Deck 60: Nursing Management: Alzheimers Disease and Dementia

Question 1

A 72-year-old patient hospitalized with pneumonia is disoriented and confused 2 days after admission. Which assessment information obtained by the nurse about the patient indicates that the patient is experiencing delirium rather than dementia?

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

Answer 1

The patient was oriented and alert when admitted.

Question 2

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) Move the patient to a quieter room at night.
B) Open the blinds in the patient's room and provide frequent activities.
C) Have the patient take a brief mid-morning nap.
D) Provide hourly orientation to time of day.

Answer 2

Open the blinds in the patient's room and provide frequent activities.

Question 3

A 71-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) variable ability to perform simple tasks.
C) difficulty eating and swallowing.
D) loss of recent and long-term memory.

Answer 3

loss of recent and long-term memory.

Question 4

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 answer?"
C) "Wait, let me think about that."
D) "Who are those people over there?"

Question 5

Coexisting dementia and depression are identified in a patient with Parkinson's disease. The nurse anticipates that the greatest improvement in the patient's condition will occur with administration of

A) antipsychotic drugs.
B) anticholinergic agents.
C) dopaminergic agents and antidepressant drugs.
D) selective serotonin reuptake inhibitor (SSRI) agents.

Question 6

When teaching the spouse 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) a diagnosis of AD can be made only when other causes of dementia have been ruled out.
C) new drugs have been shown to reverse AD dramatically in some patients.
D) the presence of brain atrophy detected by MRI confirms the diagnosis of AD in patients with dementia.

Question 7

A patient with Alzheimer's disease (AD) is hospitalized with a urinary tract infection. The spouse tells the nurse, "I am just exhausted from the constant care and worry. We don't have any children and we can't afford a nursing home. I don't know what to do." The most appropriate nursing diagnosis for the spouse is

A) anxiety related to limited financial resources.
B) ineffective health maintenance related to stress.
C) caregiver role strain related to limited resources for caregiving.
D) social isolation related to unrelieved caregiving responsibilities.

Question 8

A 62-year-old patient is brought to the clinic by a family member who is concerned about the patient's increasing sleep disturbances and 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 have any feelings of sadness?"
C) "What day of the week is it today?"
D) "How positive is your self-image?"

Question 9

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

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

Question 10

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

A) have a close family member remain with the patient and provide reassurance.
B) assign a staff member to stay with the patient and offer frequent reorientation.
C) ask the health care provider about ordering an antipsychotic drug.
D) secure the patient in bed with a soft chest restraint.

Question 11

A home-health patient with Alzheimer's disease (AD) and mild dementia has a new prescription for donepezil (Aricept). Which nursing action will be most effective in ensuring compliance with the medication?

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

Question 12

A family member of a patient with possible Alzheimer's disease asks the nurse the purpose of the Mini-Mental State Examination (MMSE). Which response by the nurse is appropriate?

A) The MMSE helps in establishing the diagnosis of Alzheimer's disease (AD).
B) The MMSE is useful in determining the degree of mental impairment.
C) The MMSE determines the choice of the most appropriate treatment.
D) The MMSE aids in differentiating acute delirium from chronic dementia.

Question 13

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

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

Question 14

The nurse has identified the nursing diagnosis of disturbed thought processes related to effects of dementia for a patient with late-stage Alzheimer's disease (AD). An appropriate intervention for this problem is to

A) maintain a consistent daily routine for the patient's care.
B) encourage the patient to discuss events from the past.
C) reorient the patient to the date and time every few hours.
D) provide the patient with current newspapers and magazines.

Question 15

Risperidone (Risperdal) is prescribed for an outpatient with moderate Alzheimer's disease (AD). Which information obtained by the nurse at the next clinic appointment indicates that the medication is effective?

A) The patient has less agitation.
B) The patient is dressed appropriately.
C) The patient is able to swallow a pill.
D) The patient's speech is clearer.

Question 16

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

Question 17

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

A) Reminding the patient frequently about being in the hospital
B) Placing suction at the bedside to decrease the risk for aspiration
C) Providing complete personal hygiene care for the patient
D) Repositioning the patient frequently to avoid skin breakdown