Question 1

Which of the following is a rare and fatal infectious brain disorder that progresses rapidly to death within 1 year?&#10;A) Vascular dementia&#10;B) Dementia with Lewy bodies&#10;C) Creutzfeldt-Jakob disease&#10;D) Neurofibrillary tangle disease

Accepted Answer

Creutzfeldt-Jakob disease is a rare and fatal infectious brain disorder that progresses rapidly to death within 1 year. Vascular dementia and dementia with Lewy bodies are types of dementia, but they are not infectious, and they progress more slowly. Neurofibrillary tangle disease is not a recognized medical condition.

Question 2

What does the nurse document when assessment findings indicate that a patient with dementia has lost her ability to initiate purposeful movement?&#10;A) Amnesia&#10;B) Agnosia&#10;C) Apraxia&#10;D) Anosognosia

Accepted Answer

Apraxia is the inability to initiate voluntary movements despite having the desire and physical ability to do so. Dementia can cause apraxia, as it affects the brain's motor planning and coordination areas. The nurse would document this finding in the patient's assessment. Amnesia refers to memory loss, agnosia is the inability to recognize objects or people, and anosognosia is the lack of awareness or denial of one's own health condition.

Question 3

A 62-year-old woman is brought to the clinic by her daughter,who is concerned about her mother's increasing sleep disturbances and inability to solve common problems.To obtain information about the patient's current mental status,which question should the nurse ask the patient?

A) "Where were you were born?"
B) "Do you have any feelings of sadness?"
C) "What day of the week is it today?"
D) "How positive is your self-image?"

"What day of the week is it today?"

Accepted Answer

Asking the patient about the current day of the week will provide important information about her orientation to time, which is typically assessed in the mental status exam. This can help identify cognitive deficits that may be contributing to her sleep disturbances and difficulty solving common problems. Questions about birthplace, feelings of sadness, and self-image are also important in a mental health assessment, but may not be as immediately relevant to the patient's current mental status evaluation.

Question 4

A home care patient with Alzheimer's disease and mild dementia has a new prescription for donepezil.Which nursing action will be most effective in ensuring compliance with the medication?&#10;A) Setting the medications up weekly in a medication box&#10;B) Calling the patient daily with a reminder to take the medication&#10;C) Having the patient's spouse administer the medication&#10;D) Posting reminders to take the medications in the patient's house

Accepted Answer

Having the patient's spouse administer the medication ensures direct oversight and assistance, which is particularly effective for patients with Alzheimer's disease and mild dementia who may forget to take their medication or be unable to manage it themselves.

Question 5

Which of the following is a modifiable risk factor for reducing the risk for getting Alzheimer's disease?&#10;A) Type 1 diabetes&#10;B) Hypotension&#10;C) Inadequate intellectual stimulation&#10;D) Inadequate nutrition

Accepted Answer

Inadequate intellectual stimulation is a modifiable risk factor for reducing the risk of getting Alzheimer's disease.

Question 6

Risperidone (Risperdal)is prescribed for a patient with moderate Alzheimer's disease.In evaluating the effectiveness of this medication,what would the nurse expect the patient to demonstrate?&#10;A) Less agitation and aggression&#10;B) Enhanced functional abilities&#10;C) Improved memory and judgement&#10;D) Stabilization of mood and sleep patterns

Accepted Answer

Risperidone is an antipsychotic medication commonly used to manage behavioral symptoms of Alzheimer's disease, such as agitation and aggression. It may also help stabilize mood and sleep patterns, but it is unlikely to improve functional abilities or memory and judgement.

Question 7

A 70-year-old woman visits her 72-year-old husband who has advanced Alzheimer's disease and is hospitalized with pneumonia.She tells the nurse that it is a relief to have someone besides herself care for her husband because she is physically and mentally exhausted from caring for him at home.She says she has no family to help her and that they cannot afford institutional care for her husband.What is an appropriate nursing diagnosis for the patient's wife?

A) Anxiety related to financial insecurity
B) Ineffective health maintenance related to chronic stress
C) Caregiver role strain related to limited resources for caregiving
D) Social isolation related to unrelieved caregiving responsibilities

Accepted Answer

The patient's wife is experiencing caregiver role strain due to limited resources for caregiving, including lack of family support and inability to afford institutional care for her husband. She is physically and mentally exhausted from caring for him at home, which further supports this nursing diagnosis. While anxiety related to financial insecurity may be a contributing factor, it is not the primary nursing diagnosis in this case. Ineffective health maintenance and social isolation may also be present, but they are not the most appropriate nursing diagnosis given the information provided.

Question 8

The nurse has identified the nursing diagnosis of disturbed thought processes related to effects of dementia for a patient with late-stage Alzheimer's disease.What is an appropriate intervention for this problem?

A) Maintain a consistent daily routine.
B) Keep the television in the room on all day.
C) Reorient the patient to the date and time every few hours.
D) Provide the patient with current newspapers and magazines.

Accepted Answer

Maintaining a consistent daily routine can help reduce confusion and agitation in patients with dementia. It provides structure and predictability, which can help the patient feel more secure and calm. Keeping the television on all day can overstimulate the patient and contribute to confusion. Reorienting the patient every few hours can be helpful, but it may not address the underlying thought disturbances. Providing current newspapers and magazines may be overwhelming and potentially confusing for the patient.

Question 9

When teaching the husband of a woman who is being evaluated for Alzheimer's disease about the disorder,what should the nurse explain?&#10;A) &#34;The most important risk factor for Alzheimer's disease is a family history of the disorder.&#34;&#10;B) &#34;A diagnosis of Alzheimer's disease can be made only when other causes of dementia have been ruled out.&#34;&#10;C) &#34;New medications,such as donepezil (Aricept),have been shown to dramatically reverse Alzheimer's disease in some patients.&#34;&#10;D) &#34;The presence of brain atrophy and enlarged ventricles detected by magnetic resonance imaging confirms the diagnosis of Alzheimer's disease in patients with dementia.&#34;

Accepted Answer

It is important for the husband to understand that the process of diagnosing Alzheimer's disease involves ruling out other potential causes of dementia. This can sometimes be a lengthy and complex process. It is also important to note that there is currently no cure for Alzheimer's disease, and while medications like donepezil can help to mitigate some of the symptoms, they do not reverse the disease itself. Family history can be a risk factor, but it is not the most important factor. Brain imaging can be helpful in diagnosing Alzheimer's disease, but it is not the only method used for diagnosis.

Question 10

A long-term care patient with moderate dementia develops increased restlessness and agitation.What is the nurse's initial action?&#10;A) Administer the as-needed dose of lorazepam (Ativan).&#10;B) Reorient the patient to time and place.&#10;C) Assess the patient for anything that might be causing discomfort.&#10;D) Have a nursing assistant stay with the patient to ensure safety.

Accepted Answer

Restlessness and agitation in a patient with dementia can indicate discomfort or pain, which should be assessed first before administering medication or trying to reorient the patient. It is important to identify and address the underlying cause of the behavior.

Question 11

In which of the following conditions does the patient have fluctuations in consciousness throughout the course of the disease?&#10;A) Delirium&#10;B) Depression&#10;C) Psychosis&#10;D) Dementia

Accepted Answer

The answer of In which of the following conditions does...

Question 12

A 71-year-old patient is diagnosed with moderate dementia as a result of multiple strokes.During assessment of the patient,what would the nurse expect to find?&#10;A) Extreme suspiciousness&#10;B) Irritability and withdrawal&#10;C) Difficulty eating and swallowing&#10;D) Loss of recent and long-term memory

Accepted Answer

The answer of A 71-year-old patient is diagnosed with moderate...

Question 13

When assessing a patient with Alzheimer's disease who is being admitted to a long-term care facility,the nurse learns that the patient has had several episodes of wandering away from home.Which nursing action will the nurse include in the plan of care?

A) Ask the patient why the wandering episodes have occurred.
B) Reorient the patient to the new living situation several times daily.
C) Place the patient in a room close to the nurses' station.
D) Have the family bring in familiar items from the patient's home.

Accepted Answer

The answer of When assessing a patient with Alzheimer's disease...

Question 14

A 72-year-old woman hospitalized with pneumonia becomes disoriented and confused 2 days after admission.Which assessment information obtained by the nurse about the patient indicates that the patient is experiencing delirium rather than dementia?

A) The patient is disoriented to place and time but oriented to person.
B) The patient has a history of increasing confusion over several years.
C) The patient's speech is fragmented and incoherent.
D) The patient was oriented and alert when admitted.

Accepted Answer

The answer of A 72-year-old woman hospitalized with pneumonia becomes...

Question 15

A family member of a patient with possible Alzheimer's disease asks the nurse the purpose of the MMSE.Which response is appropriate?&#10;A) &#34;The MMSE helps in establishing the diagnosis of Alzheimer's disease.&#34;&#10;B) &#34;The MMSE is useful in determining the degree of mental impairment.&#34;&#10;C) &#34;The MMSE determines the choice of the most appropriate treatment.&#34;&#10;D) &#34;The MMSE aids in differentiating acute delirium from chronic dementia.&#34;

Accepted Answer

The answer of A family member of a patient with...

Question 16

Some patients with dementia have a pattern of behavioural disturbance that occurs consistently in the late afternoon.How does the nurse document this assessment finding?&#10;A) Turning the tide&#10;B) Sundowning&#10;C) Worsening symptoms of dementia&#10;D) Disorientation to time of day

Accepted Answer

The answer of Some patients with dementia have a pattern...

Question 17

When administering a mental status examination to a patient,the nurse suspects depression when the patient gives which of the following responses?&#10;A) &#34;I don't know.&#34;&#10;B) &#34;Is that the right answer?&#34;&#10;C) &#34;Wait,let me think about that.&#34;&#10;D) &#34;What are those people doing over there?&#34;

Accepted Answer

The answer of When administering a mental status examination to...

Deck 62: Nursing Management: Delirium,alzheimers Disease,and Other Dementias