Question 1

Dementia is a likely cause of behavior demonstrated by a resident who:

Accepted Answer

Memory loss is of a permanent nature and therefore is more likely caused by dementia. The other behaviors are likely delirium resulting from an infection, pain, or some other acute factor.

Question 2

Which is considered the most common type of dementia?

Accepted Answer

Alzheimer disease is the most common type of dementia. Alzheimer disease is most often seen in people between the ages of 65 and 85 years; however, people as young as 40 years may get the disease. The other options are not considered common forms of dementia because they are not responsible for significant numbers of dementia cases.

Question 3

What changes to the brain is the primary underlying cause of Alzheimer disease?

Accepted Answer

Physical changes occur in the brains of people with Alzheimer disease. Abnormal deposits of protein, called plaques and tangles, develop in the brain. These protein deposits interfere with the way that the nerves inside the brain communicate with each other. Brain scans done on people with Alzheimer disease show large areas in the brain where there is no activity. There is no current research to connect the other options with the cause of Alzheimer disease.

Question 4

Which condition(s) put a person at risk for developing vascular dementia? Select all that apply.

Accepted Answer

Conditions such as a history of myocardial infarction (heart attack), hypertension (high blood pressure), diabetes mellitus, peripheral vascular disease, transient ischemic attacks (TIAs), obesity, or smoking can put a person at risk for developing vascular dementia. Depression is not currently believed to be a risk for developing vascular dementia.

Question 5

The nursing assistant is caring for a resident diagnosed with dementia on an Alzheimer's unit. What action should the nursing assistant take to keep the resident safe?

Accepted Answer

Residents with dementia tend to wander away, so the assistant's best action is to make sure before unlocking the unit's door for visitors to enter that there is no resident nearby that could accidently escape the unit. Explain to visitors the reason behind the need to maintain the lockdown system. The family needs to visit their loved one inside of the unit and its courtyard and not take the resident away from the unit, which offers special features to protect the resident from wandering. If the room is hot, call maintenance right away so a portable air-conditioner may be used, for instance. Don't unlock the specialty locks; this creates a way for the resident to wander off. Because of the disease process, the resident may change behaviors quickly so the activity may not last long to keep the resident's interest.

Question 6

The nursing assistant is caring for a client with dementia in the hospital. The assistant enters the client's room with the breakfast tray to find the client fully dressed. The client states, "I have to catch the bus, or I will be late to work." What is the best statement for the assistant to respond with?

Accepted Answer

The nursing assistant needs to accept the client's reality and then redirect the behavior to keep the resident safe, content, and able to maintain a sense of importance. Using validation, the best statement is, "You still have time to eat breakfast because the bus is delayed." This redirects the client's attention to breakfast so the client eats and may forget about work. Because the client's reality is that it's time for work, stating the client is retired will not help. Stating the nursing assistant's reality that the resident is confused or needs help with the hospital gown conflicts with the client's reality and can cause frustration and anger.

Question 7

When one of the residents insists that they are the Secretary of Defense, the nursing assistant responds by saying,

Accepted Answer

The nursing assistant should not try to correct the resident because doing so will only serve to upset the resident, who honestly does believe that they are the Secretary of Defense. It is likely that encouraging the delusion will serve to further confuse the resident. Using reminiscence therapy (by asking them to talk about their World War II days) would be a much more effective approach.

Question 8

The nursing assistant is attempting to help a resident diagnosed with dementia dress for bed. The resident begins to scream and cry and cannot be consoled. What is the best action for the the nursing assistant to take?

Accepted Answer

The nursing assistant observes the resident is exhibiting a catastrophic reaction based upon the behaviors. The best action to take is to remain calm and reassure the resident, "I am here to help you." "It's alright." Wait until the resident calms down and then break the task into simple short instructions, "Put your head through this hole." "Put your arm in this hole, etc." The assistant would not use negative language or raise their voice because this would make it worse. Telling the resident to stop acting that way and get ready for bed will increase the resident's confusion because it is too much for the resident to process. Forcing the gown would result in anger and potential violence from the resident. The client with dementia in this case can't get dressed alone, so the assistant needs to help.

Question 9

When a resident diagnosed with dementia begins undressing in the dining room, the nursing assistant:

Accepted Answer

The resident's dignity is being compromised by their behavior. In this situation, the best approach would be to gently, but firmly, lead them back to their room and redirect their attention by introducing another activity. The behavior needs to be stopped, but restraints are not necessary because the resident is not violent. The resident would be unable to tell the nursing assistant why they are undressing and asking would likely confuse them even more.

Question 10

Validation therapy is a therapeutic communication technique used to help manage dementia that stresses the importance of:

Accepted Answer

Validation therapy is a communication technique that is often used with people who have dementia. The caregiver acknowledges the person's reality; rather than correcting the person, the caregiver attempts to distract the person and redirect the conversation whenever possible. Although it may help a person talk with others, that is not its purpose.

Question 11

A nursing assistant best helps a person diagnosed with dementia with activities of daily living (ADLs) by:

Accepted Answer

When assisting a person diagnosed with dementia with ADLs, it is useful to use hand gestures in addition to spoken instructions to "walk" the person through the procedure. The person with dementia needs the environment to be structured and to follow a set regular routine to decrease stressing the person. Speaking in a normal, calm tone of voice is more effective than shouting at the person. People diagnosed with dementia are not likely to understand written instructions.

Question 12

A resident diagnosed with dementia gets very agitated at the idea of having to bathe. To help make sure that bath time goes smoothly, the nursing assistant will avoid:

Accepted Answer

The resident may become agitated when told that it is "time to take a bath." Therefore, it is better to say something like, "It's time to freshen up." Singing to the person can have a calming effect. Allowing the person to "wear" a towel while bathing can help the person to feel less exposed and provides some warmth. Preparing the tub room in advance helps to prevent the person from being frightened by the sound of running water.

Question 13

When assisting a person diagnosed with dementia to dress, the nursing assistant will best minimize the person's confusion by:

Accepted Answer

People diagnosed with dementia can become easily overwhelmed, so limiting the number of outfits the person must choose from can make the task of selecting an outfit to wear seem less daunting and overwhelming. All residents should be allowed to choose their own clothing for as long as they are able to do so. Allowing the person to wear dirty clothing should be avoided if possible. Asking family members to purchase several identical outfits for the person will allow the person to wear the same thing every day if the person wants to, while still allowing the laundry to get done. Clothing should be selected with an eye toward ease of wearing; buttons and other complicated fasteners are likely to be a source of frustration to a person with dementia.

Question 14

A confused resident hits a nursing assistant who reacts by slapping the resident. What will likely happen to the nursing assistant?

Accepted Answer

It is never acceptable to abuse a client or resident. Abuse is punishable in a court of law and will result in the loss of current and future employment. If the nursing assistant still feels angry, the assistant should make sure that the person is safe and walk away. The nursing assistant should ask a coworker or the nurse for help with the person. Sometimes the nursing assistant may need to ask to be assigned to another resident for a while.

Question 15

A person diagnosed with dementia often refers to staff using foul names in a very mean tone of voice. What is the best action for the nursing assistant to take next?

Accepted Answer

The person cannot be held responsible for their behavior. Taking their comments personally and responding to them in kind words is not likely to help the nursing assistant. A better approach would be to walk away from the situation. If "taking a breather" doesn't help, it may be necessary to ask to be assigned to another resident for a while. Finally, to provide the best care for our clients or residents, we must care for ourselves. Taking a deep breath, understanding the source of the behavior, and "leaving work at work" can help the nursing assistant to cope in a positive way with the stress of being a caregiver.

Question 16

The nursing assistant is caring for a resident diagnosed with rheumatoid arthritis and diabetes who is always alert and oriented but who suddenly starts undressing in the hall, appearing to be hallucinating. Which action should the assistant take first?

Accepted Answer

Unlike dementia, delirium is temporary. Delirium is a sign of an underlying problem, such as an infection. Once the cause of the delirium is discovered and treated, the delirium goes away. The first action the nursing assistant should take in this scenario is to cover the resident with the nearby blanket and help the resident back to their room to maintain respect and dignity for the resident. Then the assistant can observe for foul-smelling urine that is cloudy and any changes in the resident's vital signs before reporting the observations of the delirium to the nurse.

Question 17

It is true that Alzheimer disease:

Accepted Answer

In people with Alzheimer disease, the brain tissue is damaged by abnormal protein deposits called plaques and tangles. Alzheimer disease progresses through several stages, with each progression causing the person to become more and more dependent on others for care.

Question 18

A catastrophic reaction is most likely to occur when a person diagnosed with dementia is: (Select all that apply.)

Accepted Answer

An exaggerated response is most likely to occur when the person is overstimulated, is in a new or unfamiliar place (e.g., the person is hospitalized for treatment of an acute health problem), or is trying to express a physical or emotional need. Common causes include feeling threatened, overwhelmed, or fatigued. Boredom or loneliness is not a common trigger.

Question 19

A resident spends hours each day looking for "something" but never seems to find it. In order to help manage the resident's need to rummage, the nursing assistant:

Accepted Answer

Giving the person a special drawer or box filled with small personal items that they can rummage through will best meet the person's need to search for their belongings. The other options do not help satisfy the person's irrational need.

Question 20

When a resident diagnosed with dementia seems more relaxed about taking a bath when a towel is placed around their shoulders, the nursing assistant determines that the calmness is most likely a result of:

Accepted Answer

Allowing the person to wear a robe as long as possible and draping a bath blanket or towel over the person's shoulders while they are bathing will make the person feel less exposed as well as provide some warmth. The other options are not related to the use of the towel.

Quiz 12: Caring for People With Dementia