Deck 60: Nursing Management: Alzheimers Disease, Dementia, and Delirium

Question 1

When teaching the children of a patient who is being evaluated for Alzheimer's disease ( AD ) about the disorder, the nurse explains that

A) the most important risk factor for AD is a family history of the disorder.
B) new drugs have been shown to reverse AD dramatically in some patients.
C) a diagnosis of AD can be made only when other causes of dementia have been ruled out.
D) the presence of brain atrophy detected by MRI confirms the diagnosis of AD in patients with dementia.

Answer 1

a diagnosis of AD can be made only when other causes of dementia have been ruled out.

Question 2

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

Answer 2

Place the patient in a room close to the nurses' station.

Question 3

A 62-year-old patient is brought to the clinic by a family member who is concerned about the patient's 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 did you have for breakfast?"
D) "How positive is your self-image?"

Answer 3

"What did you have for breakfast?"

Question 4

When developing a plan of care for a hospitalized patient with moderate dementia, which intervention will the nurse include?

A) Provide complete personal hygiene care for the patient.
B) Remind the patient frequently about being in the hospital.
C) Reposition the patient frequently to avoid skin breakdown.
D) Place suction at the bedside to decrease the risk for aspiration.

Question 5

During the morning change-of-shift report at the long-term care facility, the nurse learns that the patient with dementia has had sundowning. Which nursing action should the nurse take while caring for the patient?

A) Provide hourly orientation to time of day.
B) Move the patient to a quieter room at night.
C) Keep blinds open during the daytime hours.
D) Have the patient take a brief mid-morning nap.

Question 6

To determine whether a new patient's confusion is caused by dementia or delirium, which action should the nurse take?

A) Assess the patient using the Mini-Mental Status Exam.
B) Obtain a list of the medications that the patient usually takes.
C) Determine whether there is positive family history of dementia.
D) Use the Confusion Assessment Method tool to assess the patient.

Question 7

Which intervention will the nurse include in the plan of care for a patient who has late-stage Alzheimer's disease ( AD )?

A) Encourage the patient to discuss events from the past.
B) Maintain a consistent daily routine for the patient's care.
C) Reorient the patient to the date and time every 2 to 3 hours.
D) Provide the patient with current newspapers and magazines.

Question 8

A long-term care patient with moderate dementia develops increased restlessness and agitation. The nurse's initial action should be to

A) reorient the patient to time, place, and person.
B) administer the PRN dose of lorazepam (Ativan).
C) assess for factors that might be causing discomfort.
D) have a nursing assistant stay with the patient to ensure safety.

Question 9

A 72-year-old patient is diagnosed with moderate dementia as a result of multiple strokes. During assessment of the patient, the nurse would expect to find

A) excessive nighttime sleepiness.
B) difficulty eating and swallowing.
C) variable ability to perform simple tasks.
D) loss of both recent and long-term memory.

Question 10

The spouse of a male patient with early stage Alzheimer's disease ( AD ) tells the nurse, "I am just exhausted from the constant worry. I don't know what to do." Which action is best for the nurse to take next (select all that apply)?

A) Suggest that a long-term care facility be considered.
B) Offer ideas for ways to distract or redirect the patient.
C) Suggest that the spouse consult with the physician for antianxiety drugs.
D) Educate the spouse about the availability of adult day care as a respite.
E) Ask the spouse what she knows and has considered about dementia care options.

Question 11

To protect a patient from injury during an episode of delirium, the most appropriate action by the nurse is to

A) secure the patient in bed using a soft chest restraint.
B) ask the health care provider about ordering an antipsychotic drug.
C) instruct family members to remain with the patient and prevent injury.
D) assign a nursing assistant to stay with the patient and offer frequent reorientation.

Question 12

A patient who is hospitalized with pneumonia is disoriented and confused 2 days after admission. Which information obtained by the nurse about the patient indicates that the patient is experiencing delirium rather than dementia?

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

Question 13

When administering a mental status examination to a patient with delirium, the nurse should

A) medicate the patient first to reduce any anxiety.
B) give the examination when the patient is well-rested.
C) reorient the patient as needed during the examination.
D) choose a place without distracting environmental stimuli.

Question 14

When administering a mental status examination to a patient, the nurse suspects depression when the patient responds with

A) "I don't know."
B) "Is that the right solve?"
C) "Wait, let me think about that."
D) "Who are those people over there?"

Question 15

A patient with mild dementia has a new prescription for donepezil (Aricept). Which nursing action will be most effective in ensuring compliance with the medication?

A) Having the patient's spouse administer the medication
B) Setting the medications up weekly in a medication box
C) Calling the patient daily with a reminder to take the medication
D) Posting reminders to take the medications in the patient's house

Question 16

Which action will the nurse in the outpatient clinic include in the plan of care for a patient with mild cognitive impairment (MCI)?

A) Suggest a move into an assisted living facility.
B) Schedule the patient for more frequent appointments.
C) Ask family members to supervise the patient's daily activities.
D) Discuss the preventive use of acetylcholinesterase medications.