Deck 10: Cognition and Perception

Question 1

What assessment finding would be indicative of delirium?

A) The onset of the behavior was rapid.
B) There is no change in the level of consciousness.
C) The absence of disorientation.
D) The absence of hallucinations.

Answer 1

The onset of the behavior was rapid.

Question 2

How can continuity of care be provided for a patient with dementia in the hospital setting?

A) Keep the patient in the room.
B) Reduce environmental stimuli such as the TV or radio.
C) Assign care to a consistent group of staff.
D) Attach a bed alarm to the patient.

Answer 2

Assign care to a consistent group of staff.

Question 3

Which condition could cause delirium in the older adult?

A) Uncontrolled pain
B) Death of a loved one
C) Relocation to a long-term care facility
D) Altered sleep patterns

Answer 3

Uncontrolled pain

Question 4

The nurse in an extended-care facility finds an 86-year-old female resident in tears and her hearing aids on the floor. The resident says, "I'll just be deaf! I can't stand those things in my ears! All I can hear is static, hums, and whistles!" What would be the most helpful response by the nurse?

A) "Everybody says that. I'm going to put these back in the box in your bedside table."
B) "Those are very expensive pieces of equipment. Because you paid for them, it seems to me to just be good sense to use them."
C) "Let's put them back in. You'll get used to them in a few days."
D) "It's frustrating to have something not work. Let me help you replace them and after 10 minutes, I'll help you take them out."

Question 5

When attempting to communicate with a patient who is hearing-impaired, what should the nurse consider?

A) Keep the message simple.
B) Provide lengthy explanations and information.
C) Assume understanding if the patient does not ask for clarification.
D) Use many hand gestures.

Question 6

The home health nurse is caring for a patient who has been recently diagnosed with a cognitive disorder. How can the nurse best prepare the family for the patient's care?

A) Leave them literature about the disorder.
B) Instruct them about the physiological changes that cause the disorder.
C) Allow them time for expression of their feelings and grief.
D) Discuss options for placement in a long-term care facility.

Question 7

What is an appropriate response by the nurse to a resident with dementia in a long-term care facility who becomes combative when being prepared for a shower?

A) Call for assistance to complete the shower.
B) Say, "I understand you don't want a shower, so I'll give you a sponge bath."
C) Medicate the patient with a sedative and complete the bath when the patient is more cooperative.
D) Say, "Okay. It's your right to remain dirty."

Question 8

The nurse reading the history of a newly admitted 88-year-old man with dementia sees that this resident is prone to catastrophic reactions. What behavior does the nurse expect to see in the patient?

A) Excessive emotional reactions
B) Combativeness with little stimulus
C) Displays of self-destructive behaviors
D) Displays of public exposure or sexual advances

Question 9

How should the nurse approach a patient who has profound hearing loss?

A) Knock on the door before entering.
B) Touch the patient on the hand to gain attention.
C) Give the patient a list of interventions that the nurse plans to perform.
D) Speak in a higher tone of voice.

Question 10

What would be the most effective intervention by the nurse when a patient with a cognitive disorder begins to exhibit delusional behavior as a result of excessive stimulation?

A) Medicate with a psychoactive drug such as lorazepam or diazepam.
B) Send the patient to his or her room for "time out."
C) Remind the patient that acting out behavior will not be tolerated.
D) Distract the patient with a quiet activity.

Question 11

Antipsychotic medication can be prescribed to control which patient symptom?

A) Disruptive verbal behavior
B) Constant yelling and hitting others
C) Hallucinations
D) Disorientation

Question 12

An 84-year-old female resident with dementia in an extended-care facility rapidly paces the halls and the common areas from right after breakfast to bedtime. What should be included in the nursing plan of care?

A) Restrain the resident from pacing.
B) Apply a bracelet that sounds an alarm if the resident leaves the building.
C) Encourage rest by asking her to sit and have a glass of juice or a snack.
D) Pace with her and engage her in conversations.

Question 13

A nurse is teaching a family member about her mother's memory loss. Which teaching points would be included in the teaching regarding memory loss? (Select all that apply.)

A) Increases with age
B) Decreases in a person with more education
C) Increases with the use of antihistamines
D) Decreases with the use of vitamin A
E) Decreases in persons who have many varied memories

Question 14

How should the nurse adapt the environment for a person with right-sided hemianopsia?

A) Approach the patient from the right side.
B) Arrange personal articles on the left side of the bed.
C) Remind the patient to avoid turning his or her head to reduce added perceptual problems.
D) Touch the patient on the right side to get his or her attention.

Question 15

What does perception refer to in the environment?

A) Intellect
B) Memory
C) Judgment
D) Interpretation

Question 16

Which of the following are indicators of hearing loss? (Select all that apply.)

A) Understanding the female voice better than the male voice
B) Reluctance to have telephone conversations
C) Becoming irritable with background noise
D) Turning the TV up to the loudest volume
E) Responding with off-the-wall answers to a question

Question 17

The nurse hears a high whistling noise coming from the hearing aids that are lying on the bedside table of the sleeping patient. What would be the most appropriate action by the nurse?

A) Replace the hearing aids in the patient's ears.
B) Turn off the hearing aids.
C) Place the hearing aids in a drawer to prevent loss.
D) Ask that an audiologist be notified of the problem.

Question 18

An older adult has expressive aphasia. What would be the most effective intervention for the nurse to use to improve the patient's communication?

A) Provide flash cards with text and pictures.
B) Be patient and ask him to repeat himself.
C) Encourage him to practice slow speech.
D) Arrange with him to blink the eyes once for "yes" and twice for "no."

Question 19

What observation would cause the nurse to suspect cataracts in the older adult?

A) Holds the newspaper a good distance away while attempting to read small print
B) Seeks an area in a room that is free from glare in order to read the newspaper
C) Holds a hand over one eye while attempting to read small print
D) Uses only peripheral vision while attempting to read a newspaper

Question 20

The physician states that the patient with Alzheimer disease has progressed from the preclinical stage of the disease to the mild cognitive impairment stage. What would the nurse expect to find upon assessment of the patient?

A) Inability to communicate
B) Incontinent episodes
C) Total dependency
D) Forgetfulness

Question 21

The person who is unable to identify time, place, or person to the point that he or she is unable to make appropriate decisions is described as __________.

Question 22

What are the three types of confusion? (Select all that apply.)

A) Acute confusion
B) Mixed confusion
C) Idiopathic confusion
D) Generic confusion
E) Dementia

Question 23

The nurse instructs a hearing-impaired patient on some methods to improve communication, which include __________. (Select all that apply.)

A) informing others of the hearing deficit
B) focusing on the speaker
C) facing the speaker
D) requesting the speaker to shout if necessary
E) asking the speaker to repeat what is not clear

Question 24

The nurse should include which factor(s) in a pain assessment? (Select all that apply.)

A) What provokes it
B) Location
C) Race
D) Severity
E) Frequency

Question 25

In what ways can a nurse help a person with dementia maintain orientation? (Select all that apply.)

A) Consistently calling the patient by name, usually the first name
B) Referring the patient to a calendar to note special events
C) Reminding the patient about the time of day by pointing to the clock
D) Calmly taking the patient to an appointment without explanation
E) Reminding the patient of her or his whereabouts frequently

Question 26

The nurse explains that the term that describes the ability to make judgments quickly on the basis of unfamiliar stimuli is __________ __________.

Question 27

What should be stressed in a teaching plan for a family caring for an older adult who is experiencing pain? (Select all that apply.)

A) Give medication before the pain becomes severe.
B) Distract the patient instead of medicating.
C) Pain reported by the older adult may be exaggerated.
D) Delay administration to reduce the risk of addiction.
E) Observe the effectiveness of the medication.

Question 28

The center for speech located in the brain is the __________ area.