Question 1

Which of the following is a rare and fatal infectious brain disorder that progresses rapidly to death within 1 year?

Accepted Answer

Creutzfeldt-Jakob disease is a rare and fatal infectious brain disorder that progresses rapidly to death within 1 year. Vascular dementia and dementia with Lewy bodies are types of dementia, but they are not infectious, and they progress more slowly. Neurofibrillary tangle disease is not a recognized medical condition.

Question 2

What does the nurse document when assessment findings indicate that a patient with dementia has lost her ability to initiate purposeful movement?

Accepted Answer

Apraxia is the inability to initiate voluntary movements despite having the desire and physical ability to do so. Dementia can cause apraxia, as it affects the brain's motor planning and coordination areas. The nurse would document this finding in the patient's assessment. Amnesia refers to memory loss, agnosia is the inability to recognize objects or people, and anosognosia is the lack of awareness or denial of one's own health condition.

Question 3

A 62-year-old woman is brought to the clinic by her daughter,who is concerned about her mother'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?

Accepted Answer

Asking the patient about the current day of the week will provide important information about her orientation to time, which is typically assessed in the mental status exam. This can help identify cognitive deficits that may be contributing to her sleep disturbances and difficulty solving common problems. Questions about birthplace, feelings of sadness, and self-image are also important in a mental health assessment, but may not be as immediately relevant to the patient's current mental status evaluation.

Question 4

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

Accepted Answer

Having the patient's spouse administer the medication ensures direct oversight and assistance, which is particularly effective for patients with Alzheimer's disease and mild dementia who may forget to take their medication or be unable to manage it themselves.

Question 5

Which of the following is a modifiable risk factor for reducing the risk for getting Alzheimer's disease?

Accepted Answer

Inadequate intellectual stimulation is a modifiable risk factor for reducing the risk of getting Alzheimer's disease.

Question 6

Risperidone (Risperdal)is prescribed for a patient with moderate Alzheimer's disease.In evaluating the effectiveness of this medication,what would the nurse expect the patient to demonstrate?

Accepted Answer

Risperidone is an antipsychotic medication commonly used to manage behavioral symptoms of Alzheimer's disease, such as agitation and aggression. It may also help stabilize mood and sleep patterns, but it is unlikely to improve functional abilities or memory and judgement.

Question 7

A 70-year-old woman visits her 72-year-old husband who has advanced Alzheimer's disease and is hospitalized with pneumonia.She tells the nurse that it is a relief to have someone besides herself care for her husband because she is physically and mentally exhausted from caring for him at home.She says she has no family to help her and that they cannot afford institutional care for her husband.What is an appropriate nursing diagnosis for the patient's wife?

Accepted Answer

The patient's wife is experiencing caregiver role strain due to limited resources for caregiving, including lack of family support and inability to afford institutional care for her husband. She is physically and mentally exhausted from caring for him at home, which further supports this nursing diagnosis. While anxiety related to financial insecurity may be a contributing factor, it is not the primary nursing diagnosis in this case. Ineffective health maintenance and social isolation may also be present, but they are not the most appropriate nursing diagnosis given the information provided.

Question 8

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.What is an appropriate intervention for this problem?

Accepted Answer

Maintaining a consistent daily routine can help reduce confusion and agitation in patients with dementia. It provides structure and predictability, which can help the patient feel more secure and calm. Keeping the television on all day can overstimulate the patient and contribute to confusion. Reorienting the patient every few hours can be helpful, but it may not address the underlying thought disturbances. Providing current newspapers and magazines may be overwhelming and potentially confusing for the patient.

Question 9

When teaching the husband of a woman who is being evaluated for Alzheimer's disease about the disorder,what should the nurse explain?

Accepted Answer

It is important for the husband to understand that the process of diagnosing Alzheimer's disease involves ruling out other potential causes of dementia. This can sometimes be a lengthy and complex process. It is also important to note that there is currently no cure for Alzheimer's disease, and while medications like donepezil can help to mitigate some of the symptoms, they do not reverse the disease itself. Family history can be a risk factor, but it is not the most important factor. Brain imaging can be helpful in diagnosing Alzheimer's disease, but it is not the only method used for diagnosis.

Question 10

A long-term care patient with moderate dementia develops increased restlessness and agitation.What is the nurse's initial action?

Accepted Answer

Restlessness and agitation in a patient with dementia can indicate discomfort or pain, which should be assessed first before administering medication or trying to reorient the patient. It is important to identify and address the underlying cause of the behavior.

Question 11

In which of the following conditions does the patient have fluctuations in consciousness throughout the course of the disease?

Accepted Answer

Delirium is a condition characterized by acute onset of fluctuations in consciousness, attention, and cognitive function. It may also include disorientation, memory impairment, hallucinations, and delusions. Depression, psychosis, and dementia do not typically have fluctuations in consciousness as a defining characteristic.

Question 12

A 71-year-old patient is diagnosed with moderate dementia as a result of multiple strokes.During assessment of the patient,what would the nurse expect to find?

Accepted Answer

Loss of recent and long-term memory is a common symptom of moderate dementia, and can be caused by multiple strokes. Extreme suspiciousness and irritability and withdrawal may also be present, but are less specific to dementia. Difficulty eating and swallowing may occur in severe stages of the disease.

Question 13

When assessing a patient with Alzheimer's disease 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?

Accepted Answer

Placing the patient in a room close to the nurses' station can help prevent wandering episodes and ensure prompt intervention and supervision if the patient does attempt to wander. It is unlikely that the patient can provide a clear explanation for the wandering, and reorienting the patient several times daily may not be effective in preventing wandering behavior. Bringing familiar items from home may provide some comfort to the patient but may not prevent wandering.

Question 14

A 72-year-old woman hospitalized with pneumonia becomes 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?

Accepted Answer

The sudden onset of confusion and disorientation, as indicated by the patient being oriented and alert upon admission and then becoming disoriented and confused, is characteristic of delirium. Dementia typically involves a gradual decline in cognitive function over time, not a sudden change.

Question 15

A family member of a patient with possible Alzheimer's disease asks the nurse the purpose of the MMSE.Which response is appropriate?

Accepted Answer

The MMSE (Mini-Mental State Examination) is a tool used to assess cognitive function and determine the degree of mental impairment. It is helpful in screening patients for possible dementia or Alzheimer's disease. It is not used to diagnose Alzheimer's disease, determine treatment options or differentiate acute delirium from chronic dementia.

Question 16

Some patients with dementia have a pattern of behavioural disturbance that occurs consistently in the late afternoon.How does the nurse document this assessment finding?

Accepted Answer

This pattern of behavioural disturbance in patients with dementia occurring consistently in the late afternoon is commonly referred to as "sundowning."

Question 17

When administering a mental status examination to a patient,the nurse suspects depression when the patient gives which of the following responses?

Accepted Answer

"I don't know." responses can indicate a lack of interest or motivation, which are common symptoms of depression.

Quiz 62: Nursing Management: Delirium,alzheimers Disease,and Other Dementias