Cognitive - NCLEX

The family of a client with increasing dementia asks the nurse how to convince one sibling who refuses to acknowledge their elderly mother's personality change. Which information would the nurse address in teaching the family about personality change in dementia?Select all that apply. A. Loss of interest in surroundings B. Lack of consideration for others C. Difficulty learning new things D. Disregard for the concept of time E. Inability to do things in sequence F. Decreased performance of daily activities

A,B

A 90-year-old patient is admitted to the hospital. Shortly after admission, the family notices that the patient is exhibiting disorientation and agitation. When questioned about the behavior by the family, the nurse states that the patient is at risk for developing which common complication of hospitalization in older adults? A. Delirium. B. Dementia. C. Alzheimer's disease. D. Sundowner syndrome.

A. Delirium.

A successful business executive continually thinks that job accomplishments are not adequate. A nurse recognizes that the client's thinking is reflective of which cognitive error? A. Minimization B. Dichotomous thinking C. Arbitrary inference D. Personalization

A. Minimization

A nurse is caring for a client with delirium. Which nursing intervention has the highest priority? A. Providing a safe environment B. Offering recreational activities C. Providing a structured environment D. Instituting measures to promote sleep

A. Providing a safe environment

The nurse is asking a client in the psychiatric crisis unit specific questions about recent substance use. Which assessment finding could indicate to the nurse that the client is experiencing mild to moderate delirium? A. Time and place disorientation B. Impaired abstract thinking C. Persistent memory disturbance D. Changes in personality

A. Time and place disorientation

The nurse is explaining the symptoms of dementia to a military family member who has not seen his mother in 15 months. Which characteristics of dementia of the Alzheimer's type would the nurse address in her teaching session?Select all that apply. A. Experiences an impending sense of doom B. Forgets that food is cooking on the stove C. Becomes lost walking on her own street D. Unable to write and to sign her name E. Begins to fear using public transportation F. Unable to understand new information

B,C,D,F

During an interaction with the spouse of a client with Alzheimer's disease, the nurse is asked the following question: "What exactly is Alzheimer's disease?" Which is the correct explanation for the nurse to tell the spouse? A. " Often, Alzheimer's disease is a combination of several common autoimmune diseases that attack and shrink brain tissue." B. " It is a brain disease that results from the development of abnormal structures called neurofibrillary tangles found in the person's brain." C. " The disease is a genetic disease that changes a person's brain tissue, causing it to deteriorate due to an accumulation of excessive fluid." D. " A biological and psychosocial component of undiagnosed moderate depression is causing a steady decline in daily performance."

B. " It is a brain disease that results from the development of abnormal structures called neurofibrillary tangles found in the person's brain."

A nursing assistant has failed a prerequisite course toward admission to nursing school and states, "I will always be only a nursing assistant and never an RN." Her nursing advisor understands this is an example of which automatic thought? A. Arbitrary inference B. Overgeneralization C. Dichotomous thinking D. Personalization

B. Overgeneralization

The nurse has taught a family about the medication donepezil (Aricept). The nurse determines that teaching was successful when the family makes which statement? A. " We will need to figure out a schedule to get dad's weekly blood work done." B. " When dad's Alzheimer's disease worsens, he will need to stop taking this drug." C. " This drug may slow down dad's pulse, since he has preexisting heart disease." D. " Aricept acts like a diuretic medication, so dad should take it in the morning."

C. " This drug may slow down dad's pulse, since he has preexisting heart disease."

The nurse notices that a client with dementia about to eat his dinner picks up his spoon, looks at it, puts it down, and then picks up his fork, looks at it, and puts it back on the table. He sits staring at the utensils and his dinner. How does the nurse interpret this behavior? A. A risk for altered nutrition B. A disruption in metabolic functioning C. A disturbance in executive functioning D. A potential sensory-motor deficit

C. A disturbance in executive functioning

A nursing student states, "The instructor gave me a failing grade on my research paper. I know it's because the instructor doesn't like me." Which cognitive error does a nurse recognize in this student's statement? A. Dichotomous thinking B. Catastrophic thinking C. Magnification D. Overgeneralization

C. Magnification

he home health nurse notices that the elderly, diabetic client she sees every week is starting to demonstrate some difficulty answering questions about her chronic disease strategies and self-management activities. Which action would the nurse take to validate her suspicion of the client having cognitive changes and possibly the beginning stages of dementia? A. Speak to the doctor about ordering cardiac diagnostic studies. B. Petition the insurance company for a weekly home health aide. C. Request that another nurse visit and perform a mental status exam. D. Arrange to speak to a family caregiver as soon as possible.

D. Arrange to speak to a family caregiver as soon as possible.

Which intervention should help a client diagnosed with Alzheimer's disease perform activities of daily living? A. Have the client perform all basic care without help. B. Tell the client morning care must be done by 9 a.m. C. Give the client a written list of activities he's expected to do. D. Encourage the client and give ample time to complete basic tasks.

D. Encourage the client and give ample time to complete basic tasks.

The nurse is establishing a therapeutic environment for a patient admitted with dementia and influenza. Which intervention would be important for the nurse to implement? A. Keep a radio on all the time to provide sound for the patient. B. Decrease patient confusion by limiting verbal interactions. C. Limit family visits to one person for 30 minutes per day. D. Provide a quiet environment in a private room.

D. Provide a quiet environment in a private room.