Deck 23: Cognition

Question 1

A client is admitted with signs and symptoms of early Alzheimer disease.What would be used to confirm this client's diagnosis?

A) Abnormal CT scan findings of neuritic plaques and tangles in the brain
B) Client history and physical examination
C) Positive blood tests for beta-amyloid and tau proteins
D) Blood test for amyloid plaques and neurofibrillary tangles

Answer 1

Client history and physical examination

Question 2

A student nurse is learning about the physiology of the nervous system and its relationship to cognition.What structure plays a role in memory formation?

A) Neuron
B) Hippocampus
C) Cerebrum
D) Neurotransmitter

Answer 2

Hippocampus

Question 3

The nurse is assessing an older adult client and observes that the client is having several cognitive problems,including memory and attention deficits and fluctuating levels of orientation.The nurse confirms with the family that the client's symptoms developed over a several-year period.Which health problem is the client most likely experiencing?

A) Depression
B) Dementia
C) Intellectual disability
D) Delirium

Answer 3

Dementia

Question 4

The nurse is planning care for a client with Stage 1 Alzheimer disease.Which are the priority nursing diagnoses for the client and family?

A) Impaired Memory and Caregiver Role Strain
B) Hopelessness and Functional Family Processes
C) Knowledge Deficit and Ineffective Coping
D) Pseudohostility and Ineffective Coping

Question 5

The nurse is teaching the family of a client who has just been diagnosed with dementia.The family asks what treatments are available that will cure the client.What would be the nurse's best response to the family?

A) "There are no treatments that will cure dementia."
B) "Treatments to cure dementia include the use of vitamin E."
C) "Treatments to cure dementia involve hormone replacement therapy."
D) "Treatments to cure dementia include the daily use of ginkgo biloba."

Question 6

An older adult client complains of periods of confusion and forgetfulness,but reports clear thought process at most times of the day.Which is the appropriate response from the nurse?

A) "Are you having trouble hearing?"
B) "You probably have nothing to worry about. It's most likely stress-related."
C) "Everybody has a few problems with memory as they get older."
D) "You should probably have an MRI of your brain."

Question 7

An older adult client comes into the clinic for a pneumonia vaccine.During the client interview,the client seems to have mild difficulty with several words and has problems remembering the nurse's name.The client is alert and oriented to time,person,and place and most responses seem appropriate.How should the nurse describe this client's cognitive changes?

A) Memory impairment that may be related to cerebral ischemia
B) Normal signs of aging
C) Indicators of depression in the elderly
D) Early symptoms of dementia

Question 8

The nurse is working with a group of parents of children with intellectual disabilities.Which should the nurse recommend to support environmental safety for these children? Select all that apply.

A) Have parents maintain a regular schedule for activities.
B) Teach emotional safety.
C) Use medications to decrease agitation.
D) Provide aids to assist with orientation.
E) Turn the temperature down on the hot water heater.

Question 9

The nurse is planning care for a client who is experiencing Stage 1 Alzheimer disease.Which intervention will promote a therapeutic environment for a client with acute confusion?

A) Background noise like music will keep this client calm.
B) Dim the lights during waking hours.
C) Schedule meals at the same time each day.
D) Pain medications will enhance the therapeutic environment.

Question 10

An older adult client with no history of cognitive impairment is showing signs of increased confusion.Which health problem should the nurse suspect is causing this client's confusion?

A) Cataracts
B) Hypertension
C) Urinary tract infection
D) Lower back strain

Question 11

The family of an older adult client is concerned about the changes in the client's behavior.The client used to be a wonderful cook but now cannot even remember how to use a blender.For which causes of impaired cognitive function should the nurse assess the client? Select all that apply.

A) Obesity
B) Nutritional deficiencies
C) Medication reactions
D) Stroke
E) Snoring

Question 12

The spouse of a client with Alzheimer disease does not understand why the client developed the disorder because no one else in the family has the health problem.Which response by the nurse is appropriate?

A) "Alzheimer disease develops because of smoking and alcohol intake."
B) "Someone in your family must not have been correctly diagnosed with the disorder."
C) "Alzheimer disease does not have the same course in every individual."
D) "There are genetic and environmental factors in the development of Alzheimer disease."

Question 13

A nurse is preparing an educational program for clients in a long-term care facility regarding methods for coping with age-associated cognitive changes.Which information should the nurse include? Select all that apply.

A) Becoming involved in activities such as reading that keep the mind active
B) Playing board games
C) Using assistive devices such as a pill box for medications
D) Making lists, posting appointments on calendars, and writing notes to self
E) Not relying on habits; challenging your mind to remember new things

Question 14

A nurse is caring for an older adult who displays symptoms of cognitive decline.Which is true regarding the aging process and cognition? Select all that apply.

A) Generally, older adults' short-term memory changes significantly.
B) Generally, many older adults have increased difficulty finding and rapidly listing words.
C) The ability to use and understand word combinations declines steadily with age.
D) The ability to acquire practical information declines steadily with age.
E) The ability to engage in abstract thought declines slightly.

Question 15

A client diagnosed with Alzheimer disease has a catastrophic reaction during an activity involving simultaneous music playing and a craft project.The client starts shouting,"No! No! No!" and runs from the room.Which action by the nurse is the most appropriate?

A) Administer a PRN anti-anxiety medication and restrict the client's activity participation.
B) Intervene one-on-one with the client until the client is calm, and then redirect the client to another activity such as Bingo.
C) Discontinue the activity program because it is upsetting the client.
D) Follow the client, reassure the client one-on-one, and then redirect the client to a quiet activity.

Question 16

While assessing the cognitive status of a school-age child,the nurse notes that the child was unable to perform division problems and unable to name several former presidents of the United States.Prior to determining that this client has cognitive issues,what should the nurse keep in mind?

A) The child's developmental level
B) The child's home environment
C) The child's nutritional status
D) The parent's participation in the child's cognitive development

Question 17

An adult child brings a parent in to be evaluated and is told the client has Alzheimer disease.The adult child asks the nurse if all the children of the client are going to get the disease.Which risk factors will the nurse include when responding to the inquiry? Select all that apply.

A) Genetic predisposition
B) Age
C) History of hypertension
D) Race
E) Environmental exposure

Question 18

The nurse is preparing an educational program for the family of a client with Alzheimer disease who is ready for discharge.Which will the nurse focus on to reduce the client's risk for injury? Select all that apply.

A) Have all objects in the room be the same color.
B) Check shoes for fit and support.
C) Be aware that client in the early stages usually have few problems with unfamiliar places.
D) Keep all familiar objects in the home.
E) Remove throw rugs and electrical cords.

Question 19

A nursing instructor is teaching a group of student nurses about the different theories of cognition.Which cognitive development theory proposes that all children progress through the same stages of development?

A) Piaget
B) Vygotsky
C) Information-processing
D) Erickson

Question 20

The nurse includes information regarding long-term care placement in the discharge materials for the family of a client newly diagnosed with Alzheimer disease.Which is the rationale for providing this information to the family at this time?

A) It often takes 6 to12 months for an individual with Alzheimer disease to establish a successful transfer to a facility, and this will allow adequate time.
B) It's better to address the issue of placement now instead of later.
C) Early introduction to long-term options will allow the client and family time to make a more informed decision.
D) Long-term care placement is inevitable with this diagnosis.

Question 21

The staff on a care area that has a high percentage of clients with confusion attends an educational program on delirium management.Which statement,made by a staff nurse,indicates that teaching has been effective?

A) "It is important to provide education for family members as needed."
B) "Sensory deprivation and overstimulation can worsen the symptoms the client exhibits."
C) "Decreasing all stimulation in the client's room is essential."
D) "The family should involve the client in all conversations and interactions involving care."

Question 22

A client with Alzheimer disease is scheduled to attend occupational therapy three times a week.Which is the purpose of the client attending this type of therapy?

A) Improve language deficits
B) Improve muscle tone
C) Perform activities of daily living
D) Improve access to community organizations

Question 23

The nurse identifies the diagnosis of Risk for Injury for a client who is disoriented.Which statement should the nurse identify as an expected outcome for this client's care?

A) The client does not sustain injuries during wanderings.
B) The client maintains continence on four out of five voidings.
C) The client receives culturally appropriate care.
D) The client sleeps through the night and stays awake most of the day.

Question 24

A student nurse is reviewing the pathophysiology and etiology of Alzheimer disease (AD).Which is true regarding the pathophysiology and etiology of this disease? Select all that apply.

A) Damage to the limbic system results in speech decline and slowed movements.
B) Familial Alzheimer disease (FAD) is also called delayed-onset Alzheimer disease.
C) Sporadic Alzheimer disease usually manifests before age 65.
D) Sporadic Alzheimer disease is more common than familial Alzheimer disease.
E) In Alzheimer disease, neuronal cells die in a characteristic order.

Question 25

A non-English-speaking school-age client is hospitalized with encephalitis and is experiencing delirium.Which intervention promotes a therapeutic environment for this child and family?

A) Making sure the parents can set up the treatments for their child
B) Encouraging the family to remain at the bedside with the client
C) Making sure the child comes back for the follow-up appointment
D) Providing written instructions before discharge

Question 26

A nurse manager is educating a group of staff nurses on recognizing the differences between confusion and delirium.Which statements will the nurse manager include? Select all that apply.

A) "Delirium is seen only in older adults."
B) "Delirium is a reversible condition while dementia is not."
C) "Older adult men are at higher risk for developing delirium."
D) "Younger adult females are at higher risk for developing delirium."
E) "Adolescents are more prone to developing delirium than young children."

Question 27

The nurse is explaining the difference between delirium and dementia to a family member of a client with confusion.Which statement is appropriate for the nurse to include?

A) "The cause of delirium is unknown."
B) "Dementia develops suddenly."
C) "Delirium is a common occurrence in older adult clients who are hospitalized."
D) Delirium is often confused with depression in older adult clients."

Question 28

The client's family says,"We don't understand what is happening to Dad.He becomes very agitated in the evenings,cussing like a sailor." When responding to the family,which phenomenon will the nurse include?

A) Delirium
B) Sundown syndrome
C) Anxiety
D) Psychosis

Question 29

An older adult client,hospitalized post-surgery,wakes up in the middle of the night very confused.The nurse reorients the client to the surroundings and gets the client to return to sleep.Which should the nurse consider as a source for the client's confusion?

A) Ambien 10 mg as needed at bedtime for sleep
B) The client's age
C) The death of the client's husband last month
D) History of cardiac disease

Question 30

The nurse plans a class about Alzheimer disease for a caregiver support group.Which should the nurse include when teaching this class of caregivers? Select all that apply.

A) Glutamatergic inhibitors are the most common class of drugs for treating Alzheimer disease.
B) Alzheimer disease accounts for about 70% of all dementias.
C) Chronic inflammation of the brain may be a cause of the disease.
D) Depression and aggressive behavior are common with the disease.
E) Memory difficulties are an early symptom of the disease.

Question 31

A nurse is caring for a client with Alzheimer disease (AD)who recently lost the ability to live independently but can still perform activities of daily living (ADLs).Which stage of the disease is this client in?

A) Stage 3
B) Stage 4
C) Stage 5
D) Stage 6

Question 32

A hospitalized older adult client suddenly does not recognize an adult daughter and states,"Why hasn't my wife come to see me?" The client's spouse has been dead for 5 years.Prior to the hospitalization,the client was clear of mind and thought.Which nursing diagnoses would be appropriate for this client? Select all that apply.

A) Risk for Autonomic Dysreflexia
B) Anxiety
C) Acute Confusion
D) Impaired Memory
E) Ineffective Coping

Question 33

A client is diagnosed as having Stage 1 Alzheimer disease.Which are appropriate goals for the client and family at this time? Select all that apply.

A) Resolving grief over the diagnosis
B) Deciding on the desired treatment and selecting a healthcare proxy; sharing the treatment decision with the healthcare proxy
C) Beginning cognitive-enhancing medication, such as Aricept
D) Setting up a protective physical environment-such as removing throw rugs
E)None of above

Question 34

A client with schizophrenia is unable to complete activities of daily living.The client does not respond much to what is happening,and lacks interest in the environment.Based on this data,which conclusion by the nurse is appropriate?

A) The client is experiencing negative symptoms.
B) The client is experiencing positive symptoms.
C) The client is most likely very depressed.
D) The client is most likely hearing voices.

Question 35

A nurse is caring for a client who is confused and agitated.The nurse understands that the best method to determine if the client has reversible confusion is to use the Confusion Assessment Method (CAM).What is true regarding this diagnostic tool?

A) It consists of five parts and is a lengthy test.
B) It measures the severity of the client's delirium.
C) It is also effective in screening for depression.
D) It is effective in screening for cognitive impairment and reversible confusion.

Question 36

The family of an older adult client is informed that the client has delirium.Which statement indicates that the family understands the diagnosis?

A) "Dad has always been so independent. He's lived alone for years since my mom died."
B) "The changes in his behavior came on so quickly. He was fine when he woke up but didn't know the year or where he was by lunch time."
C) "Dad has been becoming increasingly forgetful over the last several months."
D) "Maybe it's just caused by aging. This usually happens when people get older."

Question 37

The family of a school-age client is very upset because the child does not seem to know the family.The client has been admitted with pneumonia and has a high fever.What should the nurse teach this family to alleviate stress about the child's confusion? Select all that apply.

A) Reorient the client to time and place as much as possible.
B) Encourage the family remain at the bedside as much as possible.
C) Explain that high fevers can cause delirium.
D) Reassure that the confusion will not last very long.
E) Teach the family how to care for the child upon discharge.

Question 38

A nurse is caring for a client with Alzheimer disease (AD)who has receptive aphasia.Which area of the brain is likely damaged from AD?

A) Temporal lobe
B) Limbic system
C) Frontal lobe
D) Occipital lobe

Question 39

A home health nurse visits a client with Stage 2 Alzheimer disease who lives at home with a spouse.Which action by the nurse enhances the spouse's ability to meet the needs of the client?

A) Encouraging the caregiver to take rest periods and avoid fatigue
B) Providing the client a list of daily activities to complete
C) Making arrangements for the client to visit the local senior citizen center in the afternoon
D) Finding placement in a long-term care facility

Question 40

The nurse is reviewing content provided to a caregiver of an individual with Alzheimer disease.Which statement indicates that teaching has been effective?

A) "There are effective drugs, but they cannot be used over a long period."
B) "There aren't any drugs that are effective in treating this disease."
C) "The earlier the drugs are started, the greater the effect they will have on the disease."
D) "There are drugs that can control symptoms for many years."

Question 41

The client is receiving risperidone (Risperdal)for the treatment of schizophrenia.Which client statement indicates the medication is effective?

A) "I promise not to skip breakfast anymore."
B) "I am not hearing the voices anymore."
C) "I will start going to group therapy."
D) "I feel better and I am ready to go home."

Question 42

A nurse working in a psychiatric unit is caring for a client with schizophrenia who manifests positive symptoms of the disease.Based on this data,which does the nurse anticipate when providing care?

A) Social withdrawal
B) Hallucinations
C) Anhedonia
D) Concrete thinking

Question 43

A nurse is caring for a client with schizophrenia.The client asks the nurse what causes the disease.Which response indicating the pathophysiology and etiology of the disease is appropriate by the nurse?

A) "Reduced blood flow to the thalamus interferes with the brain's filter, turning the normal flow of sensory information into an overload."
B) "There is an increased number of nicotinic receptors in the hippocampus, which makes it harder to form new memories and interpret sensory stimuli.
C) "Genetics do not seem to factor into the cause of the disease."
D) "The ventricles and sulci of the brain are decreased in size."

Question 44

An adolescent client is admitted to the hospital for the treatment of schizophrenia.The client's mother is confused and wants to know what she did to cause this to occur.Which responses by the nurse are appropriate? Select all that apply.

A) "Schizophrenia is a biological brain disorder."
B) "Research indicates that schizophrenia is a genetic disorder."
C) "Research indicates that a very stressful environment causes schizophrenia."
D) "Schizophrenia is due to too much dopamine in certain parts of the brain."
E) "Schizophrenia is linked to drinking alcohol during pregnancy."

Question 45

The nurse is providing family therapy for the family of an adolescent diagnosed with schizophrenia.When planning care for this client,which is the focus for the nursing interventions? Select all that apply.

A) Establishing boundaries
B) Coping mechanisms
C) Providing happiness
D) Preventing future episodes
E) Improving communication

Question 46

A client with schizophrenia is exhibiting attention deficit and difficulty remembering recent events.Which is an appropriate expected outcome for this client?

A) Client will interact well with others before discharge.
B) Client will develop occupational skills by discharge.
C) Client will exhibit an increased attention span in 1 week.
D) Client will deny auditory hallucinations within 7 days.

Question 47

The healthcare provider prescribes aripiprazole (Abilify)for the client with schizophrenia.Which is the priority outcome for the client?

A) The client will report a decrease in auditory hallucinations.
B) The client will report symptoms of restlessness.
C) The client will consume adequate fluids and a high-fiber diet.
D) The client will be compliant with taking the medication as prescribed.

Question 48

The nurse is providing discharge instructions to the family of a client with schizophrenia.What should the nurse teach regarding effective communication skills? Select all that apply.

A) Talk with family or friends.
B) Pick a time and topic to practice.
C) Decrease external stimuli.
D) Leave the client alone.
E) Increase the dose of medication.

Question 49

The nurse is helping the family of an adolescent understand why their child has been diagnosed with schizophrenia.Which risk factor in the client's history supports the current diagnosis?

A) Association with psychotic clients
B) Smoking
C) Genetic predisposition
D) Allergy to shellfish

Question 50

The nurse is caring for a client who is experiencing auditory hallucinations.Which is the priority nursing diagnosis for this client?

A) Disturbed Thought Processes
B) Individual Ineffective Coping
C) Impaired Verbal Communication
D) Risk for Violence, Self-Directed or Other-Directed

Question 51

A client receiving chlorpromazine (Thorazine)for the treatment of schizophrenia is demonstrating signs of tardive dyskinesia.Which assessment findings does the nurse anticipate for this client? Select all that apply.

A) Wormlike motions of the tongue
B) Lip smacking
C) Unusual facial movements
D) Muscle spasms of the neck
E) Shuffling gait