cognition
c
A nurse educator is preparing a presentation for a group of students regarding Alzheimer disease (AD). Which statement regarding the early pathophysiological changes that occur with this disease process indicates appropriate understanding by the students who attended the presentation? a There are deposits of a fat-soluble material in the speech areas of the brain, caused by poor circulation, early in the disease. b Deposits of insoluble material accelerate neuron impulses early in the disease. c There are deposits of insoluble material in the memory and cognition areas of the brain early in the disease. d The neurons secrete a substance that causes the growth of abnormal neurons.
c
A nurse in a long-term care facility is providing care for a client who is receiving memantine for Alzheimer disease (AD). Which adverse reaction to the medication would the nurse report to the healthcare provider? a Hypotension b Weight gain c Guaiac positive stool d Tachycardia
c
A nurse is assessing Andrew Parson, a 37-year-old client with cerebral palsy, admitted to the hospital with a broken tibia after being hit by a car as he crossed the street. Mr. Parson has significant communication difficulties and his speech is very difficult to understand. How can the nurse evaluate Mr. Parson's cognitive functioning? a Assume that Mr. Parson's severe speech problems indicate cognitive impairment. b Request a psychiatric consultation, because a mental status exam requires psychiatric skills. c Try to use such assistive devices as a communication board to help assess Mr. Parson's functioning. d Attempt to assess cognitive functioning in a client with severe communication limitations.
c
A nurse is providing care for a client who is suspected to have Alzheimer disease (AD). The client has numerous tests scheduled. The client asks the nurse why there are so many tests ordered. Which response by the nurse is the most appropriate? a "The tests are used to identify which gene is causing Alzheimer disease." b "There are a number of diagnostic tests that are needed to accurately diagnose Alzheimer disease." c "Alzheimer disease is diagnosed in part by ruling out other diseases that affect memory." d "The tests are necessary to determine what is causing Alzheimer disease."
a,b,d,e
A nurse is providing information about tacrine hydrochloride for the spouse of a client diagnosed with Alzheimer disease (AD). Which items will the nurse include in the teaching session? Select all that apply. a Notify the healthcare provider if manifestations worsen. b Observe the client for improvement in manifestations. c Tacrine hydrochloride will stop the progression of Alzheimer disease. d The medication must be administered 1 hour before meals. e Do not stop the medication without consulting the healthcare provider.
b
Mr. Casales, a 77-year-old man with a history of Alzheimer disease (AD), is brought to his healthcare provider by his daughter. She expresses concerns that her father's AD seems to be getting worse. Mr. Casales's medical record reflects that during his last healthcare visit, he was diagnosed as having stage 4 AD. For which changes would you assess Mr. Casales to help determine if his AD has progressed to the next stage? a Knowledge deficit of recent events b Confusion regarding place and time c Losing everyday objects such as keys and glasses d Inability to remember names when introduced to new people
c
Sally asks the nurse whether she should be concerned that her 68-year-old mother, who recently retired, is experiencing memory problems; seems unusually restless; and loses her temper frequently. Sally wants to know whether this change is a normal part of the aging process. What should the nurse tell Sally? a "Don't worry. Memory loss is a normal part of aging." b "Your mother will probably return to normal once she has had time to adjust to retirement." c "Your mother should be evaluated for possible cognitive changes." d "If your mother changes her eating patterns, these symptoms will probably end."
a,b,c,e
The nurse educator asks a group of students to name the stages of development identified by Piaget. Which responses indicate understanding of Piaget's theory? Select all that apply. a Preoperational b Formal operational c Sensorimotor d Postoperational e Concrete operational
a
The nurse educator is discussing intellectual disability with a group of students in the classroom environment. Which statement made by a student indicates correct understanding of the criterion of intellectual disability? a "Clients who score below 70dash-75 on an IQ test are considered intellectually disabled. " b "Clients who exhibit echolalia are intellectually disabled. " c "Clients with delirium that occurs after the age of 50 are intellectually disabled. " d "Clients with ataxia are intellectually disabled"
a
The nurse educator is teaching a group of students about the brain and asks the class to name the term for specialized cells in the brain. Which response indicates understanding by the class? a Neurons b Exocrine cells c Erythrocytes d Epithelial cells
b,d,e
The nurse is assessing a 74-year-old Japanese client who has been admitted with a diagnosis of dementia. Which actions indicate an understanding of culturally competent care? (Select all that apply.) a Asking her to name the first president of the United States b Asking her in what month and year was she born c Asking her to explain the meaning of the saying "A stitch in time saves nine." d Asking the family if she is proficient speaking English, or would prefer a translator e Asking her family if she uses assistive devices, such as hearing aids, before questioning
a,b,d,e
The nurse is caring for a client diagnosed with dementia. Which client behaviors support this diagnosis? Select all that apply. a Anomia b Akathisia c Anorexia d Dysphagia e Carphologia
d
The nurse is caring for a client in the ICU who tells the nurse that snakes are coming out of the electrical plugs in his room. He then becomes agitated.Which would the nurse expect to see on the client's medication record? a A scheduled dose of methylphenidate (Ritalin). b A scheduled dose of memantine (Namenda). c A prn dose of donepezil (Aricept). d A scheduled dose of risperidone (Risperdal).
a,b,e
The nurse is caring for a client with Alzheimer disease (AD). Which assessment findings does the nurse expect while caring for this client? Select all that apply. a Gradual behavior changes if the nurse was to care for this patient over a course of time. b Trouble finding the right name for an object c Hypotension d Tachycardia e Confusion that occurs over a matter of hours.
a,c,d,e
The nurse is caring for an older adult client who is being visited by her daughter who lives several hundred miles away. The daughter asks the nurse which cognitive alterations she should expect as her mother grows older. Which alterations will the nurse include in the response to the client's daughter? Select all that apply. a A decline in mental flexibility b Difficulty with receptive language c A decrease in information processing speed d A decrease in multitasking abilities e A decrease in long-term memory processing
b,c,d,e
The nurse is caring for a school-age client who is prescribed methyphenidate (Ritalin) for attention deficit hyperactivity disorder (ADHD). Which adverse effects will the nurse include in the medication teaching? Select all that apply. a Hypothyroidism b Insomnia c Increased heart rate d Hypertension e Decreased appetite
a,b,c,e
The nurse is conducting a mental status interview with a new client. Which questions are useful as part of the assessment process? Select all that apply. a "What day of the week is today? " b "Can you count by 5s from 0 to 100? " c "What is your name? " d "Do you enjoy exercising? " e "Where did you go to high school?
a
The nurse is conducting an admission assessment for a client who is diagnosed with delirium of unknown cause. Which item will the nurse include during the health history of this client to determine a cause for the diagnosis? a Asking about drug and alcohol use b Determining visual impairments c Conducting a mental status exam d Assessing orientation
d
The nurse is conducting an assessment for a client diagnosed with delirium. Which risk factor found in the client's health history may have caused the current diagnosis? a History of anorexia nervosa b Diet high in folic acid c History of hypertension d Recent heroin use
b,d
The nurse is conducting an in-service for peers regarding the physiology of the neurological system. Which of the following statements are true? (Select all that apply.) a The occipital lobe of the brain controls conscious awareness. b Abnormalities in neurotransmitter function are involved in many cognitive disorders. c Speech, learning, and intellect are controlled by the temporal lobe. d The hippocampus plays a role in memory formation. e Within the brain, most cognitive tasks occur in the cerebellum.
a,d,e
The nurse is orienting a novice nurse to the intensive care unit (ICU). When assessing clients, which items might contribute to the development of delirium? Select all that apply. a A client experiences unrelieved pain. b The client has a history of cerebral atherosclerosis. c A client's MRI shows atrophy of the hippocampus. d A client is awakened for frequent assessments and treatment. e A client is admitted after a motor vehicle crash with a blood alcohol level of 0.25%.
d
The nurse is planning care for a client who is diagnosed with delirium. Which cognitive intervention is appropriate for this client? a Administering oxygen b Monitoring intravenous fluids c Providing nutrition d Reorienting to time and place
a,b,c
The nurse is planning care for a client who is pregnant based on her knowledge of cognitive dysfunction. Which will the nurse incorporate into the care plan? (Select all that apply.) a Ask the client to describe her typical daily diet. b Assess the client's socioeconomic status and refer to the social worker if needed. c Educate the client on the importance of avoiding alcohol and smoking during pregnancy. d Place the client on bedrest since she has difficulty ambulating due to her size. e Tell the client that her newborn will not be tested for PKU unless ordered by her obstetrician.
c
The nurse is preparing a care plan for a 9-year-old client. Which statements are true regarding theories of cognitive development in the pediatric population? a According to Piaget, the client is in the preoperational stage of cognitive development. b Information-processing theory views physical changes associated with brain maturation as the least important determinant of cognitive ability. c Vygotsky's theory emphasizes the importance of culture and social interactions on cognitive development in children. d Piaget's theory emphasizes that the normal range of cognitive development is broad and variable.
c
The nurse is preparing to assess a client for cognitive impairments. Which tool does the nurse plan to use during the nursing assessment of this client? a Wechsler Adult Intelligence Scale (WAIS) b Minnesota Multiphasic Personality Inventory (MMPI) c Mini-Mental State Examination (MMSE) d Rorschach
c,e
The nurse is promoting a therapeutic environment for a confused client. The family expresses concern about caring for him after discharge. Which would the nurse expect to be ordered for the client? (Select all that apply.) a Encourage the client to complete tasks quickly in order to promote increased self-esteem. b Keep the television on for noise to keep the client company. c Review the client's medications and their purpose with family members. d Discourage family visitation to keep the client quiet and promote sleep. e Teach the family about methods to keep the client safe at home, such as removing throw rugs.
a
The nurse is providing care for a pregnant woman and her husband who just learned that their baby may have Down syndrome. The couple asks the nurse what this condition means. Which response by the nurse is the most appropriate? a "This condition occurs because of extra genetic material in chromosome 21. " b "This condition occurs as a result of maternal substance abuse " c "This condition occurs as the result of a traumatic head injury " d "This condition occurs due to alcohol consumption prior to pregnancy.
d
The nurse is providing care to a client recently diagnosed with Alzheimer disease. Which medication does the nurse anticipate will be prescribed for this client to decrease the rate of cognitive decline? a Zoloft b Haldol c Buspar d Aricept
a,c,d
The nurse is providing care to a client who is diagnosed with delirium. The client's family asks what they can expect. Which symptoms of delirium will the nurse include in the response to the family? Select all that apply. a Fluctuations in the intensity and level of consciousness, from drowsy to near unconsciousness b Manic behavior and flight ideas c Sudden loss of both long-term and short-term memory d Might look physically unwell; acute onset of irrational and repetitive behaviors e Chest pain that radiates to the left arm
a
The nurse is providing care to a client who is diagnosed with delirium. Which assessment finding supports the client's diagnosis? a Lack of ability to remember childhood anecdotes b Obsessive correctness and efficiency with tasks c Desire to discuss his/her opinion on why delirium started d Sleeping heavily night and day
a
The nurse is providing education to a client and family regarding complementary therapies that may be useful in the treatment for Alzheimer disease (AD). Which response by the family indicates the need for further education? a "Huperzine A is an antioxidant that supports brain function. " b "Selenium is a supplement that is known to support brain function. " c "Zinc is a supplement known to support brain function. " d "Coenzyme Q10 naturally occurs in the body and I can take a supplement to support brain function.
a,c,d,e
The nurse is providing education to a client recently diagnosed with Alzheimer disease. The client's daughter wants to know which services are offered by the Alzheimers Association. Which services will the nurse include in the response? Select all that apply. a Legal referrals b Treatment c Caregiver respite guidance d Support e Education
c
The nurse is reviewing the medical records of several clients. Which condition may have been revealed by genetic testing prior to conception? a Learning disability b Schizophrenia c Fragile X syndrome d Fetal alcohol syndrome
b,d,e
The nurse wants to provide culturally sensitive care to the clients who are seen in the clinic for the treatment of mental disabilities. What cultural factors should a nurse consider when completing a cognitive assessment of these clients? Select all that apply. a Traditional dress b Culturally specific information c Number of children d Educational level e Language proficiency
a,b,d,e
The spouse of a client who is experiencing confusionasks the nurse what tests will be done to determine the cause. The nurse would expect to see which tests ordered for the client? (Select all that apply.) a An MRI or CT to rule out a tumor or fluid buildup as the cause of the client's confusion b A chest x-ray to evaluate the client's respiratory status c Genetic testing to see if the client has a genetic cause for confusion d Blood work to determine the liver and kidney function e Strict I's and O's, daily weights, and serum electrolytes
a,c,e
To what does the term "adaptive behavior" refer? Select all that apply. a Practical skills b Computer skills c Social skills d Mechanical skills e Conceptual skills
a,b,d,e
What is assessed during a mini-mental state examination? Select all that apply. a Mood b Orientation c Vocabulary d Judgment e Memory
a
When providing care to clients with alterations in cognition, the nurse understands that whichis true regarding assessment procedures? a Before asking questions involving abstract thought or judgment in the pediatric client, the level of cognitive development must be known. b If the client has difficulty answering questions or answers inappropriately, this is an indication of altered cognition. c The nurse does not need to screen older clients for depression using the Geriatric Depression Scale. d Direct questioning is an effective method in the client experiencing delusions.
a,b,c,e
nurse on the medical-surgical unit has identified safety as a priority problem for a client who is in the late stages of Alzheimer disease (AD). The client is awake at night and tends to wander. Which priority interventions would the nurse use in the care of this client? Select all that apply. a Place nonskid slippers on the client. b Take the client to the bathroom every 2 hours. c Keep the client's room free of clutter. d Place a vest restraint on the client. e Keep a nightlight on in the room.
c
A student nurse is writing a research paper about Vygotsky's theory of cognitive development. Which core element of this theory will the student include in the paper? a The mind is always evolving. b There are structured developmental stages. c The influence of culture is central to human development. d The mind is a computational system.
d
A student nurse is writing a research paper on developmental disabilities for a psychology class. Which developmental disability will the student include that is the most prevalent? a Learning disability b Dementia c Psychosis d Intellectual disability
d
Amanda Hind, a 54-year-old woman with Down syndrome, and a resident of a group home, is diagnosed with metastatic pancreatic cancer. She tells the nurse that she doesn't want to end up in the hospital with all those machines attached. How should the nurse respond to Ms. Hind's statement? a Ask the supervisor of Ms. Hind's home to encourage her to accept aggressive treatment. b Change the subject so that Ms. Hind will be distracted and not think about her future. c Tell Ms. Hind not to worry, that everything will be all right. d Explain about advance directives and help Ms. Hind to formulate one that specifies her wishes.
Delirium
______________ is a reversible, acute condition characterized by symptoms of confusion, mental status changes, and personality changes can be caused by a physical or mental condition and is almost always treatable.
d
Family members are questioning a nurse about their mother's postoperative confusion. They ask, "Is our mother developing dementia from the anesthesia? She was thinking so clearly before the surgery." Which response by the nurse is the most appropriate to the family? a "Your mother might have been developing mild dementia prior to surgery, and the anesthesia accelerated the progression." b "Yes, your mother is experiencing postanesthesia dementia, which is completely reversible. She will recover in a few weeks." c "It is not uncommon for dementia to begin after anesthesia in an older adult." d "Your mother is experiencing postanesthesia delirium, which should clear as soon as she is completely recovered from the anesthesia."
a,b,d
Which are expected outcomes for clients with delirium? Select all that apply. a Maintain adequate nutrition. b Remain free of injury. c Prepare advanced future planning for progressive disease stages. d Return to an optimal level of functioning, if possible. e Verbalize feelings of being able to cope with the disease.
a,c,d
Which are important elements of client and family education that the nurse should provide for individuals with cognitive disabilities? Select all that apply. a Important elements of client care b Referral for residential care c Explanation of the diagnosis d Expected course of the condition e Stories about neighbors with the same condition
a,b,e
Which are potential precipitating factors associated with delirium? Select all that apply. a History of falls b Fracture or trauma c Moderate alcohol use d Excessive sleep e Infection
c,d
Which data are used to diagnose Alzheimer disease (AD)? Select all that apply. a Borg scale b SF-36 health survey c Mental status examination d Presence of dementia e Braden scale
d
Which disorder is not diagnosed using brain imaging? a Brain tumor b Stroke c Fluid buildup d Schizophrenia
b,c,d,e
Which elements constitute a safe environment for a client with cognitive impairments? Select all that apply. a Limiting phone access b Prevention of wandering c Providing such environmental clues as calendars d Restricting access to medications e Minimization of fire and fall hazards
b
Which expected outcome is NOT appropriate for a client diagnosed with Alzheimer disease (AD)? a Maintain adequate nutrition. b Restores previous level of functioning. c Maintain an adequate fluid and electrolyte balance. d Maintain an adequate balance of activity and rest.
a
Which is the best description of Alzheimer disease? a A progressive deterioration of brain function b An exaggerated feeling of physical and mental well-being c A temporary state of mental confusion and fluctuating consciousness d Dyskinetic movements caused by disordered tonicity of muscle
b
Which medication is used to treat clients with dementia? a Beta-blockers b Acetylcholine precursors c Antiemetics d Proton pump inhibitors
a,d,e
Which pieces of legislation provide protection for individuals with cognitive impairments? Select all that apply. A. Education for Handicapped Children Act of 1975 B. Title VII of the Civil Rights Act of 1964 C. Title IX of the Education Amendments of 1972 D. Americans with Disabilities Act of 1990 E. Developmental Disabilities Act and Bill of Right of 2000
a,b,d
Which traits are associated with Down syndrome? Select all that apply. a Congenital heart defects b Eventual dementia c Crossed eyes d Physical disabilities e Large ears
a
You are caring for Mr. Mitchell, a 74-year-old client who is diagnosed with delirium after having an emergency appendectomy 2 days ago. Mrs. Mitchell, the client's wife, asks the nurse how this could have happened. Based on the assessment data collected, which response is most appropriate? a "This can happen with opioids that have been administered to control your husband's pain." b "This is a normal part of aging. Your husband is just unlucky." c "Your husband's history of heavy smoking is the most likely cause." d "Your husband's uncontrolled blood pressure is causing the delirium."
