Deck 93: Psychiatric Nursing

Question 1

The nurse caring for clients in a nursing home is performing assessments for mental functioning impairments. Which accurately describes these states?

A) Dementia is poor judgment, impaired memory, and disorientation to time, place, situation, or person.
B) Dementia begins with confusion, sleep disturbances, and restlessness, and progresses to anxiety, delusions, hallucinations, or fear.
C) Symptoms of mild cognitive impairment include ongoing problems in reasoning, judgment, perception, attention, language, reading, and writing.
D) Delirium is a progressive, irreversible, fatal neurologic disorder in which behavioral, intellectual, and emotional changes develop in fairly regular patterns.

Answer 1

Symptoms of mild cognitive impairment include ongoing problems in reasoning, judgment, perception, attention, language, reading, and writing.

Question 2

A nurse is caring for a client diagnosed with delirium. For what should the nurse assess this client?

A) Complete loss of muscle control
B) Inability to use objects properly
C) Inability to eat or swallow
D) Altered level of consciousness

Answer 2

Altered level of consciousness

Question 3

A nurse is caring for a client diagnosed with dementia who resides in a long-term care facility. The client is adamant about going back home. What measure should the nurse employ?

A) Reassure the client that the facility is safe.
B) Convince the resident that the facility is his home.
C) Restrain the client with the use of soft restraints.
D) Comfort the client that he will be sent home soon.

Answer 3

Reassure the client that the facility is safe.

Question 4

For which client would the nurse document pseudodementia?

A) A client who is confused and clinically depressed
B) A client who has the beginning signs of Alzheimer disease
C) A client who has mild cognitive impairment related to medications
D) A client who has dementia related to an endocrine problem

Question 5

The nurse is teaching the family of a client diagnosed with dementia about the disease process. Which teaching point accurately describes this mental alteration?

A) Dementia is a normal part of aging.
B) Dementia is not any specific disease or disorder.
C) Dementia does not cause personality changes.
D) Dementia does not affect level of consciousness.

Question 6

An older adult client diagnosed with dementia manifests an inability to recognize objects or persons via auditory, visual, sensory, or tactile sensations. Which is the correct term for this condition?

A) Akinesia
B) Agnosia
C) Aphagia
D) Apraxia

Question 7

The nurse performing a physical assessment of a client diagnosed with dementia documents "emotional liability" on the client chart. Which describes this condition?

A) Suspicion of others
B) Depressed state
C) Fearful and having false beliefs
D) Unexpected mood swings

Question 8

A nurse is caring for a client who diagnosed with Parkinson disease. What mental functioning impairment is associated with this disease?

A) Confusion
B) Delirium
C) Dementia
D) Alzheimer disease

Question 9

The nurse caring for a client with Alzheimer disease states the risk factors of the disease to the family members. Which are risk factors for this mental functional impairment? Select all that apply.

A) Age <50 years
B) Genetics
C) Hypertension
D) Having higher education
E) Late retirement from a mentally stimulating job
F) Low levels of vitamin folate

Question 10

A nurse is caring for an older adult client who is to undergo a brief mental status examination as part of psychometric testing. What function is lost in the initial stages of Alzheimer disease (AD)?

A) Memory of childhood events
B) Ability to complete simple tasks
C) Ability to concentrate
D) Ability to remember everyday words

Question 11

A nurse is caring for a client diagnosed with Alzheimer disease (AD). What finding should the nurse assess for during the mid-stage level of AD?

A) Failing to recognize people
B) Forgetting the telephone number
C) Forgetting familiar words
D) Forgetting the car keys

Question 12

A nurse is caring for an elderly client diagnosed with Alzheimer disease (AD). What should the nurse assess for in this client?

A) History of a series of small strokes
B) High-dose folate supplementation
C) Crack cocaine abuse
D) Elevated blood pressure

Question 13

The nurse is performing an assessment of a new client admitted to a long-term facility with a diagnosis of Alzheimer disease (AD). Which common symptoms of the disease would the nurse suspect? Select all that apply.

A) Memory loss
B) Personality changes
C) Self-care deficits
D) Self-violence
E) Weight gain
F) Dysrhythmias

Question 14

The nurse is administering donepezil to a client who is diagnosed with Alzheimer disease (AD). What is the therapeutic effect of this drug?

A) Slows memory impairment associated with (AD)
B) Treats moderate to severe AD
C) Treats depression of AD
D) Treats vascular dementia accompanying AD

Question 15

The nurse caring for clients with dementia and Alzheimer disease (AD) in a long-term care setting explains to the new nurse how multi-infarct dementia (MID) differs from AD. Which is one of these differences?

A) AD has a faster onset.
B) AD progresses in step-wise fashion instead of gradual and continuous.
C) AD does not cause dementia.
D) MID usually coexists with other conditions.

Question 16

A nurse is assessing a client for multi-infarct dementia (MID). For what should the nurse assess this client?

A) Confirming crack cocaine abuse.
B) Checking for hypertension or cardiovascular disease.
C) Checking if the progress of symptoms was gradual and continuous.
D) Confirming a history of alcohol consumption.

Question 17

The nurse is caring for clients in a nursing home who have been diagnosed with various forms of dementia. Which client would most likely demonstrate signs and symptoms of Wernicke-Korsakoff syndrome?

A) A client with a history of long-term alcohol abuse
B) A client diagnosed with uncontrolled hypertension
C) A client who currently abuses cocaine
D) A client who has been diagnosed with AIDS

Question 18

The nurse is caring for a client who is diagnosed with Creutzfeldt-Jakob disease (CJD). What is the causative factor of this disease?

A) Bacteria
B) Substance abuse
C) Viral infection
D) Strokes

Question 19

A client manifesting the signs of Alzheimer disease is undergoing testing to rule out other causes of this dementia. What test would be performed to rule out an immune disorder as the cause?

A) Complete blood count
B) Chemistry screening
C) Fasting blood sugar
D) Erythrocyte sedimentation rate

Question 20

A client is undergoing computed tomography (CT) scanning to determine the progress of Alzheimer disease. Atrophy of what area of the brain is the first sign seen in AD?

A) Meninges
B) Hippocampus
C) Dura mater
D) Frontal lobe

Question 21

A nurse is caring for a client diagnosed with dementia. For what functional activity of daily living (ADL) should the nurse evaluate this client during the diagnostic workup?

A) Determine whether the client is able to drive safely.
B) Evaluate if the client can take a bus without getting lost.
C) Evaluate whether the client can walk without assistance.
D) Determine whether the client is able to follow recipes.

Question 22

A nurse is caring for a client diagnosed with dementia. What measure should the nurse take when assisting the client with nutrition and hydration?

A) Keep reminding the client to chew and swallow.
B) Place the spoon and fork in the client's hand.
C) Provide a variety of foods to encourage eating.
D) Encourage the client to sit alone for meals.

Question 23

The nurse performing a physical assessment of a client diagnosed with Alzheimer disease documents that the client is delusional. Which is an example of this mental alteration?

A) A client rummages through drawers without any purpose.
B) A client accuses a nurse of taking her slippers, which are under the bed.
C) A client hears voices telling her to leave the building.
D) A client believes that the nursing home has taken all her money.

Question 24

The nurse caring for a client prescribed haloperidol for dementia, should monitor the client for which condition?

A) Urinary retention
B) Constipation
C) Joint stiffness
D) Respiratory distress

Question 25

The nurse manager discussing safety issues with the staff of a nursing home outlines interventions to keep clients diagnosed with Alzheimer disease from getting lost. Which practice is recommended for these clients?

A) Place hospital bands on both wrists and ankles.
B) Keep a recent photo of the client on file.
C) Put at least four phone numbers on the identification band.
D) Identify the client as having dementia on the identification band.

Question 26

A nurse assessing a client diagnosed with severe Alzheimer disease (AD) should associate which observation with the disorder??

A) Client always tends to sleep in the prone position
B) Muscles of the client become flaccid and lose tone.
C) Client keeps talking to himself throughout the day.
D) Client is unable to sit upright without support.

Question 27

A nurse is caring for a client diagnosed with dementia. What measure should the nurse employ when communicating with the client?

A) Give simple, one-step commands.
B) Use questions to assist reasoning.
C) Wear a nametag for identification.
D) Always verbalize all communications.

Question 28

The nurse is teaching the family of a client diagnosed with cognitive dysfunction how to make the home environment safe for the client. Which guideline is recommended to include in the teaching plan?

A) Allow the client to drive only if supervised.
B) Remove all medications and poisonous substances from the home.
C) Install safety locks and buzzers on all doors.
D) Get a pet for the client to serve as a companion.

Question 29

A nurse is caring for clients living in a nursing home who have been diagnosed with dementia. Which guideline is recommended for dealing with behavioral issues?

A) If a person balks, go away briefly and come back later with a pleasant tone of voice.
B) If a person displays catastrophic reaction, forcibly remove the client from the activity.
C) Provide extra stimulation in the environment for a client with paranoia.
D) If a client displays aggression, leave the client and call for security.

Question 30

The nurse is teaching the family of a client a process that parallels the nursing process to use to make decisions for their loved one. What would be the second step in this process?

A) Realize the ambiguity of the situation that the adult is now like a child.
B) Restate and clarify the family's perceptions and feelings.
C) Verify the family's feelings and perceptions to be sure they understand the situation.
D) Assist the family to create solutions for the problems presented.