Adult Health final part one

107. The client with end-stage ALS requires a gastrostomy tube feeding. Which findingwould require the nurse to hold a bolus tube feeding? 1. A residual of 125 mL. 2. The abdomen is soft. 3. Three episodes of diarrhea. 4. The potassium level is 3.4 mEq/L.

1. A residual (aspirated gastric contents)of greater than 50 to 100 mL indicatesthat the tube feeding is not being digested and that the feeding shouldbe held.

Which diagnostic test is used to confirm the diagnosis of ALS? 1. Electromyogram (EMG). 2. Muscle biopsy. 3. Serum creatine kinase (CK). 4. Pulmonary function test.

2. Biopsy confirms changes consistent with atrophy and loss of muscle fiber, both characteristic of ALS.

Which statements about ototoxicity and aminoglycosides does the nurse identify as true? (Select all that apply.) 1.The risk of ototoxicity is related primarily to excessive peak levels. 2.The first sign of impending cochlear damage is headache. 3.The first sign of impending vestibular damage is headache. 4. Ototoxicity is largely irreversible. 5. Use of aminoglycosides for less than 10 days is recommended to avoid ototoxicity

3 4 5

The nurse is assessing the client diagnosed with bacterial meningitis. Which clinicalmanifestations would support the diagnosis of bacterial meningitis? 1. Positive Babinski's sign and peripheral paresthesia. 2. Negative Chvostek's sign and facial tingling. 3. Positive Kernig's sign and nuchal rigidity. 4. Negative Trousseau's sign and nystagmus.

3. A positive Kernig's sign (client unableto extend leg when lying flat) andnuchal rigidity (stiff neck) are signs ofbacterial meningitis, occurring becausethe meninges surrounding the brainand spinal column are irritated.)

A nurse monitors a patient who is receiving an aminoglycoside (gentamicin) for symptoms of vestibular damage. Which finding should the nurse expect the patient to have first? 1.Unsteadiness 2.Vertigo 3.Headache 4.Dizziness

3. headache

The nurse is assessing a 48-year-old client diagnosed with multiple sclerosis. Which clinical manifestation warrants immediate intervention? 1. The client has scanning speech and diplopia. 2. The client has dysarthria and scotomas. 3. The client has muscle weakness and spasticity. 4. The client has a congested cough and dysphagia.

4.Dysphagia is a common problem of clients diagnosed with multiple sclerosis,and this places the client at risk for aspiration pneumonia. Some clients diagnosed with multiple sclerosis eventually become immobile and are at risk for pneumonia. 1. These are clinical manifestations of multiple sclerosis and are expected. 2. These are expected clinical manifestations of multiple sclerosis. 3. These are expected clinical manifestations of multiple sclerosis.

A client with myasthenia gravis has been receiving Neostigmine (Prostigmin). This drug acts by: A.Blocking the action of cholinesterase B.Accelerating transmission along neural swaths C.Replacing deficient neurotransmitters D.Stimulating the cerebral cortex

A. Blocking the action of cholinesterase

A nurse is beginning a physical assessment of a client who has a new diagnosis of multiple sclerosis. Which of the following findings should the nurse expect? (Select all that apply.) A. Areas of paresthesia B. Involuntary eye movements C. Alopecia D. Increased salivation E. Ataxia

A. CORRECT: Areas of loss of skin sensation are a finding in a client who has MS. B. CORRECT: Nystagmus is a finding in a client who has MS. C. Hair loss is not a finding in a client who has MS. D. Dysphagia, swallowing difficulty, is a finding in a client who has MS. E. CORRECT: Ataxia occurs in the client who has MS as muscle weakness develops and there is loss of coordination.

A nurse is caring for a client who has myasthenia gravis and has developed drooping eyelids. Which of the following actions should the nurse take? Select all that apply. A. Apply lubricating eyedrops B. Encourage use of sunglasses C. Support the head with pillows D. Tape eyes closed at night E. Provide for periods of rest during the day

A. D. A) Lubrication decreases corneal dryness and irritation, caused by weakness of eyelids B) Sunglass does not prevent corneal dryness and irritation C) Providing head support does not correct drooping eyelids caused by muscle weakness D) Taping eye lids at night prevents corneal dryness and irritation E) Promoting rest does not reduce eyelid drooping in the patient who has MG

A nurse is caring for a client who has multiple sclerosis. Which of the following findings should the nurse expect? A. Fluctuations in blood pressure B. Loss of cognitive function C. Ineffective cough D. Drooping eye lids

A. Fluctuations in blood pressure is a manifestation associated with amyotrophic lateral sclerosis. B. CORRECT: Loss of cognitive function is a manifestation associated with MS. C. Ineffective cough is a manifestation associated with amyotrophic lateral sclerosis. D. Drooping eyelids is a manifestation associated with myasthenia gravis.

A nurse is caring for a child who has absence seizures. Which of the following findings can the nurse expect? (Select all that apply.) A. Loss of consciousness B. Appearance of daydreaming C. Dropping held objects D. Falling to the floorE. Having a piercing cry

A. Loss of consciousness B. Appearance of daydreaming C. Dropping held objects

The diagnostic work-up of a client hospitalized with complaints of progressive weakness and fatigue confirms a diagnosis of myasthenia gravis. The medication used to treat myasthenia gravis is: A. Prostigmine (neostigmine) B. Atropine (atropine sulfate) C. Didronel (etidronate) D. Tensilon

A. Prostigmine (neostigmine) Protigmine is used to treat clients with myasthenia gravis. Atropine (atropine sulfate) is incorrect because it is used to reverse the effects of neostigmine. Didronel (etidronate)is incorrect because the drug is unrelated to the treatment of myasthenia gravis. Tensilon (edrophonium) is incorrect because it is the test for myasthenia gravis.

The nurse is caring for a client with a diagnosis of detached retina. Which assessment sign would indicate that bleeding has occurred as a result of the retinal detachment? A Complaints of a burst of black spots or floaters B A sudden sharp pain in the eye C Total loss of vision D A reddened conjunctiva

A.Complaints of a sudden burst of black spots or floaters indicate that bleeding has occurred as a result of the detachment.

Which of the following symptoms you as the nurse expect to see in the patient with primary progressive multiple sclerosis? (Select All that Apply): A) Unilateral Vision Loss B) Fatigue C) Diarrhea D) Intention tremors E) Paralytic ileus

Answer: A, B and D.

The client is experiencing a myasthenic crisis. Which of the following is a priority action of the following ordered actions? A) Insert NG tube B) Administer Ativan C) Monitor I&O D) Immediately stop anticholinesterase medications

Answer: A. Inserting the NG tube is the priority because it will help reduce risk for aspiration. The patient experiencing a myasthenic crisis is at a large risk for respiratory failure due to dysphagia and extreme muscle weakness. All priority actions should be focused on respiratory assessment and support. Ativan and any other sedating medication should NEVER be administered. Stopping anticholinesterase medications is associated with a cholinergic crisis. Monitoring I&O is important, but not as important as NG tube

You are teaching your patient diagnosed with myasthenia gravis about treatments. Which of the following statements, if made by the patient indicates the need for further teaching? A) Plasmapheresis is way to reduce symptoms but will need to be done every day B) A thymectomy is a removal of my thymus gland and will show some immediate relieving of my symptoms C) Corticosteroids can be used for short periods of time to help improve my symptoms, but it isn't good for long periods of time D) I need to take my Mestinon four times a day at the same time each day

Answer: B. A thymectomy may help reduce symptoms, but the effects may not be seen for many months after surgery. Plasmapheresis is the removal of antibodies from blood plasma. It must be done daily for a period of time. Corticosteroids are mostly used for short periods of time unless the patient is experiencing ocular complications. Pyridostigmine bromide (Mestinon) is divided into several doses and should be taken at the same time daily.

You're providing teaching to a group of patients with myasthenia gravis. Which of the following is not a treatment option for this condition? A. Plasmapheresis B. Cholinesterase medications C. Thymectomy D. Corticosteroids

B. Cholinesterase medications

The nurse is assessing the results of diagnostic tests on a client's cerebrospinal fluid (CSF). Which values and observations does the nurse correlate as most indicative of bacterial meningitis? (select all that apply.) A. Clear B. Cloudy C. Normal protein level D. Increased protein level E. Normal glucose level F. Decreased glucose level

B. Cloudy D. Increased protein level F. Decreased glucose level Rationale:Viral meningitis does not cause cloudiness or increased turbidity of CSF. Protein levels are slightly increased, and glucose levels are normal. In bacterial meningitis, the presence of bacteria and white blood cells causes the fluid to be cloudy.

A patient has been receiving scheduled doses of phenytoin (Dilantin) and begins to experience diplopia. The nurse immediately assesses the patient for A. an aura or focal seizure. B. nystagmus or confusion. C. abdominal pain or cramping. D. irregular pulse or palpitations.

B. nystagmus or confusion. Diplopia is a sign of phenytoin toxicity. The nurse should assess for other signs of toxicity, which include neurologic changes, such as nystagmus, ataxia, confusion, dizziness, or slurred speech. An aura, focal seizure, abdominal pain or cramping, irregular pulse, or palpitations are not associated with phenytoin toxicity.

A 68-year-old man with suspected bacterial meningitis has just had a lumbar puncture in which cerebrospinal fluid was obtained for culture. Which medication should the nurse administer first? A. Codeine B. Phenytoin (Dilantin) C. Ceftriaxone (Rocephin) D. Acetaminophen (Tylenol)

C Bacterial meningitis is a medical emergency. When meningitis is suspected, antibiotic therapy (e.g., ceftriaxone) is instituted immediately after the collection of specimens for cultures, and even before the diagnosis is confirmed. Dexamethasone may also be prescribed before or with the first dose of antibiotics. The nurse should collaborate with the health care provider to manage the headache (with codeine), fever (with acetaminophen), and seizures (with phenytoin).

The nurse performs a neurological assessment of the client. The client has a Glasgow coma score of three. Which nursing diagnosis indicates the nurses correctly analyzes the neurological assessment findings? A) risk for infection B) risk for injury C) self-care deficit D) disturbed thought processes

C) self-care deficit

The nurse sees a client walking in the hallway who begins to have a seizure. What should the nurse do in order of priority from first to last? All options must be used. A. Maintain a patent airway B. Record the seizure activity observed C. Ease the client to the floor D. Obtain vital signs

C, A, D, B Rationale: To protect the client from falling, the nurse first should ease the client to the floor. It is important to protect the head and maintain a patent airway since altered breathing and excessive salivation can occur. The assessment of the postictal period should include level of consciousness and vital signs. The nurse should record details of the seizure once the client is stable. The events preceding the seizure, timing with descriptions of each phrase, body parts affected and sequence of involvement, and autonomic signs should be recorded.

A nurse instructs a client who has MG about home care and the risk factors that can exacerbate the disease. Which of the following client statement indicates a need for further teaching. A. I should take my medication 45 min before meals. B. I have suction equipment at home in case i start to choke. C. I will soak in a warm bath every day D. I ordered a medical identification bracelet

C. A) The patient who has MG is instructed to take cholinesterase inhibitors 45 min before mealsB) Dysphagia occurs in patients who have MG, suction equipment should be available in case of chokingC) Hot temps can cause patients who have MG to have exacerbationsD) Medical alert bracelets identify patients who have MG and should be worn

The nurse is caring for a group of patients on a medical unit. After receiving report, which patient should the nurse see first? A. A 42-year-old patient with multiple sclerosis who was admitted with sepsis B. A 72-year-old patient with Parkinson's disease who has aspiration pneumonia C. A 38-year-old patient with myasthenia gravis who declined prescribed medications D. A 45-year-old patient with amyotrophic lateral sclerosis who refuses enteral feedings

C. A 38-year-old patient with myasthenia gravis who declined prescribed medications Patients with myasthenia gravis who discontinue pyridostigmine (Mestinon) will develop a myasthenic crisis. Myasthenia crisis results in severe muscle weakness and can lead to a respiratory arrest.

Which nursing diagnosis is likely to be a priority in the care of a patient with myasthenia gravis (MG)? A. Acute confusion B. Bowel incontinence C. Activity intolerance D. Disturbed sleep pattern

C. Activity intolerance The primary feature of MG is fluctuating weakness of skeletal muscle. Bowel incontinence and confusion are unlikely signs of MG, and although sleep disturbance is likely, activity intolerance is usually of primary concern.

What is a priority nursing intervention in the postictal phase of a seizure? A. Reorient the client to time, person, and place B. Determine the client's level of sleepiness C. Assess the client's breathing pattern D. Position the client comfortably

C. Assess the client's breathing pattern Rationale: A priority for this client in the postictal phase (after a seizure) is to assess the client's breathing pattern for effective rate, rhythm, and depth. The nurse should apply oxygen and ventilation to the client as appropriate. Other interventions, to be completed after the airway has been established, include reorientation of the client to time, person, and place. Determining the client's level of sleepiness is useful, but it is not a priority. Positioning the client comfortably promotes reset but is of less importance than ascertaining the that the airway is patent.

The nurse is assessing the level of consciousness in a client with a head injury who has been unresponsive for the last 8 hours. Using the Glasgow Coma Scale, the nurse notes that the client opens the eyes only as a response to pain, responds with sounds that are not understandable, and has abnormal extension of the extremities. What should the nurse do? A. Attempt to arouse the client B. Reposition the client with the extremities in normal alignment C. Chart the client's level of consciousness as coma. D. Notify the healthcare provider

C. Chart the client's level of consciousness as coma. Rationale: The client has a score of 6 (eye opening to pain=2; verbal response, incomprehensible sounds=2, best motor response, abnormal extension=2); a score >7 is indicative of coma. While the nurse should continue to speak to the client, at this time the client will not be able to be aroused. The nurse should continue to provide skin care and appropriate alignment, but the client will continue to have a motor response of limb extension. It is not necessary to notify the HCP as this assessment does not represent a significant change in neurological status.

A client arrives in the emergency department with an ischemic stroke. Because the healthcare team is considering administering tissue plasminogen activator (t-PA) administration, the nurse should first: A. Ask what medications the client is taking B. Compete a history and health assessment C. Identify the time of onset of the stroke D. Determine if the client is scheduled for any surgical procedures

C. Identify the time of onset of the stroke Rationale: Studies show that clients who receive recombinant t-PA treatment within 3 hours after the onset of a stroke have better outcomes. The time from the onset of a stroke to t-PA treatment is critical. A complete health assessment and history is not possible when the client is receiving emergency care. Upcoming surgical procedures may need to be delayed because of the administration of t-PA, which is a priority in the immediate treatment of the current stroke. While the nurse should identify which medications the client is taking, it is more important to know the time of the onset of the stroke to determine the course of action for administering t-PA.

When the nurse applies a painful stimulus to the nailbeds of an unconscious patient, the patient responds with internal rotation, adduction, and flexion of the arms. The nurse documents this as a. decorticate posturing. b. decerebrate posturing. c. localization of pain. d. flexion withdrawal.

Correct Answer: A Rationale: Internal rotation, adduction, and flexion of the arms in an unconscious patient is documented as decorticate posturing. Extension of the arms and legs is decerebrate posturing. Because the flexion is general, it does not indicate localization of pain or flexion withdrawal.

When caring for a patient who has Guillain-Barré syndrome, which assessment data obtained by the nurse will require the most immediate action? a. The patient complains of severe tingling pain in the feet. b. The patient has continuous drooling of saliva. c. The patient's blood pressure (BP) is 106/50 mm Hg. d. The patient's quadriceps and triceps reflexes are absent.

Correct Answer: B Rationale: Drooling indicates decreased ability to swallow, which places the patient at risk for aspiration and requires rapid nursing and collaborative actions such as suctioning and possible endotracheal intubation. The foot pain should be treated with appropriate analgesics, and the BP requires ongoing monitoring, but these actions are not as urgently needed as maintenance of respiratory function. Absence of the reflexes should be documented, but this is a common finding in Guillain-Barré syndrome.

The nurse notes that a patient with a head injury has a clear nasal drainage. The most appropriate nursing action for this finding is to a. obtain a specimen of the fluid and send for culture and sensitivity. b. take the patient's temperature to determine whether a fever is present. c. check the nasal drainage for glucose with a Dextrostik or Testape. d. have the patient to blow the nose and then check the nares for redness.

Correct Answer: C Rationale: If the drainage is cerebrospinal fluid (CSF) leakage from a dural tear, glucose will be present. Fluid leaking from the nose will have normal nasal flora, so culture and sensitivity will not be useful. A dural tear does increase the risk for infections such as meningitis, but the nurse should first determine whether the clear drainage is CSF. Blowing the nose is avoided to prevent CSF leakage.

A 24-year-old patient is hospitalized with the onset of Guillain-Barré syndrome. During this phase of the patient's illness, the most essential assessment for the nurse to carry out is a. monitoring the cardiac rhythm continuously. b. determining the level of consciousness q2hr. c. evaluating sensation and strength of the extremities. d. performing constant evaluation of respiratory function.

Correct Answer: D Rationale: The most serious complication of Guillain-Barré syndrome is respiratory failure, and the nurse should monitor respiratory function continuously. The other assessments will also be included in nursing care, but they are not as important as respiratory assessment.

The male client with MG is undergoing plasmapheresis at the bedside. Which assessment data would warrant immediate intervention by the nurse? 1. The client complains of being lightheaded and dizzy. 2. The client can smile and clamp his teeth together. 3. The client states that his leg cramps have gone away. 4. The client has a small hematoma at the vascular access site.

Correct answer 1: Hypovolemia is a complication of plasmapheresis, especially during the procedure when up to 15% of the blood volume is in the cell separator. The nurse should immediately assess for shock. All other options are expected.

The client diagnosed with MG is admitted to theemergency department with a sudden exacerbation of motor weakness. Which assessment data indicate the client is experiencing a myasthenic crisis? 1. The serum assay of circulating acetylcholine receptor antibodies is increased. 2. The client's symptoms improve when administering on a cholinesterase inhibitor. 3. The client's blood pressure, pulse, and respirations improve after intravenous (IV) fluid. 4. The Tensilon test does not show improvement in the client's muscle strength

Correct answer 2: This assessment datum indicates a myasthenic crisis that is due to undermedication, missed doses of medication, or developing an infection. Serum assays are useful in diagnosing the disease, not in identifying a crisis. Vital signs do not differentiate the type of crisis. No improvement after Tensilon indicates a cholinergic crisis, not amyasthenic crisis.

The nurse assesses a patient for signs of meningeal irritation and observes for nuchal rigidity. What indicates the presence of this sign of meningeal irritation? A. Tonic spasms of the legs B. Curling in a fetal position C. Arching of the neck and back D. Resistance to flexion of the neck

D Nuchal rigidity is a clinical manifestation of meningitis. During assessment, the patient will resist passive flexion of the neck by the health care provider. Tonic spasms of the legs, curling in a fetal position, and arching of the neck and back are not related to meningeal irritation.

Which patient below is MOST at risk for developing a cholinergic crisis? A. A patient with myasthenia gravis is who is not receiving sufficient amounts of their anti cholinesterase medication B. A patient with myasthenia gravis who reports not taking the medication Pyridostigmine for 2 weeks. C. A patient with myasthenia gravis who is experiencing a respiratory infection and recently had left hip surgery. D. A patient with myasthenia gravis who reports taking too much of their anticholinesterase medication.

D. A patient with myasthenia gravis who reports taking too much of their anticholinesterase medication.

The nurse is assessing a client for decerebrate posturing. The nurse should assess the client for: A. Internal rotation and adduction of the arms with flexion of the elbows, wrists, and fingers B. Back hunched over and rigid flexion of all four extremities with supination of the arms and plantar flexion of the feet C. Supination of the arms and dorsiflexion of the feet D. Back arched and rigid extension of all four extremities

D. Back arched and rigid extension of all four extremities Rationale: Decerebrate posturing occurs in clients with damage to the upper brain stem, midbrain, or pons and is demonstrated clinically by arching of the back, rigid extension of the extremities, pronation of the arms, and plantar flexion of the feet. Internal rotation and adduction of arms with flexion of elbows, wrists, and fingers describes decorticate posturing, which indicates damage to corticospinal tracts and cerebral hemispheres.

Ben is diagnosed with a retinal detachment at the inner aspect of the right eye. Into which position would the nurse place the client? A Fowler's position B Supine with a small pillow C Right-side lying D Left-side lying

D. When retinal detachment occurs, the client is positioned so that the area of detachment is dependent. For this client, the left-side lying position is used. Positioning the client in the Fowler, supine, or right-side lying position would not place the detached area in a dependent position.

A physician diagnoses a client with myasthenia gravis, prescribing pyridostigmine (Mestinon), 60 mg P.O. every 3 hours. Before administering this anticholinesterase agent, the nurse reviews the client's history. Which preexisting condition would contraindicate the use of pyridostigmine? A. Ulcerative colitis B. Blood dyscrasia C. Intestinal obstruction D. Spinal cord injury

Intestinal obstruction Anticholinesterase agents such as pyridostigmine are contraindicated in a client with a mechanical obstruction of the intestines or urinary tract, peritonitis, or hypersensitivity to anticholinesterase agents. Ulcerative colitis, blood dyscrasia, and spinal cord injury dont contraindicate use of the drug.

The nurse is administer eyedrops to the client. Which guidelines should the nurse adhere to when instilling the drops into the eye? SATA a. Do not touch the tip of the medication container to the eye. b. Apply gently pressure on the outer cants of the eye. c. Apply sterile gloves prior to instilling eyedrops d. Hold the lower lid down and instill drops into the conjunctiva e. Gently pat the skin to absorb excess eyedrops on the cheek

a. Do not touch the tip of the medication container to the eye. Rationale: Touching the tip of the container to the eye may cause eye injury or an eye infection d. Hold the lower lid down and instill drops into the conjunctivaRationale: Medication should not be placed directly on the eye but in the lower part of the eyelid e. Gently pat the skin to absorb excess eyedrops on the cheekRationale: Eyedrops are meant to go in the eye, not on the skin, so the nurse should use a clean tissue to remove excess medication

The nurse is caring for a client diagnosed with acute otitis media. Which s/s support this medical diagnosis? a. Unilateral pain in the ear b. Green, foul-smelling drainage c. Sensation of congestion in the ear d. Reports of hearing loss

a. Unilateral pain in the earRationale: Otalgia (ear pain) is experienced by clients with otitis media

The client diagnosed with glaucoma is prescribed a biotic cholinergic medication. Which data indicate the medication has been effective? a. No redness or irritation of the eyes b. A decrease in intraocular pressure c. The pupil reacts briskly to light d. The client denies any type of floaters

b. A decrease in intraocular pressure Rationale: Both systemic and topical medications are used to decrease the intraocular pressure in the eye, which causes glaucoma

Which ototoxic medication should the nurse administer cautiously? a. An oral calcium channel blocker b. An intravenous amino glycoside antibiotic c. An intravenous glucocorticoid d. An oral lood diuretic

b. An intravenous amino glycoside antibiotic Rationale: Aminoglycoside antibiotics are ototoxic. Overdosage of these medications can cause the client to go deaf, which is why peak and trough serum levels are drawn while the client is taking a medication of this type. These antibiotics are also very nephrotoxic

When developing a plan of care for a hospitalized patient with moderate dementia, which intervention will the nurse include? a. Provide complete personal hygiene care for the patient. b. Remind the patient frequently about being in the hospital. c. Reposition the patient frequently to avoid skin breakdown. d. Place suction at the bedside to decrease the risk for aspiration.

b. Remind the patient frequently about being in the hospital. The patient with moderate dementia will have problems with short- and long-term memory and will need reminding about the hospitalization. The other interventions would be used for a patient with severe dementia, who would have difficulty with swallowing, self-care, and immobility.

A nurse is discussing with an older female patient the factors that affect sleep. What fact does the nurse teach her? a. Drinking a cup of regular tea at night induces sleep. b. Using alcohol moderately promotes a deep sleep. c. Aging decreases the amount of REM sleep a person experiences. d. Exercising decreases REM and NREM sleep

c. The nurse would teach the patient that the amount of REM sleep decreases with age. Regular tea contains caffeine and increases alertness. Large quantities of alcohol limit REM and delta sleep. Physical activity increases both REM and NREM sleep.

The client is scheduled for right-eye cataract removal surgery in 5 days. Which prep instruction should be discussed with the client? a. Administer dilating drops to both eyes for 72 hours prior to surgery. b. Prior to surgery do not lift or push any objects heavier than 15 pounds. c. Make arrangements for being in the hospital for at least 3 days. d. Avoid taking any type of medication which may cause bleeding, such as aspirin.

d. Avoid taking any type of medication which may cause bleeding, such as aspirin.Rationale: To reduce retrobulbar hemorrhage, any anticoagulant therapy is withheld, including aspirin, NSAIDs, and warfarin (Coumadin).

A 72-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. difficulty eating and swallowing. c. variable ability to perform simple tasks. d. loss of both recent and long-term memory.

d. loss of both recent and long-term memory. Loss of both recent and long-term memory is characteristic of moderate dementia. Patients with dementia have frequent nighttime awakening. Dementia is progressive, and the patient's ability to perform tasks would not have periods of improvement. Difficulty eating and swallowing is characteristic of severe dementia.