after age 80.
D) increases with age, especially after age 80.

Question 38

As Alzheimer's disease progresses, which area will be the last to change significantly?

A) physical abilities
B) memory
C) ability to drive a car
D) level of consciousness

Question 39

Impaired ability to use or comprehend spoken language, as when a person has difficulty speaking or cannot understand what is being said to him, is called

A) apraxia.
B) agnosia.
C) aphasia.
D) executive functioning deficit.

Question 40

A person who has partial or fragmentary deficits with dementia, may be referred to as having

A) partial deficit debilitation.
B) inconsistent deficit to dementia.
C) patchy distribution of deficits.
D) specialized deficit dementia.

Question 41

A cognitive disorder associated with chronic alcohol use is

A) Korsakoff's syndrome.
B) Alzheimer's syndrome.
C) Parkinson's syndrome.
D) Pick's syndrome.

Question 42

Relatively ____ evidence for a genetic predisposition of Alzheimer's disease has been found.

A) strong
B) weak
C) inconclusive
D) moderate

Question 43

Miguel has sustained a traumatic brain injury. Things that used to be quite simple are now very difficult. In particular, Miguel finds he is unable to give his address when asked for it. He can't think of his parents' first names when the physician asks him for those. When put on the spot, he really struggles to give an answer to things that he should actually know. Miguel is having difficulty with

A) thiamine balance.
B) vitamin D balance.
C) spontaneous recall.
D) retrograde recall.

Question 44

Shaun is an alcoholic who consumes more alcohol than food. He develops symptoms of disorientation and memory loss, but at the same time, seems to have a fantastic imagination. For example, when he met his doctor for the first time, they had a long discussion about how they were both from Portland, Oregon, and went to school with many of the same people. In reality, Shaun is from Chicago, Illinois, and has never been to Oregon. His ability to manufacture a story like this to cover the fact that he cannot remember his own personal history likely results from

A) thiamine excess.
B) thiamine deficiency.
C) vitamin D excess.
D) vitamin D deficiency.

Question 45

Which person has a concern having to do with structural stigma associated with neurocognitive disorders?

A) Lyla is disgusted by some of the duties she has to perform as part of being a caregiver for patients on an Alzheimer's unit.
B) Rachel is ashamed to be seen with her mom, who has Alzheimer's, because her appearance is disheveled and behavior strange.
C) Jon is concerned that his aging father, who has dementia, will not have adequate access to appropriate healthcare services.
D) No one invites the Johnsons out to dinner because the father of the family has early-onset dementia and can be inappropriate.

Question 46

In general, the prevalence of delirium

A) is not related to age.
B) increases with age.
C) decreases with age.
D) stays constant with aging.

Question 47

The prevalence of Alzheimer's disease is highest in

A) Africa
B) the Middle East
C) Asia
D) Europe and the Americas

Question 48

Candace's mother has advanced stage Alzheimer's disease. Candace is her primary caregiver. Candace is most likely to mistreat her mother if

A) she and her mother do not share living space.
B) she and her mother have a wide network of friends.
C) her mother is aggressive toward her.
D) any of these choices occur.

Question 49

Alexander has experienced a traumatic brain injury. Subsequent to the injury, he is unable to form new memories. He can recall events from the distant past, but if he meets a person and has a conversation, then that person leaves the room and returns, he will not recall that they spoke a few moments earlier. Alexander is exhibiting characteristics of

A) retrograde memory problems.
B) anterograde memory problems.
C) Alzheimer's disease.
D) Korsakoff's syndrome.

Question 50

Dementia due to Pick's disease has deterioration mainly in the ____ brain lobes, and the onset is generally ____ when compared to Alzheimer's disease.

A) parietal and temporal; later
B) occipital and frontal; about the same time
C) frontal and temporal; earlier
D) frontal and parietal; later

Question 51

John is a chronic alcohol abuser and has been an alcoholic for well over 30 years. If he presents with confabulation, disorientation, and confusion, his health care team may consider a diagnosis of

A) Tourette's syndrome.
B) Korsakoff's syndrome.
C) neural degeneration syndrome.
D) cognitive alcohol deficit.

Question 52

The four main genetic factors that seem related to Alzheimer's disease are all are related to ____ and involve ____ combinations.

A) neurotransmitter; neural networks
B) proteins; chromosomes
C) hormone; endocrine glands
D) lipid; cell body structures

Question 53

Delirium is a disorder that can affect anyone because the problem can result from various medical conditions, substances, and other variables. With age, the prevalence of delirium

A) remains the same.
B) decreases.
C) increases.
D) varies greatly.

Question 54

The neurocognitive disorders described in your textbook are ____ with one another and ____ with emotional problems.

A) nonrecurring; comorbid
B) highly comorbid; highly comorbid
C) slightly comorbid; not connected
D) highly comorbid; not connected

Question 55

Camden has a mutation of presenilin 1, which means he is at greater risk for

A) early onset Parkinson's disease.
B) late onset Parkinson's disease.
C) early onset Alzheimer's disease.
D) late onset Alzheimer's disease.

Question 56

In the United States, risk for Alzheimer's disease is highest for

A) African Americans and Hispanics.
B) European Americans and Hispanics.
C) European Americans and African Americans.
D) European Americans and Asians.

Question 57

Which statement about vascular dementia is most accurate?

A) African Americans tend to have higher rates of vascular dementia than European Americans.
B) Women have higher rates of vascular dementia than do men, especially at younger ages.
C) Vascular dementia rates decrease with age after about age 75.
D) Almost everyone who has a stroke will develop vascular dementia.

Question 58

Which person has a concern having to do with lay public stigma associated with neurocognitive disorders?

A) Lyla is disgusted by some of the duties she has to perform as part of being a caregiver for patients on an Alzheimer's unit.
B) Rachel is ashamed to be seen with her mom, who has Alzheimer's, because her appearance is disheveled and behavior strange.
C) Jon is concerned that his aging father, who has dementia, will not have adequate access to appropriate healthcare services.
D) No one invites the Johnsons out to dinner because the father of the family has early-onset dementia and can be inappropriate.

Question 59

Men and women show

A) equal rates of Parkinson's disease and equal rates of dementia due to Parkinson's.
B) equal rates of Parkinson's disease, but unequal rates of dementia due to Parkinson's, with women showing more dementia than men.
C) unequal rates of Parkinson's disease, with men more likely than women to have it, but equal rates of dementia due to Parkinson's.
D) unequal rates of Parkinson's disease, with women more likely than men to have it, and unequal rates of dementia due to Parkinson's

Question 60

People with Parkinson's disease can experience stigma due to ____, which makes them appear socially disengaged and apathetic

A) facial masking
B) emotional numbing
C) physical tremors
D) slow speech

Question 61

Moderate alcohol use may enhance ____ release from the hippocampus to improve memory.

A) acetylcholine
B) GABA
C) dopamine
D) serotonin

Question 62

As neurofibrillary tangles occur more frequently and affect multiple areas, the brain's ability to coordinate behavior and communicate with the body

A) increases.
B) remains consistent.
C) fluctuates unpredictably.
D) becomes severely impaired.

Question 63

Which statement about cultural and neurocognitive disorders is false?

A) Alzheimer's disease appears more prevalent in Western nations.
B) Native Americans tend to view dementia as a normal and expected part of aging.
C) Minority caregivers report increased service use due to higher rates of dementia among minority groups.
D) European American caregivers report increased rates of inaccurate diagnosis and poor feedback from physicians.

Question 64

Insoluble protein formations that accumulate on synapses and block information transmission are called

A) alpha nucleus proteins.
B) atrophy compounds.
C) alpha-beta proteins.
D) Lewy bodies.

Question 65

Large deposits of beta-amyloid may force the overproduction of ____, which lead to the changes resulting in dementia.

A) antioxidants
B) oxidants
C) free radicals
D) oxidative stressors

Question 66

High levels of dietary antioxidants ____ the progression of Alzheimer's disease.

A) slow but do not stop
B) stop
C) speed up
D) have no effect

Question 67

A common brain change in people with dementia is due to plaques that accumulate into spaces between neurons in the brain. These are known as

A) neuritic plaques.
B) fibrillatory plaques.
C) dementing plaques.
D) neurological plaques.

Question 68

Another name for deterioration of brain tissue and dementia is

A) putrefaction.
B) decomposition.
C) atrophy.
D) senility.

Question 69

Frontotemporal atrophy is often seen in people with

A) Pick's disease.
B) Parkinson's disease.
C) DLB.
D) Alzheimer's disease.

Question 70

Dementia risk may be lowered by a diet consisting of all EXCEPT

A) fish.
B) fruits.
C) vegetables.
D) saturated fats.

Question 71

Many single-gene disorders such as sickle-cell disease predispose people toward a major cause of vascular dementia known as

A) vasculitis.
B) dementing vesicles.
C) stroke.
D) vascular bleeding.

Question 72

The process involving gradual deterioration of different brain areas is called

A) atrophy.
B) degradation.
C) cellular reduction.
D) synapse pruning.

Question 73

Which of the following is the best analogy for neurofibrillary tangles that occur in Alzheimer's disease?

A) long hair that has not been brushed for a while and is in knots
B) railroad tracks with ties that have become twisted around themselves, resulting in the collapse of the tracks
C) a series of runways at an airport without an effective air traffic controller
D) an extremely congested highway that has road construction combined with poor signs to direct commuters

Question 74

Alpha-synuclein proteins that collect in the brain and cause damage and dementia create

A) senile plaques.
B) neuritic plaques.
C) Lewy bodies.
D) atrophistic plaques.

Question 75

Steve has Parkinson's disease. Over time, this is likely to produce lower levels of ____, particularly in the region of the brain known as the ____.

A) acetylcholine; hippocampus
B) acetylcholine; substantia nigra
C) dopamine; hippocampus
D) dopamine; substantia nigra

Question 76

Risk factors for cognitive disorders are primarily biological, but environmental risk factors may also play a part in the areas of

A) stress reaction, lack of social support, and radiation.
B) drug overdose, debilitation anxiety, and lead exposure.
C) birth order, family dynamics, and social alienation.
D) diets, alcohol and tobacco, exposure to neurotoxins, and culture.

Question 77

Brain cells are normally exposed to oxygen, which can damage the cells, but ____ in vitamins and other substances help prevent major damage.

A) oxidation reduction substances
B) free radicals
C) oxidative stress
D) antioxidants

Question 78

Dementias are often marked by low levels of the neurotransmitter

A) acetylcholine.
B) GABA.
C) dopamine.
D) all of these choices.

Question 79

Increased dietary ____ may be associated with increased risk of cognitive decline.

A) vitamin B₆
B) antioxidants
C) cholesterol
D) omega 3 fatty acids

Question 80

Neurochemical changes found in dementia are often related to lower levels of

A) ACH, dopamine, and epinephrine.
B) serotonin, melatonin, and norepinephrine.
C) acetylcholine, serotonin, and norepinephrine.
D) acetylcholine, melatonin, and serotonin.