Question 1

While a nurse is dressing a patient with dementia as a result of Huntington disease,the patient states,"I don't want to wear clothes today," and begins to resist help putting on her clothes.The nurse's best action would be to:

Accepted Answer

When patients with dementia resist activities such as bathing or dressing,avoiding confrontations and diverting their attention elsewhere are best.

Question 2

The patient asks the nurse what causes dementia.The nurse's response would be based on the understanding that the two most prevalent types of dementia are:

Accepted Answer

Alzheimer disease and vascular dementia are the two most prevalent types of dementia.

Question 3

When admitting a patient who has recently become confused,the nurse asks the family for a list of all the medications that the patient is currently taking.The nurse is aware that the medication that could be causing confusion is:

Accepted Answer

Drugs that most commonly cause confusion include anticholinergics,digoxin,histamine-2 receptor blockers,benzodiazepines,nonsteroidal antiinflammatory drugs,and many antiarrhythmic and antihypertensive medications.

Question 4

Reality orientation is helpful for some patients with confusion.The nurse should use this technique on a patient diagnosed with:

Accepted Answer

Acute confusional state is another name for delirium.The other choices are other names for dementia.Reality orientation may be helpful for patients with delirium but tends to agitate patients with dementia.

Question 5

The nurse is taking a patient who has Alzheimer disease to the bathing room for a tub bath.The patient states,"Please don't make me take a bath today.I am so afraid that I will be washed down the drain." The nurse's best response would be:

Accepted Answer

The nurse should recognize irrational fears and arrange alternative ways to give personal care.

Question 6

The family of a patient with dementia expresses concern to the nurse about the patient wandering at night.They are afraid that the patient might get up while they are sleeping and go outside.The nurse's best advice would be to have them:

Accepted Answer

Take advantage of the fact that patients with dementia are usually unable to learn new things.They will probably not be able to figure out how to work a new lock.

Question 7

The patient with delirium repeatedly cries out for her husband.The first intervention by the nurse would be to:

Accepted Answer

Anyone dealing with a delirious patient should be calm,warm,and reassuring.Frequent orientation to the surroundings and situation is important as well.

Question 8

The family of a patient with Alzheimer disease asks the nurse,"When will my mother quit being so confused?" The nurse's response should be based on the fact that dementia is a:

Accepted Answer

Alzheimer disease is a type of dementia that is chronic and irreversible.Delirium is a short-term confusional state that has a sudden onset and is typically reversible.

Question 9

When teaching family members to care for the patient with dementia,the nurse must be sure that they understand two important concepts,which are that the patient usually:

Accepted Answer

Keeping in mind the following two important concepts when taking care of patients with dementia is helpful: (1)They usually forget things relatively quickly; and (2)they are usually unable to learn new things.

Question 10

The nurse in a long-term care facility is taking patients to the dining room for lunch.She asks the patient who has been diagnosed with delirium if she is ready to go eat lunch.When the patient does not respond,the nurse should:

Accepted Answer

The patient with delirium may have difficulty focusing or paying attention,and questions must often be repeated several times.

Question 11

When assisting the patient with dementia to dress,the nurse's first action should be to:

Accepted Answer

The goal should be to maintain the highest level of functioning possible,but tasks must be broken down into individual steps to be performed one at a time.

Question 12

In assessing a patient for the possibility of confusion,the nurse should keep in mind that the two major types of confusion are:

Accepted Answer

The two major types of confusion are acute confusional states,or delirium,and chronic confusion dementia.

Question 13

A patient has been admitted with a diagnosis of confusion.The physician's admission note states that he wants to assess for delirium versus dementia.The nurse knows that the main differences are:

Accepted Answer

Delirium is a short-term,confusional state that has a sudden onset and is typically reversible.Dementia is a syndrome that is often chronic and irreversible.

Question 14

The nurse has found the patient with delirium in other patients' rooms several times.The best action by the nurse would be to:

Accepted Answer

Avoid using physical restraints,which tend to increase anxiety and agitation.Sitting at the nurses' station will allow the nurses to monitor his activity and frequently orient him to his surroundings.

Question 15

When admitting a patient who has been diagnosed as having confusion,the most important observation that the nurse should make is the patient's:

Accepted Answer

The first step in assessing a confusional state is to observe the patient's behavior,orientation,memory,and sleeping habits.

Question 16

A patient's presentation included confusion,which began very suddenly and lasted less than a week.The nurse should be able to identify this as:

Accepted Answer

Acute confusion begins abruptly and generally lasts a short period.It usually lasts 1 week and rarely lasts longer than 1 month.

Question 17

The Cognitive Developmental Approach (CDA)to caring for patients with dementia adapts interventions that are designed to:

Accepted Answer

The CDA adapts implementations based on the patient's cognitive abilities as they are,modifies the environment,and offers limited choices.

Question 18

The nurse is planning for the nutritional needs of a patient with Alzheimer disease.The best plan is to have the dietary department provide:

Accepted Answer

Small,frequent meals are less confusing to the patient.Finger foods high in protein and carbohydrates allow patients to feed themselves more easily.

Question 19

When assessing the patient for delirium versus dementia,the nurse would expect the patient with dementia to have signs of a(n):

Accepted Answer

The patient with dementia will have a flat or indifferent affect.The other three choices would be presented by a patient with delirium.

Question 20

The nurse is gathering information from the family of a patient who is experiencing confusion.An important question the nurse should ask the family is:

Accepted Answer

Family members may be able to provide helpful information when the patient cannot.The nurse should ask when the symptoms of confusion started and whether the confusion is constant or intermittent.

Quiz 22: Confusion