Deck 14: Neurocognitive Disorders

Question 1

In trying to make a differential diagnosis between delirium and dementia,which of the following would be accurate?

A)Delirium has a stable,rather than fluctuating,course.
B)Delirium often involves hallucinations,but dementia rarely does.
C)With delirium,one has consistently poor insight,but with dementia,there are often insightful periods.
D)Sleep is more disturbed with dementia than it is with delirium.

Answer 1

Delirium often involves hallucinations,but dementia rarely does.

Question 2

A group of medical students is learning the criteria used to diagnose neurocognitive disorders.The professor is discussing evidence of disturbances of consciousness along with changes in cognition,such as memory deficits,that occur rapidly.What type of disorder is being discussed?

A)dementia
B)delirium
C)amnestic disorder
D)depersonalization

Answer 2

delirium

Question 3

The cognitive symptoms seen in dementia and delirium

A)are not seen in any other disorders.
B)are seen in other disorders as well but are not defining features.
C)are seen in other disorders but are not as severe.
D)are only seen in schizophrenia and other psychotic disorders.

Answer 3

are seen in other disorders as well but are not defining features.

Question 4

You are head of an assessment team that needs some testing to determine the level and type of cognitive impairment being experienced by your client.You call on the services of which type of team member for this assessment?

A)psychiatric social worker
B)neuropsychiatrist
C)neuropsychologist
D)psychiatric nurse

Question 5

Last year,Bob was admitted and released from the hospital within two days.The diagnosis was a neurocognitive disorder.Since that time,he has held down a job as a carpenter.Which of the following disorders is most likely to have caused Bob's hospitalization?

A)delirium
B)dementia
C)Parkinson's disease
D)Huntington's disease

Question 6

After suffering a head injury in a car accident,Molly cannot remember anything that happened before the accident.What term will her physician use to describe her condition?

A)agnosia
B)apraxia
C)retrograde amnesia
D)dissociative amnesia

Question 7

Your textbook states that the hallmark of dementia is

A)aphasia.
B)hallucinations.
C)delirium.
D)memory loss.

Question 8

What is the most obvious problem during the beginning stages of dementia?

A)chorea
B)delirium
C)retrograde amnesia
D)anterograde amnesia

Question 9

Your textbook presents the case of 84-year-old Mary.What was one of the first indications that Mary was suffering from dementia?

A)She could not remember her age.
B)She reported hearing voices calling her.
C)Some of her animals were found dead because she forgot to feed them.
D)After being admitted to a nursing home,she became agitated and belligerent.

Question 10

Forgetting to make a phone call or to pick up something from the store are

A)signs of delirium.
B)symptoms that suggest that Alzheimer's disease is reaching an advanced stage.
C)part of normal experience.
D)probably diagnostic of dementia.

Question 11

A television report described a case of a person who exhibited a disturbance in consciousness,memory deficits,and disorientation to time and place.If these symptoms developed within 24 hours,you believe the diagnosis is

A)apraxia.
B)dementia.
C)delirium.
D)amnestic disorder.

Question 12

Among elderly psychiatric patients,neurocognitive disorders are the ________ disorders.

A)most frequent
B)second-most frequent
C)fifth-most frequent
D)rarest

Question 13

Ms.Castle is in the early stages of dementia.Which of the following is most characteristic of the symptoms she is likely to exhibit?

A)She shows writhing movements.
B)She cannot be understood when she speaks.
C)She can't remember the new neighbor she met yesterday.
D)She can't remember the name of the town she grew up in.

Question 14

Stanley is 65,and for the past couple of years he has been suffering from a gradual worsening of his memory,as well as experiencing some language difficulties and problems with his reasoning and decision making.What is the most likely diagnosis?

A)delirium
B)organic psychosis
C)dementia
D)schizophrenia

Question 15

A 68-year-old man is brought to the emergency room by his family.Family members tell the physician that their relative has been confused,agitated,and exhibiting memory impairments.These symptoms developed in the last few days; he has no prior history of memory problems.Based on the family's information,the physician suspects the man is experiencing delirium.Which of the following questions would provide information that could confirm this diagnosis?

A)"Does schizophrenia run in your family?"
B)"Is he taking any medications at this time?"
C)"Does he experience any difficulties with motor movements?"
D)"Do any members of the family suffer from Huntington's disease?"

Question 16

Aphasia refers to various types of loss or impairment in

A)language.
B)spatial ability.
C)muscle coordination.
D)neurotransmitter production.

Question 17

At the insistence of family members,you take your elderly grandfather to a general practice physician,who refers him to a neurologist.When you ask for a description of neurologists,the general practitioner tells you they are

A)psychologists specializing in neuroses.
B)psychiatrists specializing in nervous disorders.
C)psychologists specializing in neuropsychological testing.
D)physicians specializing in diseases of the brain and nervous system.

Question 18

Typically the symptoms of delirium

A)develop rapidly and then remain at a steady level as they further develop.
B)develop slowly and fluctuate throughout the day.
C)occur rapidly and then fluctuate throughout the day.
D)occur slowly and then remain at a steady level as they further develop.

Question 19

While hospitalized,Jack begins to show signs of delirium.Which of the following is a possible clue that leads his physician to suspect that Jack is experiencing delirium?

A)Jack reports paranoid delusions.
B)Jack experiences fleeting perceptual disturbances.
C)Motor functions on Jack's right side have slowed.
D)Jack appears sedated and doesn't show much emotion.

Question 20

Which of the following is characteristic of delirium?

A)agnosia
B)delusions
C)identity confusion
D)clouded consciousness

Question 21

The disruption of short-term memory,perceptual skills,and higher-level cognitive abilities for people with dementia can also lead to

A)hallucinations.
B)disruptions of judgment.
C)aggressive outbursts and use of obscene language.
D)disorientation to time,place and person.

Question 22

Your aunt,who is in her 80s,has been referred to a professional.Your aunt is given a series of tests that assess cognitive,sensorimotor,perceptual,and speech function.It is most likely that your aunt is seeing a

A)physician.
B)neuropsychologist.
C)psychiatrist.
D)mneumonist.

Question 23

A neuropsychologist is describing several patients at a case conference.He says John does not know the names of common objects,such as shoes,shirts,and screwdrivers.Jill does not know how to use such objects.What terms will he use to describe John and Jill's difficulties?

A)John exhibits apraxia; Jill exhibits aphasia.
B)John exhibits aphasia; Jill exhibits apraxia.
C)John exhibits retrograde amnesia; Jill exhibits anterograde amnesia.
D)John exhibits anterograde amnesia; Jill exhibits retrograde amnesia.

Question 24

Which of these individuals is experiencing visual agnosia?

A)Tim,who cannot see as a result of a sensory deficit
B)Ted,who knows what an object is for,but who does not know its name
C)Teresa,who cannot move her mouth muscles to name an object
D)Tess,who does not recognize a pencil as something meaningful

Question 25

The Mini-Mental State Examination is used to assess

A)cognitive impairment.
B)microscopic brain lesions.
C)a patient's level of depression.
D)clinicians' qualifications as neurologists.

Question 26

In a study of mental functioning comparing young adults to individuals in their sixties,a psychologist asks questions like the following: "You are about to buy a new car,what factors will you have to consider?" What is the psychologist doing and what is he likely to find?

A)The psychologist is using questions that tap fluid intelligence; the older group will perform at a higher level.
B)The psychologist is using questions that tap wisdom; the two groups will not differ in their performance.
C)The psychologist is using questions that tap wisdom; the young adults will outperform the older group.
D)The psychologist is using questions designed to tap fluid intelligence; the two groups will not differ in their responses to these types of items.

Question 27

In DSM-5,the disorders that were formerly referred to as "amnestic disorders" are now included under the classification of

A)minor neurocognitive disorder.
B)amnestic spectrum disorders.
C)head injuries.
D)major neurocognitive disorder.

Question 28

People with dementia often show difficulty with abstract thinking.Which of the following questions to a person with dementia would help to demonstrate this difficulty?

A)"What time is it?"
B)"What was the name of your first grade teacher?"
C)"Why are a baseball bat and a hockey stick alike?"
D)"What would you like to have for supper tonight?"

Question 29

Alois Alzheimer first discovered the disease named after him through

A)psychoanalysis.
B)conversations with Sigmund Freud.
C)the meta-analysis of published papers.
D)a microscopic postmortem examination of his patient's brain.

Question 30

What two terms do Paul Baltes and his colleagues use to describe aspects of mental functioning?

A)verbal and visual
B)acquired and innate
C)academic and practical
D)fluid intelligence and wisdom

Question 31

Dyskinesia is a symptom characterized by

A)involuntary movements.
B)exaggerated emotionality.
C)inability to name objects.
D)loss of memory for past events.

Question 32

What is the relationship of personality changes,emotional difficulties,and motivational problems to dementia?

A)They are essential to the diagnosis of dementia.
B)They only occur in early-onset forms of dementia.
C)They are frequently associated with dementia and have an impact on the person's adjustment.
D)They are among the most important causes of dementia.

Question 33

In mild neurocognitive disorder,the losses in fluid intelligence

A)are the same as those characteristic of normal aging.
B)are not yet noticeable.
C)exceed those characteristic of normal aging.
D)are the same as those in Alzheimer's disease.

Question 34

You need to look up the DSM-5 diagnostic criteria for dementia and delirium.Under what heading will you find these disorders?

A)Psychotic Disorders
B)Neurocognitive Disorders
C)Somatoform Disorders
D)Organic Mental Disorders

Question 35

The person who introduced the term "Alzheimer's disease" was

A)Alois Alzheimer
B)Emil Kraepelin.
C)Sigmund Freud.
D)Burrhus Frederic Skinner.

Question 36

Abuse of drugs would be most likely in

A)some forms of dementia.
B)delirium.
C)depression.
D)all forms of dementia.

Question 37

Which problem is experienced by someone with apraxia?

A)cannot understand speech
B)forgets the names of objects
C)muscles are too weak to move
D)cannot translate ideas into meaningful action

Question 38

In DSM-5,the distinction between major neurocognitive disorder and mild neurocognitive disorder is

A)the evidence of significant cognitive decline,which is characteristic of major NCD.
B)a recessive gene.
C)the evidence of significant cognitive decline,which is characteristic of mild NCD.
D)an interference with a person's capacity for independence,which is characteristic of mild NCD.

Question 39

Two patients on the neurology ward at the hospital have different memory problems.Ann has difficulty remembering what happened before a car accident,whereas Carson's difficulty is in learning to remember new material.At a case conference,how will these two cases be described?

A)Ann has apraxia; Carson has aphasia.
B)Ann has aphasia; Carson has apraxia.
C)Ann has retrograde amnesia; Carson has anterograde amnesia.
D)Ann has anterograde amnesia; Carson has retrograde amnesia.

Question 40

A psychologist holds out a comb and asks Mr.Bonte if he knows what it is called.Mr.Bonte replies,"I have no idea what that's called." The psychologist then asks Mr.Bonte to show what he would do with the object.Mr.Bonte says,"How should I know? I don't know what it is!" Mr.Bonte's response led the psychologist to describe his condition as

A)aphasia.
B)agnosia.
C)apraxia.
D)Alzheimer's disease.

Question 41

In comparison to patients with Alzheimer's disease,patients with frontotemporal neurocognitive disorder are

A)more likely to engage in impulsive sexual actions,roaming,and aimless exploration.
B)less likely to engage in impulsive sexual actions,roaming,and aimless exploration.
C)likely to engage in impulsive sexual actions,roaming,and aimless exploration at about the same rate.
D)more likely to develop impaired perception.

Question 42

Which of the following describes the amyloid plaques found in Alzheimer's disease?

A)asymmetrical neurofibrils
B)ballooning of nerve cells
C)clogged arteries in the frontal lobes
D)a central core of protein material surrounded by clumps of debris from destroyed neurons

Question 43

What are the typical symptoms that mark a diagnosis of Parkinson's disease?

A)chorea,tremors,and retardation
B)tremors,dementia,and postural abnormalities
C)writhing,aimless exploration,and depression
D)tremors,reduction in voluntary movements,and rigidity

Question 44

What is one way that the behavioral effects of a stroke can be distinguished from NCD?

A)In stroke,involuntary movements of the limbs are affected.
B)Behavioral effects appear suddenly in stroke,as compared to their gradual appearance in NCD.
C)Impairment is often bilateral in stroke,while impairment is unilateral in NCD.
D)Behavioral effects appear gradually in stroke,as compared to their sudden appearance in NCD.

Question 45

What are the two specific types of brain lesions found in Alzheimer's disease?

A)microtubules and dopamine deposits
B)neurofibrillary tangles and amyloid plaques
C)ballooning nerve cells and absent myelin sheaths
D)clogged train arteries and enlarged microtubules

Question 46

What is an infarct?

A)dementia due to depression
B)clogged arteries in the brain
C)a surgical procedure to clear brain plaques
D)an area of dead brain tissue caused by a stroke

Question 47

Many conditions other than those that attack the brain tissue directly can also produce symptoms of neurocognitive disorder.These can be either medical conditions or other types of mental disorders.One cause of neurocognitive disorder is the severe interruption of blood flow to the brain known as a

A)stroke.
B)myocardial infection.
C)vascular occlusion.
D)vasodementia.

Question 48

Alzheimer's disease is distinguished from other types of dementia in DSM-5 based on

A)muscular impairment.
B)personality changes.
C)the gradual speed of onset.
D)more significant memory impairment.

Question 49

You are reading a medical chart in which a patient is referred to as displaying chorea.If you met this patient,you might expect a lot of

A)restless and fidgety movements.
B)incoherent speech.
C)obscene language.
D)listlessness and psychomotor retardation.

Question 50

A doctor has just finished her examination of an 82-year-old patient who has recently been showing significant and worsening memory loss and other forms of cognitive impairment,and the doctor says,"This woman is definitely suffering from Alzheimer's disease." Why should you be skeptical about this diagnosis?

A)Alzheimer's disease only affects younger people.
B)Alzheimer's disease does not typically involve memory problems.
C)A definite diagnosis of Alzheimer's can only be determined by an autopsy.
D)The patient's condition is worsening,but Alzheimer's disease involves very stable symptoms.

Question 51

Neurofibrillary tangles,which are typically found in patients with Alzheimer's disease,

A)are unique to that disease and allow for definite diagnosis.
B)are also found in adults with other neurocognitive disorders.
C)have not yet been identified.
D)do not appear until the end stage of the disease.

Question 52

Many specific conditions are associated with neurocognitive disorder.These are distinguished primarily on the basis of the

A)specific types of brain lesions.
B)specific types of chromosomal abnormalities.
C)degree of severity.
D)age of onset.

Question 53

What is one way that Huntington's disease and Parkinson's disease can usually be distinguished?

A)Only Parkinson's disease involves motor symptoms.
B)Huntington's disease usually leads to neurocognitive disorder,while Parkinson's does not.
C)It is possible to recover from Huntington's disease but not Parkinson's.
D)Only Huntington's disease carries a risk for depression.

Question 54

The cognitive and motor deficits associated with Huntington's disease are due to neuronal degeneration in the

A)hippocampus.
B)frontal lobe.
C)basal ganglia.
D)medial thalamus.

Question 55

Although Marsha is unable to move the right side of her body,the other side of her body is mobile.What is the most likely cause of this problem?

A)a stroke
B)NCD with Lewy bodies
C)Parkinson's disease
D)neurofibrillary tangles

Question 56

Franklin has Huntington's disease,and on that basis,we can be virtually certain that

A)Franklin is at least 73 years old.
B)Franklin has a history of excessive alcohol consumption.
C)Franklin's family has a history of this disease.
D)Franklin can be effectively treated with drugs used to treat Parkinson's disease.

Question 57

Chorea is a symptom of

A)vascular neurocognitive disease.
B)Alzheimer's disease.
C)Parkinson's disease.
D)Huntington's disease.

Question 58

Which of the following symptoms is characteristic of Parkinson's disease?

A)chorea
B)delirium
C)postural abnormalities
D)catatonia

Question 59

Frontotemporal neurocognitive disorder is a rare form of dementia associated with atrophy of the frontal and temporal lobes of the brain.In this disorder,__________ generally precede(s)the onset of cognitive impairment.

A)extreme anxiety
B)personality changes
C)lose of long-term memory
D)hallucinations

Question 60

In Huntington's disease,an area of the brain implicated is the

A)putamen.
B)substantia nigra.
C)parietal lobe.
D)beta-amyloid.

Question 61

How many different genes are associated with the creation of the plaques found in Alzheimer's disease?

A)none
B)two
C)four
D)dozens

Question 62

Vascular neurocognitive disorder and Alzheimer's disease have very similar

A)causes.
B)rates of onset.
C)motor impairments.
D)cognitive symptoms.

Question 63

The average time between the diagnosed onset of Alzheimer's disease and death is

A)six months.
B)one year.
C)six years.
D)twelve years.

Question 64

If the World Health Organization assembled the most respected researchers on the genetics of Alzheimer's disease and asked them to review the research,which of the following would be the most appropriate title for that report?

A)"A Single Disease,a Single Gene"
B)"How Toxins Affect Genetic Vulnerability"
C)"Link Identified: Distractibility as the Key"
D)"Alzheimer's Disease: No Single Genetic Path"

Question 65

Pseudodementia refers to a condition in which

A)symptoms are faked.
B)memory loss is not severe.
C)motor impairment affects cognitive functioning.
D)cognitive impairment is produced by major depression.

Question 66

Why are researchers who study Alzheimer's disease also very interested in Down syndrome?

A)Both are known to be caused by a recessive gene.
B)People with Down syndrome almost always develop Alzheimer's.
C)Both have been linked to dopamine and serotonin deficiencies.
D)Both can be linked to chromosome 21.

Question 67

What is genetic linkage analysis?

A)conducting microscopic analysis of nerve cell damage
B)exploring the genome of families that have multiple members affected with a disorder
C)educating family members about chances of inheritance
D)locating a gene that is responsible for a disorder or trait

Question 68

The amyloid plaques and neurofibrillary tangles that are typical in Alzheimer's disease are also found in people with

A)schizophrenia.
B)Down syndrome.
C)Parkinson's disease.
D)Korsakoff's syndrome.

Question 69

A result of recent gene identification efforts is the

A)firm rejection of gene-environment interaction.
B)diminishment of our understanding of the etiology of disorders.
C)discovery that a single gene is responsible for most disorders.
D)incorporation of gene-environment interaction.

Question 70

One Swedish study of genetic factors in the cause of dementia found that the concordance rate for monozygotic twins was _____ percent.

A)1
B)20
C)40
D)over 50

Question 71

Neurocognitive disorder with Lewy bodies overlaps with which of these disorders?

A)Down syndrome and stroke
B)Alzheimer's disease and Down syndrome
C)Parkinson's disease and Alzheimer's disease
D)Huntington's disease and Parkinson's disease

Question 72

A common cause of delirium among the elderly is

A)mutations of genes on chromosome 21.
B)antihistamines.
C)urinary tract infection.
D)normal decline in fluid intelligence.

Question 73

Which of the following is an indication of vascular neurocognitive disorder?

A)Parkinsonian symptoms
B)focal neurological signs
C)affected large arteries
D)absence of laboratory evidence of blood vessel disease

Question 74

From the evidence so far,it seems that ________ is/are responsible for early-onset and late-onset Alzheimer's disease.

A)Pick's bodies
B)no genes
C)different genes
D)the same gene

Question 75

Approximately _____ percent of individuals over the age of 90 will exhibit symptoms of moderate to severe dementia.

A)5
B)15
C)30
D)40

Question 76

Which of the following statements is true with regard to the incidence of Alzheimer's disease (AD)?

A)The incidence of AD is greater for women at all ages.
B)The incidence of AD is greater for men at all ages.
C)After age 90,the incidence of AD apparently decreases for men.
D)After age 100,the incidence of AD apparently decreases for women.

Question 77

A pathologist has just finished an autopsy and includes in her report a reference to "Lewy bodies." This means that in her autopsy,she has discovered

A)senile plaques filled with protein.
B)ballooning of nerve cells and enlarged areas between adjacent neurons.
C)rounded clumps of protein surrounded by masses of destroyed neural tissue.
D)rounded deposits in nerve cells often found in the brains of patients with Parkinson's disease.

Question 78

Studies suggest that Alzheimer's disease

A)is more common is Asian countries,than it is in North America.
B)is more common in North America and Europe,than it is in other areas.
C)is more common in developing countries,than it is in other places.
D)did not exist prior to the 1960s.

Question 79

A new form of dementia has just been discovered,and researchers have determined that the disorder is transmitted genetically in an autosomal dominant pattern with complete penetrance.If a child's father has one of the genes,and the mother has none of the genes for the disorder,the probability that the child will inherit this disorder is _____ percent.

A)25
B)50
C)75
D)100

Question 80

Approximately _____ percent of patients diagnosed with dementia also show signs of major depressive disorder.

A)10
B)25
C)35
D)50