Deck 28: Caring for Persons With Confusion and Dementia

Question 1

Sundowning is

A) When signs, symptoms, and behaviors of Alzheimer's disease (AD) increase during hours of darkness
B) The loss of cognitive and social function caused by changes in the brain
C) A false dementia
D) A state of temporary but acute mental confusion

Answer 1

When signs, symptoms, and behaviors of Alzheimer's disease (AD) increase during hours of darkness

Question 2

Delirium is

A) A false belief
B) The loss of cognitive function caused by changes in the brain
C) A false disorder of the mind
D) A state of temporary but acute mental confusion

Answer 2

A state of temporary but acute mental confusion

Question 3

A resident is confused. When communicating with the person, which is incorrect?

A) Avoid touch.
B) Ask clear and simple questions.
C) Give the person time to respond.
D) Explain what you are going to do and why.

Answer 3

Avoid touch.

Question 4

A resident is confused. Which is incorrect?

A) Remove the person's eyeglasses and hearing aid to prevent loss or breakage.
B) Remind the person of special days and events.
C) Provide newspapers and magazines.
D) Discuss current events with the person.

Question 5

Dementia is

A) A false belief
B) The loss of cognitive function that interferes with routine personal, social, and occupational activities
C) A false disorder of the mind
D) A state of temporary but acute mental confusion

Question 6

Which is not an early warning sign of dementia?

A) Getting lost in familiar places
B) Not recognizing self or family members
C) Personality changes
D) Poor or decreased judgment

Question 7

Pseudodementia is

A) When signs, symptoms, and behaviors of Alzheimer's disease (AD) increase during hours of darkness
B) The loss of cognitive function that interferes with routine personal, social, and occupational activities
C) A false dementia
D) A state of temporary but acute mental confusion

Question 8

Which statement about dementia is incorrect?

A) Most older people show signs and symptoms of dementia.
B) For correct treatment, the cause must be found.
C) Some dementias can be treated and reversed.
D) Permanent dementias result from changes in the brain.

Question 9

Which statement about delirium is incorrect?

A) It is common in older people with acute illnesses.
B) Onset is gradual.
C) It is an emergency.
D) The cause must be found and treated.

Question 10

A resident is confused. The person usually naps after lunch. Which action is correct?

A) Prevent the person from taking a nap.
B) Help the person change into sleepwear.
C) Follow the person's routine.
D) Use music and other activities to distract the person.

Question 11

A delusion is

A) A false belief
B) Seeing, hearing, smelling, or feeling something that is not real
C) A false disorder of the mind
D) A state of temporary but acute mental confusion

Question 12

A resident is confused. The person's care plan includes the following measures. Which should you question?

A) Give the date and time as needed.
B) Face the person. Speak clearly.
C) State your name, and show your nametag.
D) Give detailed directions and answers to questions.

Question 13

Which statement about acute confusion is incorrect?

A) It occurs suddenly.
B) It is usually permanent.
C) Infection, illness, and injury are common causes.
D) Treatment is aimed at the cause.

Question 14

A hallucination is

A) A false belief
B) Seeing, hearing, smelling, or feeling something that is not real
C) A false disorder of the mind
D) A state of temporary but acute mental confusion

Question 15

Which statement is incorrect?

A) Changes in the brain and nervous system occur with aging.
B) Certain diseases affect the brain.
C) Changes in the brain can affect cognitive function.
D) When the brain is affected, signs, symptoms, and behaviors are
Permanent.

Question 16

Which statement about pseudodementia is incorrect?

A) The person has signs and symptoms of dementia.
B) There are no changes in the brain.
C) It can occur with delirium and depression.
D) All causes are treated the same way.

Question 17

Which is the most common type of permanent dementia?

A) Parkinson's disease
B) Cerebrovascular disease
C) Alzheimer's disease (AD)
D) Multi-infarct dementia

Question 18

Which is not an early warning sign of dementia?

A) Recent memory loss that affects job skills
B) Problems with language
C) Hallucinations
D) Misplacing things and putting things in unusual places

Question 19

Confusion can occur in older persons because

A) Blood flow to the brain is reduced
B) Physical disabilities occur
C) Infection is a risk
D) Drugs cause side effects

Question 20

Cognitive function involves the following except

A) Memory and thinking
B) Reasoning and understanding
C) Judgment and behavior
D) The senses and mobility

Question 21

The following occur early in AD except

A) Problems driving a car
B) Problems managing money
C) Problems using a telephone
D) Problems with ADL

Question 22

A resident has AD. The person thinks the food contains poison. This is called

A) A hallucination
B) A delusion
C) A catastrophic reaction
D) Sundowning

Question 23

A patient has AD. The person often screams a word in a foreign language. You know that screaming is

A) The person's way of communicating
B) An aggressive behavior
C) An agitated behavior
D) A restless behavior

Question 24

Catastrophic reactions usually occur from

A) Elimination needs
B) Hunger
C) Too many stimuli
D) Lack of sleep

Question 25

Signs and symptoms of delirium include the following except

A) Anxiety and disorientation
B) Sadness and withdrawal
C) Tremors and attention problems
D) Hallucinations and delusions

Question 26

At what age does AD usually occur?

A) Between age 30 and 40
B) Between age 40 and 50
C) After age 60
D) Around age 80

Question 27

Persons with AD may have abnormal sexual behaviors. The behaviors are abnormal because

A) Persons with AD do not have sexual needs
B) Of how and when they occur
C) They are at high risk for STDs
D) Persons with AD cannot perform sexually

Question 28

A resident has AD. His wife visits daily. They like to touch, hold hands, and kiss. Which action is correct?

A) Discouraging such contact
B) Providing privacy
C) Allowing only supervised visits
D) Trying to distract them

Question 29

What is the classic sign of AD?

A) Problems finding or speaking the right word
B) Gradual loss of short-term memory
C) Poor judgment
D) Forgetting how to use simple, everyday things

Question 30

A resident has AD. The person tends to wander. Her care plan includes the following. Which should you question?

A) Make sure the person's ID bracelet is on.
B) Keep door alarms turned on.
C) Explain to the person why she cannot go outside.
D) Let the person wander in an enclosed garden.

Question 31

A person with AD may react to a caregiver or family member by screaming.

Question 32

A resident has AD. Sometimes the person is agitated and combative. The person is pacing and trying to hit others. Which of the following measures will not be helpful?

A) Restraining the person
B) Meeting elimination needs
C) Meeting nutritional needs
D) Providing a calm, quite setting

Question 33

A resident has AD. She is trying to rub her perineum through her clothes. Which is incorrect?

A) The behavior is sexual.
B) She may be wet or soiled from urine or feces.
C) She may have a urinary system infection.
D) She may have pain or discomfort in her urinary or reproductive system.

Question 34

A resident is in the last stage of AD. The person's care plan includes the following. Which should you question?

A) Measures to prevent wandering
B) Providing all activities of daily living (ADL)
C) Incontinence care
D) Aspiration precautions

Question 35

Which statement about wandering is incorrect?

A) There is always a cause.
B) The person may be looking for someone or something.
C) Drug side effects are possible causes.
D) Pain, restlessness, and anxiety are possible causes.

Question 36

What is the cause of AD?

A) Family history
B) Down syndrome
C) Aging
D) Unknown

Question 37

Which statement about Alzheimer's disease (AD) is incorrect?

A) Sudden in onset, the disease progresses quickly over several months.
B) Nerve cells controlling intellectual and social function are damaged.
C) The person has behavior, mood, and personality changes.
D) Memory and mental abilities steadily decline.

Question 38

A patient has AD. The person often screams a word in a foreign language. Possible causes of screaming include the following except

A) Fatigue
B) Hearing or vision problems
C) Pain, discomfort, or fear
D) Depression and aging

Question 39

Which statement about depression is incorrect?

A) It is a common mental health problem in older persons.
B) Depression, aging, and some drug side effects have similar signs and symptoms.
C) Depression is often overlooked in older persons.
D) The person has hallucinations and attention problems.

Question 40

A resident has AD. The person's hallucinations include seeing "kitty cats" in the closet. Which of the following measures will not be helpful?

A) Making sure the person wears needed eyeglasses
B) Distracting the person
C) Eliminating noises
D) Explaining that there are no cats in the nursing center

Question 41

A maintenance worker left a hammer at the nurses' station. What should you do?

A) Leave it there.
B) Ask the maintenance department to send someone to pick it up.
C) Place it in a secure drawer. Then report its location to the maintenance department.
D) Look for the maintenance worker who left it.

Question 42

A resident has AD. The person's communication is impaired. When talking to the person, do the following except

A) Use a calm, gentle voice
B) Speak slowly, using simple words and sentences
C) Give the person time to respond
D) Explain why the person's answer is wrong

Question 43

A resident has AD. The person keeps saying, "I want to go home." "I want to go home." "I want to go home." Which action may be helpful?

A) Explain why the person cannot go home.
B) Ask why the person wants to go home.
C) Tell the person that the nursing center is her home.
D) Take the person for a walk.

Question 44

A person has AD. Which can offer the person's daughter support and encouragement?

A) The sandwich generation
B) OBRA
C) An AD support group
D) The American Dementia Association

Question 45

A patient has AD. The person is trying to tell you something. What should you do?

A) Ask the person simple questions.
B) Let the person speak. Do not interrupt or rush the person.
C) Offer words and ideas to help the person communicate.
D) Tell the person you understand.

Question 46

Some nursing centers have special care units for persons with AD and other dementias. Which is incorrect?

A) Certain conditions must be met for a person to be placed on a secured unit.
B) The center must use the least-restrictive approach to care.
C) The person's rights are always protected.
D) OBRA regulations do not apply to special care units.

Question 47

A resident has AD. The person's rights are protected by OBRA. Which is the best way to protect the person's right to personal choice?

A) Give the person many choices.
B) Let the person's family make all choices.
C) Give the person simple choices.
D) Make choices for the person based on your interests.

Question 48

You care for several persons with AD. Why must you report behavior changes to the nurse?

A) Persons with AD cannot report such changes.
B) Such changes may signal other illnesses or injuries.
C) Persons with AD depend on others for care.
D) It is your responsibility to report signs and symptoms.

Question 49

A nursing center has a secured unit for persons with AD. Which is correct?

A) OBRA considers secured units to be physical restraints.
B) A family's request is needed to place a person on a secured unit.
C) The person remains on the secured unit death.
D) Only persons with aggressive behaviors are allowed on a secured unit.

Question 50

A person has AD. Sometimes the person has repetitive behaviors. This means that the person

A) Repeats the same motion or word over and over again
B) Does things that are harmful
C) Repeats things the person said and did during childhood
D) Does everything twice

Question 51

A patient has AD. You are helping her dress. You should

A) Decide what she will wear
B) Let her choose from a dress, pant suit, sweat suit, or a skirt and blouse
C) Let her choose between a dress and a pant suit
D) Explain why she needs to wear undergarments

Question 52

All persons with AD and other dementias deserve quality care.

Question 53

A resident has AD. When planning activities for the person, the therapist considers

A) What equipment and supplies are available
B) How much time is available
C) The person's abilities and interests
D) Staff interests and needs

Question 54

While caring for a person with AD, you find yourself becoming frustrated and short-tempered. Which is incorrect?

A) The person did not choose to have AD or its signs and symptoms.
B) The person deserves to be treated with dignity and respect.
C) The person is responsible for agitated, aggressive, and wandering behaviors.
D) The person has the same rights as other residents.

Question 55

To protect persons with AD, do the following except

A) Keep utility room doors unlocked
B) Keep electrical equipment out of reach
C) Store personal care items in a safe place
D) Place safety plugs in electrical outlets

Question 56

A person has AD. The person's daughter has three children in high school and college. The daughter is likely to find herself in

A) Generation X
B) The "Baby Boom" generation
C) Generation Y
D) The sandwich generation

Question 57

A resident has AD. She tends to wander and is sometimes combative. Her son asks you to restrain her. Which is incorrect?

A) Restraints require a doctor's order.
B) Restraints are used if the family requests them.
C) Restraints can make confused and demented behaviors worse.
D) All persons have the right to be free from restraints.