Question 1

What information should the nurse provide the family of a client diagnosed with normal-pressure hydrocephalus (NPH)?

Accepted Answer

The related dementia in NPH is potentially reversible with the proper treatment of shunt placement. It is important for the nurse to provide this information to the family to give them hope for the client's improvement with proper care. Option A is incorrect because NPH does not develop into Pick disease. Option B is incorrect because there are treatments available for NPH, such as shunt placement. Option C is incorrect because many clients with NPH do regain cognitive abilities with treatment.

Question 2

A nurse gives anticipatory guidance to the family of a patient diagnosed with stage 2 Alzheimer disease (AD). Which problem common to that stage should be addressed?

Accepted Answer

Communication deficits are a common problem in stage 2 of Alzheimer's disease. The patient may have difficulty finding the right words to express themselves or understanding communication from others. Anticipatory guidance should focus on strategies to improve communication, such as speaking slowly and clearly, using simple language, and using nonverbal cues. It is important to address this problem early on to prevent frustration and potential behavioral issues. While the other problems listed may be associated with Alzheimer's disease, they are not specific to stage 2.

Question 3

What is the foundation of the cognitive process?

Accepted Answer

Memory and learning are the foundation of the cognitive process. Without the ability to remember and learn new information, other cognitive processes like reasoning, perception, and behavior would not be possible. Orientation and speech are important aspects of cognition but are not the sole foundation. Reasoning and logic are also important but depend on memory and learning as a foundation.

Question 4

A patient diagnosed with vascular dementia does not remember family members' names. The family insistently reorients the patient, and the patient becomes more agitated. What is the most likely reason for the patient's reaction?

Accepted Answer

Individuals with vascular dementia often struggle with memory loss and can become easily overwhelmed if too much information is given to them at once. The family's insistent attempts to reorient the patient could be overstimulating and causing the patient to become agitated. It is important for caregivers to find alternative methods of communication and to approach the patient in a calming and reassuring manner.

Question 5

An older adult patient developed delirium secondary to diphenhydramine use. The patient usually took this drug for allergies but recently added a cough syrup that also contained the drug. What information is most important to teach the family?

Accepted Answer

The answer of An older adult patient developed delirium secondary...

Question 6

An older patient had a subtotal gastrectomy after being diagnosed with stomach cancer. What long-term mental health risk related to this procedure should the nurse discuss with the patient?

Accepted Answer

The answer of An older patient had a subtotal gastrectomy...

Question 7

The nurse teaches a family who provides in-home care for a patient diagnosed with dementia. Which measure to facilitate environmental safety should the nurse include?

Accepted Answer

Installing gates at the tops and bottoms of stairs can prevent falls and injuries for a patient with dementia who may have difficulty with balance and spatial awareness. Storing medications in a clearly visible place, varying the daily schedule, and including daily activities that call for use of higher cognitive functions may also be beneficial, but they do not directly address environmental safety concerns.

Question 8

What is the nursing care priority for a patient diagnosed with stage 7 Alzheimer disease?

Accepted Answer

At stage 7 of Alzheimer's disease, patients have severe cognitive decline and are completely dependent on nursing care for their basic needs. The priority becomes ensuring that the patient receives proper nutrition and hydration to prevent complications such as dehydration, malnutrition, and aspiration. While promoting self-care, supporting communication, and preserving problem-solving abilities are important aspects of nursing care, they are not the top priority in this stage.

Question 9

The family of a patient diagnosed with Alzheimer disease (AD) is concerned about the patient's occasional urinary incontinence. The nurse should give which suggestion?

Accepted Answer

Taking the patient to the bathroom every 2 hours can help prevent urinary incontinence and maintain bladder control. Using adult diapers may be an option, but it is important to promote continence whenever possible. Putting a sign on the bathroom door may not be effective for patients with AD who may have difficulty recognizing the sign or following directions. Limiting fluid intake to 1000 mL daily may lead to dehydration and other complications.

Question 10

An older adult patient diagnosed with delirium is anxious, agitated, and experiencing visual hallucinations. The nurse entering the room to assess vital signs should implement which intervention to best address this behavior?

Accepted Answer

The nurse should calmly announce themselves by name and title and explain what is happening to the patient. This helps to establish trust and a connection with the patient and can help to decrease feelings of anxiety and agitation.

Question 11

A patient diagnosed with delirium stares at the corner of the room, wrings hands, and says, "I'm scared those snakes will bite me." What term should the nurse use to best document this event?

Accepted Answer

The patient's statement about snakes is a clear example of a visual hallucination, which is a common symptom of delirium. Agnosia refers to difficulty recognizing familiar objects or people, disorientation refers to confusion about time or place, and confabulation refers to the production of false or distorted memories. While these may also be present in a patient with delirium, they do not specifically apply to the situation described in the question.

Question 12

What is the expected outcome for donepezil therapy prescribed for a client diagnosed with mild-to-moderate Alzheimer disease (AD)?

Accepted Answer

Donepezil is a cholinesterase inhibitor that can improve cognitive function, including memory, in mild-to-moderate Alzheimer disease (AD). The expected outcome of therapy is better daily function than without treatment. While donepezil may temporarily interrupt the disease process and provide remissions of varying lengths of time, there is no expectation for a marked decrease in memory impairment.

Question 13

An older adult patient has fluctuating levels of awareness, anxiety, and appears to be picking things out of the air. The patient says, "I saw my granddaughter standing at the foot of the bed last night." The nurse should suspect which disorder?

Accepted Answer

The symptoms described suggest delirium, which is a sudden change in mental state that can cause confusion, disorientation, and hallucinations. Dementia is a more gradual decline in cognitive function, and schizophrenia and bipolar disorder typically present with more stable symptoms over time.

Question 14

A nurse assesses a newly admitted patient with possible delirium. Which aspect of the history provides by family members contributes to confirmation of the diagnosis?

Accepted Answer

The sudden onset of confusion is a key characteristic of delirium, and the family member's report confirms this symptom. The other answer choices do not provide specific information about delirium.

Question 15

A patient diagnosed with dementia is watching a crime story on television. Suddenly, the patient begins to yell, "Stop! He's got a gun." What is the nurse's best intervention?

Accepted Answer

Turning off the television and reassuring the patient that they are safe will help to decrease the patient's anxiety and agitation. Administering medication or providing a snack and putting the patient to bed are not appropriate interventions for this behavior. Reassuring the patient that there are no guns nearby may not be effective, as the patient with dementia may have difficulty understanding and processing information.

Question 16

Effective management of a client diagnosed with Huntington disease is best demonstrated by which documentation made by the nurse?

Accepted Answer

The answer of Effective management of a client diagnosed with...

Question 17

An older adult patient is admitted with a diagnosis of delirium secondary to a urinary tract infection. The family asks whether or not the patient will recover. Select the nurse's best response.

Accepted Answer

Delirium is usually a temporary condition that can be treated if the underlying cause is identified and treated appropriately. In this case, the delirium is secondary to a UTI, so treating the infection will likely improve the confusion.

Question 18

A newly admitted patient diagnosed with Alzheimer disease (AD) has demonstrated apraxia. The nurse should assist the patient with which activity?

Accepted Answer

Apraxia is difficulty with purposeful movement and coordination, so the nurse should assist the patient with grooming and hygiene tasks, such as brushing teeth or combing hair, that require these skills. Reading written material, word finding, and orientation are not affected by apraxia.

Question 19

An older adult presents with symptoms of delirium. The family says, "Everything was fine until yesterday." What is the most important assessment information the nurse should gather?

Accepted Answer

The most common cause of delirium in older adults is medication-related, so gathering a list of current medications is important to identify any potential medication interactions or adverse effects. However, it would also be important to gather information on the other options listed as they could contribute to delirium as well.

Question 20

The focus of nursing care for a patient diagnosed with dementia is best demonstrated by which nursing statement?

Accepted Answer

The answer of The focus of nursing care for a...

Quiz 28: Cognitive Disorders

What information should the nurse provide the family of a client diagnosed with normal-pressure hydrocephalus (NPH) ?

A nurse gives anticipatory guidance to the family of a patient diagnosed with stage 2 Alzheimer disease (AD) . Which problem common to that stage should be addressed?