Question 1

A client diagnosed recently with AD is prescribed donepezil (Aricept). The client's spouse inquires, "How does this work? Will this cure him?" Which is the appropriate nursing response?

Accepted Answer

Donepezil works by delaying the destruction of acetylcholine, which is a chemical in the brain necessary for memory processes. It is most effective in the early stages of Alzheimer's disease, but does not cure the disease.

Question 2

Major NCD constitutes what was previously described as _______________________ in the DSM-IV-TR.

Accepted Answer

dementia

Question 3

A client diagnosed with AD has impairments of memory and judgment and is incapable of performing activities of daily living. Which nursing intervention should take priority?

Accepted Answer

AD causes impairment of memory and judgment, leading to difficulty in performing activities of daily living, such as bathing and toileting. These tasks require assistance to ensure safety and hygiene, and are therefore the priority intervention. While presenting evidence of objective reality may be helpful in some cases, it is not the priority for a client with AD who is unable to perform basic self-care. Designing a bulletin board and labeling the room can be helpful, but they are not as critical as assisting with activities of daily living.

Question 4

Which of the following medications that have been known to precipitate delirium?

Accepted Answer

The answer of Which of the following medications that have...

Question 5

Which statement accurately differentiates NCD from pseudodementia (depression)?

Accepted Answer

Disorientation to time and place is a hallmark symptom of NCD, while it is not typically present in pseudodementia. Other symptoms that may differentiate NCD from pseudodementia include a slow onset, gradual progression, and the presence of neurological abnormalities.

Question 6

A client diagnosed with AD exhibits progressive memory loss, diminished cognitive functioning, and verbal aggression upon experiencing frustration. Which nursing intervention is most appropriate?

Accepted Answer

Scheduling structured daily routines can help provide a sense of predictability and stability for clients with AD, which may reduce frustration and minimize aggressive behaviors. Organizing a group activity to present reality may be overwhelming or confusing for the client, minimizing environmental lighting may exacerbate confusion and disorientation, and explaining consequences for aggressive behaviors may not be effective as the client's cognitive functioning is diminished.

Question 7

A geriatric nurse is teaching the client's family about the possible cause of delirium. Which statement by the nurse is most accurate?

Accepted Answer

Taking multiple medications or certain combinations of medications can lead to adverse drug interactions or toxicity, which is a common cause of delirium in older adults.

Question 8

An older client has recently moved to a nursing home. The client has trouble concentrating and socially isolates. A physician believes the client would benefit from medication therapy. Which medication should the nurse expect the physician to prescribe?

Accepted Answer

Sertraline (Zoloft) is an antidepressant that can help with symptoms of depression, such as trouble concentrating and social isolation, which are common in older adults adjusting to a new environment like a nursing home.

Question 9

A client diagnosed with vascular neurocognitive disorder (NCD) is discharged to home under the care of his wife. Which information should cause the nurse to question the client's safety?

Accepted Answer

Smoking is a risk factor for vascular neurocognitive disorder and can worsen the client's condition. The nurse should question the safety of the client if he continues to smoke after discharge.

Question 10

A client diagnosed with NCD is disoriented, ataxic and wanders. Which is the priority nursing diagnosis?

Accepted Answer

The priority nursing diagnosis is "Risk for trauma" because the client is disoriented, ataxic and wanders which puts them at risk for falls, injury or getting lost.

Question 11

A client diagnosed with major NCD is exhibiting behavioral problems on a daily basis. At change of shift, the client's behavior escalates from pacing to screaming and flailing. Which action should be a nursing priority?

Accepted Answer

The answer of A client diagnosed with major NCD is...

Question 12

After one week of continuous mental confusion, an older African American client is admitted with a preliminary diagnosis of AD. What should cause the nurse to question this diagnosis?

Accepted Answer

Alzheimer's Disease (AD) typically develops gradually over time, not suddenly, so a sudden onset of symptoms should prompt further investigation into other possible causes.

Question 13

A client diagnosed with Alzheimer's disease (AD) can no longer ambulate, does not recognize family members, and communicates with agitated behaviors and incoherent verbalizations. The nurse recognizes these symptoms as indicative of which stage of the illness?

Accepted Answer

The client's symptoms of not being able to ambulate, not recognizing family members, and exhibiting agitated behaviors and incoherent verbalizations indicate severe cognitive decline, which is characteristic of stage 7 of Alzheimer's disease. At this stage, the client is completely dependent on others for care and may require assistance with all activities of daily living.

Question 14

Which is the reason for the proliferation of the diagnosis of NCDs?

Accepted Answer

More people now survive into the high-risk period for neurocognitive disorders, such as Alzheimer's, due to advancements in medical care and improved standards of living. This has led to a higher prevalence of diagnoses of NCDs.

Question 15

A client is diagnosed in stage 7 of AD. To address the client's symptoms, which nursing intervention should take priority?

Accepted Answer

In stage 7 of Alzheimer's disease, the client has severe cognitive decline, and interventions to improve cognitive status would not be effective. Social activities and group therapies may not be appropriate or feasible for a client with advanced AD. Facilitating communication may also not be effective as the client's ability to communicate may be severely impaired. Therefore, promoting dignity by providing comfort, safety, and self-care measures should take priority to maintain the client's quality of life.

Question 16

A client with a history of cerebrovascular accident is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client's assessment data, which diagnosis would the nurse expect the physician to assign?

Accepted Answer

The client's history of cerebrovascular accident (commonly known as a stroke) and current symptoms of memory problems, confusion, and disorientation are consistent with a diagnosis of vascular neurocognitive disorder. This condition results from inadequate blood flow to the brain, which can cause memory impairment, difficulty with language or visual-spatial skills, and changes in personality or behavior. Delirium is a temporary state of acute confusion that can be caused by a variety of factors, including medications, while altered thought processes is a symptom rather than a specific diagnosis. Alzheimer's disease is a type of dementia that is characterized by progressive memory loss and cognitive decline, but the client's symptoms are more suggestive of a vascular cause.

Question 17

Which statement accurately differentiates mild NCD from major NCD?

Accepted Answer

Major NCD is characterized by substantial cognitive decline from a previous level of performance in multiple domains, while mild NCD involves modest decline in only one domain. The other options (A, B, D) do not accurately differentiate between mild and major NCD criteria.

Question 18

Which of the following conditions have been known to precipitate delirium in some individuals?

Accepted Answer

Febrile illness, seizures, and migraine headaches are all conditions that have been known to precipitate delirium in some individuals.

Quiz 13: Neurocognitive Disorders

A client diagnosed recently with AD is prescribed donepezil (Aricept) . The client's spouse inquires, "How does this work? Will this cure him?" Which is the appropriate nursing response?