ch 24 cognitive disorders

A client diagnosed with Alzheimer's disease says, "I'm so afraid. Where am I? Where is my family?" How should the nurse respond? A. "The name of the hospital is on the sign over the door. Let's go read it again." B. "You are in the hospital and you're safe here. Your family will return at 10 o'clock, which is 1 hour from now." C. "You know where you are. You were admitted here 2 weeks ago. Don't worry; your family will be back soon." D. "I just told you that you're in the hospital and your family will be here soon."

B

A client with delirium is attempting to remove the IV tubing from his arm, saying to the nurse, "Get off me! Go away!" What is the client experiencing? a.Delusions b.Hallucinations c.Illusions d.Disorientation

B

A client in the client's 50s has contacted the care provider because of concerns for the client's spouse, who has suddenly begun behaving uncharacteristically in recent days. Most recently, the spouse became lost while driving to the spouse's home of 30 years and temporarily forgot the name of the spouse's child. Diagnostic testing has ruled out delirium and the spouse had been previously healthy. What is the most likely cause of the spouse's cognitive changes? A. Vascular dementia B. Wernicke's encephalopathy C. Dementia of Alzheimer's type (DAT) D. Dementia with Lewy bodies (DLB)

A

A client with late moderate-stage dementia has been admitted to a long-term care facility. Which nursing intervention will help the client maintain optimal cognitive function? a.Discuss pictures of children and grandchildren with the client. b.Do word games or crossword puzzles with the client. c.Provide the client with a written list of daily activities. d.Watch and discuss the evening news with the client.

A

A nurse is caring for a client with delirium. The client sees a thermometer on the nurse's table and shouts, "Don't stab me!" and cowers. Which feature of delirium is this client exhibiting? A. Illusion B. Hallucination C. Euphoria D. Misinterpretation

A

An older client comes to the clinic for a yearly physical exam. During the assessment, the client tells the nurse that the client sometimes has begun feeling anxious about the client's forgetfulness. The nurse notes the client may have mild dementia. Which finding would lead the nurse to conclude this? A. The client has difficulty finding words B. The client reports having delusions C. The client exhibits confusion D. The client reports an inability to perform complex tasks

A

What is the greatest benefit support groups provide to the caregivers of clients diagnosed with dementia? A. provides interaction with those with similar concerns B. provides time away from the client C. provides resources for needed services D. provides a social outlet

A

Which of the following interventions is most appropriate in helping a client with early-stage dementia complete ADLs? a.Allow enough time for the client to complete ADLs as independently as possible. b.Provide the client with a written list of all the steps needed to complete ADLs. c.Plan to provide step-by-step prompting to complete the ADLs. d.Tell the client to finish ADLs before breakfast or the nursing assistant will do them.

A

Which term is used to describe the inability to execute motor functioning, despite intact motor abilities? A. Apraxia B. Executive functioning C. Aphasia D. Agnosia

A

Which would not be considered a primary goal of nursing care for a client with delirium? A. Achievement of self-esteem needs B. Protection from injury C. Meeting physiological and psychological needs D. Management of confusion

A

The nurse is caring for a client with delirium. Which interventions may help manage this client? Select all that apply. A. Allow adequate time for the client to comprehend and respond. B. Speak in simple sentences. C. Encourage the client to follow a regular routine. D. Use matter-of-fact approach when assuming tasks the client can no longer perform. E. Provide orienting verbal cues when talking with the client.

A, B, E

Interventions for clients with dementia that follow the psychosocial model of care include a.asking the clients about the places where they were born. b.correcting the any misperceptions or delusion. c.finding activities that engage the clients' attention. d.introducing new topics of discussion at dinner. e.processing behavioral problems to improve coping skills. f.providing unrelated distractions when clients are agitated.

A, C, F

A nurse is giving instructions to a client diagnosed with delirium. Why might the nurse repeat the instructions frequently? Select all that apply. A. The client may have impaired recent and immediate memory. B. The client may not understand what the nurse is saying. C. The client may have abnormal thought processing. D. The client may have impaired attention. E. The client may have poor judgment.

A, D

The nurse is talking with a woman who is worried that her mother has Alzheimer disease. The nurse knows that the first sign of dementia is a.disorientation to person, place, or time. b.memory loss that is more than ordinary forgetfulness. c.inability to perform self-care tasks without assistance. d.variable with different people.

B

When teaching a client about memantine (Namenda), the nurse will include which information? a.Lab tests to monitor the client's liver function are needed. b.Namenda can cause elevated blood pressure. c.Taking Namenda will improve the client's cognitive functioning. d.The most common side effect of Namenda is gastrointestinal bleeding.

B

Which client behavior should the nurse attempt to change when managing a client's tendency to wander and pace at night? A. watch television after dinner B. take a nap mid afternoon and before dinner C. insist on having the curtains left open at night D. request a bedtime snack of milk and cookies

B

Which type of hallucination is most commonly seen in clients diagnosed with delirium? A. Autonomic B. Visual C. Auditory D. Gustatory

B

When assessing a client with delirium, the nurse will expect to see a.aphasia. b.confusion. c.impaired level of consciousness. d.long-term memory impairment. e.mood fluctuations. f.rapid onset of symptoms.

B, C, F

A client with Alzheimer's disease has a nursing diagnosis of risk for injury related to memory loss, wandering, and disorientation. Which nursing intervention should appear in this client's care plan to prevent injury? A. Keep the client sedated whenever possible. B. Provide the client with detailed instructions. C. Remove hazards from the environment. D. Use restraints at all times.

C

The nurse understands that numerous comorbidities can contribute to the development of dementia. Which client may be at risk for dementia? A. A 30-year-old client with schizophrenia who has been admitted to the hospital because of psychogenic polydipsia B. An 87-year-old resident of a long-term care facility who has developed a urinary tract infection (UTI) C. A 49-year-old client whose human immunodeficiency virus (HIV) has progressed to acquired immunodeficiency syndrome (AIDS) D. A 69-year-old client whose lung cancer has metastasized to the bones and liver

C

The spouse caregiver of a client with dementia tells the nurse that the client has been agitated lately. The spouse states, "I don't know how to handle this. The client was always such a gentle person!" Which interventions should the nurse suggest? A. Leave the client in a safe place in the house and go to another area until the client calms down. B. Give the client a sedative when the client begins to get agitated. C. Distract the client with family photos and discuss the events pictured. D. Distract the client by turning on the television or watching a video.

C

What is the primary sign of delirium? A. Disturbed sleep-wake cycles B. Inability to fulfill roles C. An altered level of consciousness D. Impaired socialization

C

Which is the hallmark of beginning mild dementia? A. Anxiety B. Restlessness C. Forgetfulness D. Depression

C

Which medication is not known to cause delirium? A. Narcotics B. Antidepressants C. Loop diuretics D. Steroids

C

Which medication used to treat dementia requires a liver function test every 1 to 2 weeks? A. Donepezil B. Galantamine C. Tacrine D. Rivastigmine

C

Which statement by the caregiver of a client newly diagnosed with dementia requires further intervention by the nurse? a."I will remind Mother of things she has forgotten." b."I will keep Mother busy with favorite activities as long as she can participate." c."I will try to find new and different things to do every day." d."I will encourage Mother to talk about her friends and family."

C

Which statement indicates the caregiver's accurate knowledge about the needs of a parent at the onset of the moderate stage of dementia? a."I need to give my parent a bath at the same time every day." b."I need to postpone any vacations for 5 years." c."I need to spend time with my parent doing things we both enjoy." d."I need to stay with my parent 24 hours a day for supervision."

C

While reviewing the medical record of a client with moderate dementia of the Alzheimer type, a nurse notes that the client has been receiving memantine. The nurse identifies this drug as which type? A. Atypical antipsychotic B. Benzodiazepine C. N-methyl-D-aspartate (NMDA) receptor antagonist D. Cholinesterase inhibitor

C

The nurse has been teaching a caregiver about donepezil (Aricept). The nurse knows that teaching has been effective when the caregiver makes which statement? a."Let's hope this medication will stop the Alzheimer disease from progressing any further." b."It is important to take this medication on an empty stomach." c."I'll be eager to see if this medication makes any improvement in concentration." d."This medication will slow the progress of Alzheimer disease temporarily."

D

The nurse should consider the intervention referred to as "going along with" when managing the care of which client? A. the middle-aged adult who is convinced that the electrical cords are really snakes B. the adolescent who is hitting and biting because he or she was given time out for disobeying unit rules C. the young adult who is expressing concern about the "police being aliens" D. the older widower who is worried about his wife not being able to visit because of the snow

D

What is the initial intervention the nurse should implement when helping a client diagnosed with dementia deal with paranoid delusions? A. keep the client occupied when he or she first begins to express the delusion B. explain to the client that his or her fears are unfounded C. ask that the client be prescribed medication to help manage the paranoia D. observe the client in order to identify the triggers for the delusions

D

When giving tacrine to an elderly client, the nurse must be aware of what information? A. Tacrine works only in clients with late-stage dementia. B. The most common side effects are headache and dizziness, so the client must be monitored for falls. C. The client will experience dry mouth and difficulty urinating. D. Because the liver is most vulnerable to tacrine, liver function tests must be done periodically.

D

Which is an infection-related cause of delirium? A. Lithium toxicity B. Renal failure C. Sleep deprivation D. Pneumonia

D

Which is the primary treatment for delirium? A. Provide adequate nutritional food and fluid intake B. Maintain intravenous fluid administration C. Apply physical restraints D. Identify and treat any causal or contributing medical conditions

D

Which is the priority intervention for a client diagnosed with delirium? A. Promotion of sleep B. Proper nutrition C. Management of confusion D. Maintenance of safety

D

Which type of hallucination most commonly occurs in clients diagnosed with dementia? A. Olfactory B. Auditory C. Gustatory D. Visual

D