ADN 450 - Cognition Questions

A nurse is teaching an 18-year-old client about circumcision care for her second baby. Which statement made by the nurse would be most appropriate to assess the client's learning ability?

"I note you're having problems with reading the information. Will you tell me about this?"

A nurse works in a suicide crisis clinic. The clients that represent the highest risk for suicide are those who state:

"I'm thinking of driving my car into a tree on the way home."

An older adult develops sudden onset of confusion and is hospitalized. The family expresses concern that their loved one is developing Alzheimer disease. What response by the nurse is most appropriate?

"Several possible underlying factors could be causing the confusion. Alzheimer's usually does not present with sudden confusion."

The emergency department nurse evaluates the orientee's understanding of the acute stress response in a trauma client. The nurse knows the orientee understands it when he states:

"There is facilitation of neural pathways mediating arousal, alertness, vigilance, cognition and focused attention."

A client reports to the nurse that her grandmother with Alzheimer's disease recently moved in with her and her two school-aged children. The client states the grandmother becomes agitated and starts yelling and crying frequently. The woman asks, "What can I do?" The nurse first responds:

"What precipitates the outbursts?"

The spouse of a client diagnosed with Alzheimer disease asks the nurse why the client often neglects to take a shower. The spouse states that the client was always diligent with hygiene in the past; however, over the past few months that has not been the case. What is the nurse's best response?

"You should remind the client to shower."

A 35-year-old client is delirious after being lost in the woods for several days and becoming severely dehydrated. At 9 p.m. the client tells the nurse to get the client's clothes because the client has to get home to the client's family. Which response by the nurse is most therapeutic?

"You're in the hospital. You did not drink for several days, but you're getting better now."

Which client statement is suggestive of a sexual delusion?

"You've been watching me and my partner while we are together, haven't you?"

A client has chronic hyponatremia, which requires weekly laboratory monitoring to prevent the client lapsing into convulsions or a coma. What is the level of serum sodium at which a client can experience these side effects?

114 mEq/L

The nurse will use the Denver Articulation Screening for children in what age range?

2.5-7 years

A nurse teaching a client about prescribed antipsychotic medication informs the client to contact a health care provider immediately if the client notices:

A dramatic change in temperature

Which cognitive theorist conceptualized distorted cognitions as a basis for depression?

Aaron Beck

If the client provides a literal explanation of a proverb and cannot interpret its meaning, which thought process is lacking?

Abstract thinking

In clients with Alzheimer's disease, neurotransmission is reduced, neurons are lost, and the hippocampal neurons degenerate. Which neurotransmitter is most involved in cognitive functioning?

Acetylcholine

Which of the following neurotransmitters are deficient in myasthenia gravis?

Acetylcholine

A client diagnosed with schizophrenia has been prescribed clozapine. Which is a potentially fatal side effect of this medication?

Agranulocytosis

A client with stage II Alzheimer's disease is admitted to the short stay unit after cardiac catheterization that involved a femoral puncture. The client is reminded to keep their leg straight. A knee immobilizer is applied, but the client repeatedly attempts to remove it. The nurse is responsible for three other clients who underwent cardiac catheterization. What's the best step the nurse can take?

Ask the staffing coordinator to assign a nursing assistant to sit with the client.

The nurse is preparing a presentation for a local health fair on autism spectrum disorders. What statement is most important in understanding the disorder?

Autism cannot be cured

Cognitive techniques focus on the client's patterns of which type of thinking?

Automatic

Which group of theories is believed currently to explain the etiology of schizophrenia?

Biological

The nurse is working with a client seeking treatment for bulimia and determines that cognitive restructuring will help build the client's self-esteem. Which best describes the goals of cognitive restructuring?

Change distorted thinking and the subsequent behaviors

A 4-year-old child is brought to the emergency department after being in a motor vehicle accident. The child experienced head trauma in the accident. When assessing the child, which will be the first change noted in the presence of increasing intercranial pressure?

Change in level of consciousness

The psychiatric nurse recognizes that a client's cultural background can contribute to the misdiagnosis of schizophrenia primarily for which reason?

Clinicians diagnose culturally accepted beliefs as psychotic thinking

A nurse on a neurology unit is assessing a client with a brain injury. The client is unresponsive to speech, with dilated pupils that do not react to light. The client is breathing regularly with a respiratory rate is 45 breaths per minute. In response to a noxious stimulus, the client's arms and legs extend rigidly. What is the client's level of impairment?

Coma

A nurse is caring for an older adult who has experienced damage to the frontal lobe after an automobile accident. The nurse anticipates that the client will have difficulty in what area?

Concept formation

A nurse is assessing a Haitian client. The caregiver of the client tells the nurse that the client is having an episode of Bouffée delirante. What symptoms would the nurse expect to find in this client? Select all that apply.

Confusion Hallucinations Extreme aggression

The nurse is working with a client who is in a stressful situation. The nurse evaluates the client's resiliency by assessing the client's ability to do what?

Continue to function well

The instructor is discussing psychosis with the nursing students. The instructor knows that teaching was effective when the students identify what behaviors are exhibited by people with psychosis?

Disorganized and often bizarre thinking

A client with posttraumatic stress disorder (PTSD) tells the nurse that he often feels like he has left his body and is looking at things from a distance. The nurse interprets this as:

Dissociation

A nurse is caring for a client with posttraumatic stress disorder (PTSD). During the assessment interview, the nurse finds that the normally calm client at times becomes very aggressive and uses abusive language. When in the aggressive state, the client fails to recognize personal information. What is this behavior indicative of?

Dissociative identity disorder

While observing a group of 9-year-old children at school, the nurse is concerned that one of the children is not cognitively developing according the Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned?

Does not understand the phrase "slow as molasses" when used by the teacher

Parents are reluctant to accept that their preschooler has attention deficit hyperactivity disorder (ADHD), so the nurse is explaining the commonly seen characteristics of this syndrome. Which characteristics would the nurse include in her explanation? Select all that apply.

Easily distracted Failure to complete tasks before going on to another one Impulsiveness

The nurse is organizing an indoor play area for preschoolers. What play materials are least important?

Electronic teaching toys

A client is diagnosed with schizoaffective disorder. Which would the nurse identify as supporting this diagnosis?

Evidence of hallucinations and delusions accompanied by major depression

The nurse is conducting an admission assessment with a 45-year-old client who has been demonstrating signs of bipolar disorder. While conducting the assessment, the client starts speaking in illogical rhymes and using word associations. What is the name for this thought pattern?

Flight of ideas

Abnormalities in which lobe is believed to be associated with schizophrenia?

Frontal lobe

The nurse is assigned to care for a client with early stage Alzheimer's disease. Which nursing interventions should be included in the client's care plan? Select all that apply.

Furnish the client's environment with familiar possessions. Assist the client with activities of daily living (ADLs) as necessary. Assign tasks in simple steps.

A client with schizophrenia is admitted to the psychiatric unit of a local hospital. During the next several days, the client is seen laughing, yelling, and talking out loud to no one. This behavior is characteristic of:

Hallucinations

A psychiatric-mental health client informs the nurse that a tornado that hit a neighboring town was the client's fault because the client dislikes a neighbor. This disturbance of thought content is known as what?

Ideas of reference

The nurse is caring for a client who is exhibiting signs of stress. Which cognitive symptom associated with stress does the nurse recognize?

Impaired concentration

A family is sitting in the intensive care unit with a client who sustained significant head injuries in a motorcycle accident. They are questioning the nurse about why the client's eyes open but do not stay open for long. The nurse explains that the client is probably in which state?

In a stuporous state due to a reticular activated system (RAS) injury

A brain tumor causing clinical manifestations of headache, nausea, projectile vomiting, and mental changes is likely located in which part of the brain? Select all that apply.

Intra-axial Extra-axial Frontal lobe.

Following a motorcycle accident, a client is brought to the emergency department with multiple fractures. Which assessment finding would be most significant in determining the client has also suffered a closed head injury with rising intracranial pressure?

Lethargy

Which type of insulin acts most quickly?

Lispro

The nurse assesses a client with renal failure for encephalopathy caused by uremia. Which clinical manifestation will the nurse likely find?

Loss of recent memory and inattention

Which part of the brain is responsible for autonomic functioning such as ventilation, cardiac conduction, and vomiting?

Medulla oblongata

The nurse is assigned to a client with catatonic schizophrenia. Which intervention should the nurse include in the client's care plan?

Meeting all of the clients physical needs

The nurse is caring for a client with asterixis. Which assessment should the nurse make to help a diagnosis of hepatic encephalopathy?

Mental status

A nursing instructor is developing an education plan for a group of students about schizophrenia and schizoaffective disorders. The instructor identifies that in addition to psychosis, what other condition must be present at the same time for a diagnosis of schizoaffective disorder?

Mood disturbance

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?

N-methyl-D-aspartate (NMDA) receptor antagonist

A client with a diagnosis of advanced Alzheimer disease is unable to follow directions required to use an inhaled bronchodilator. Which medication delivery system is most appropriate for this client?

Neubulizer

A client receives the first dose of fluphenazine. The next day, during the follow-up appointment, the nurse finds the client is confused and the client's temperature is 103°F, pulse rate is 116 beats per minute, respirations are 34 breaths per minute, and blood pressure is 100/50 mmHg. The nurse should investigate further for which condition?

Neuroleptic malignant syndrome

The experience of delusions that are plausible in the context of a client's ethnic background are reflective of what?

Non-bizarre delusions

A nurse provides care to a client with schizoaffective disorder during hospitalization for acute psychosis. Nursing interventions to help the client to establish trust with the health care team is best accomplished by what?

Offering reassurance in a soft, nonthreatening voice

A client has been prescribed quetiapine for delusional disorder. In teaching the client about this medication, the nurse must be certain to include which information?

One of the common side effects is dry mouth.

When can autistic behaviors first be noticed?

One year of age

Nursing students are reviewing the structure and function of the ears in preparation for class the next day. The students demonstrate understanding of the information when they describe which of the following as a middle ear structure?

Ossicles

A patient has difficulty interpreting his awareness of body position in space. Which lobe is most likely to be damaged?

Parietal lobe

After having a stroke, a patient has cognitive deficits. What are the cognitive deficits the nurse recognizes the patient has as a result of the stroke? Select all that apply.

Poor abstract reasoning Decreased attention span Short- and long-term memory loss

The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's:

Potassium levels

What is the greatest benefit support groups provide to the caregivers of clients diagnosed with dementia?

Provides interaction with those with similar concerns

A client with schizophrenia is admitted to the behavioral health department and is observed drinking copious amounts of water and voiding large amounts of dilute urine. The nurse recognizes this behavior is consistent with which problem?

Psychogenic polydipsia

Following focal seizures that have damaged the dominant hemisphere of a client's auditory association cortex, the nurse may observe the client displaying:

Receptive aphasia

A care aide has rung the call light for assistance while providing a client's twice-weekly bath because the client became agitated and aggressive while being undressed. Knowing that the client has a diagnosis of dementia of Alzheimer's type and is prone to agitation, which measure may help in preventing this client's agitation?

Reminding the client multiple times that he or she will be soon having a bath

During the nurse's morning assessment of a client with a diagnosis of dementia, the client states that the year is 1949 and she believes she is in a hotel. How should the nurse best respond to this client's disorientation?

Reorient the client to place and time.

A nurse is screening for Alzheimer disease (AD) in clients in a long-term care facility. Which facts regarding AD are accurate? Select all that apply.

Scientists estimate that more than 5 million people have AD. Nearly half of 85-year-old adults have AD AD affects brain cells and is characterized by patchy areas of the brain that degenerate.

Which neurotransmitter is implicated in depression?

Serotonin

In a report, the night nurse tells the incoming nurse that one client with dementia has sundowning syndrome. Which of the following nursing diagnoses would be most appropriate for this client?

Sleep deprivation

Which situation would lead the client's family to suspect onset of dementia?

The client has increasingly experienced disorientation to familiar surroundings.

The client has early Alzheimer's disease. When asked about family history, the client relates that the client has two children who are both grown and who visit the client around the holidays each year. The nurse subsequently discovers that the client has one child who is currently assigned overseas and who has not been home for 2 years. Which would best describe the client's behavior?

The client is confabulating, most likely to cover for memory deficit.

The nurse asks a client to pretend the client is brushing the client's teeth. The client is unable to perform the action. Upon examination, the nurse finds that the client possesses intact motor abilities. What can this problem be documented as?

The client may have apraxia

The nurse is reviewing the health record of a client who developed posttraumatic stress disorder (PTSD) following a spouse's cardiac arrest and death. The health record states that the client experienced derealization during the traumatic event. What assessment finding would substantiate this statement?

The client states that the client cannot remember what happened during and immediately after the event

The nurse is caring for a client undergoing cognitive behavior therapy for obsessive-compulsive disorder. How does the cognitive model describe the client's thought process? Select all that apply.

The client wants to control own thoughts. The client has intolerance for uncertainty. The client overestimates the threats caused by the thoughts.

Research related to the development of schizophrenia has shown what?

The disorder is thought to arise from the interaction of a biological predisposition and environmental stressors.

A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child?

The infant says "da-da" when looking at her father

A client with chronic alcoholism has been found to have Korsakoff's psychosis. This irreversible complication is characterized by what?

Thiamine, or vitamin B1, deficiency

A client receives a daily injection of glargine insulin at 7:00 a.m. When should the nurse monitor this client for a hypoglycemic reaction?

This insulin has no peak action and does not cause a hypoglycemic reaction.

A client with dissociative disorder is referred for psychotherapy. What would be the main focus of therapy for this client?

To reassociate with conciousness

A 70-year-old woman is being treated at home for Parkinson's disease (PD), a health problem that she was diagnosed with 18 months ago. The nurse who is participating in the woman's care should be aware that her initial symptoms most likely consisted of:

Tremors and muscle rigidity

When assessing a client with dementia, a nurse identifies that the client is experiencing hallucinations. Based on the nurse's understanding of this disorder, which type of hallucination would the nurse expect as most common?

Visual

A client is taking rivastigmine for Alzheimer disease. The nurse will evaluate the client regularly for:

Weight loss

The nurse is observing a group of 2- and 3-year-olds in a play group. Which behavior noted in one of the children indicates to the nurse that the child may have autism spectrum disorder (ASD)?

While the other children are eating a snack, the child walks around the room feeling the walls and ignores the caregiver who offers him a snack.

A nurse is assessing a client's state of awareness and finds the client to be disoriented and restless. The client is also agitated and alternates from confusion to excessive drowsiness to extreme excitability. The nurse would document this as:

delirium.

The community health nurse is teaching sexually transmitted infections to a high school health class. The nurse determines that the teaching was successful when the group identifies what potential cause for intellectual disability in the newborn?

herpes type II (genital herpes)

What is the initial intervention the nurse should implement when helping a client diagnosed with dementia deal with paranoid delusions?

observe the client in order to identify the triggers for the delusions

A client diagnosed with schizophrenia is having delusions that the client is being plotted against by the government. This would be documented as which type of delusion?

persecutory

A client with Alzheimer disease in a nursing home is more compliant in following directions for dressing and feeding with one nurse than with other staff members. This phenomenon is best explained by

the Therapeutic Model of Interaction.

The client has finished the first round of chemotherapy. Which statement made by the client indicates a need for further teaching by the nurse?

"I can continue taking my vitamins and herbs because they make me feel better."

A client with a diagnosis of schizophrenia is admitted to the inpatient unit of the mental health center. The client starts shouting, "The government of France is trying to kill me!" Which response is most appropriate?

"I don't see evidence that a foreign government is trying to hurt you. You must feel frightened by this."

A client has been recently diagnosed with Alzheimer disease and has been prescribed a cholinesterase inhibitor. This drug will slow the progression of the client's symptoms by:

Decreasing ACh breakdown

A nurse is assessing a client diagnosed with schizophrenia. When documenting the findings, which would the nurse identify as a positive symptom? Select all that apply.

Delusions Hallucinations

An client has pernicious anemia and has been receiving treatment for several years. Which symptom may be confused with another condition in older adults?

Dementia

During a client interview, a client diagnosed with delusional disorder states, "I know my spouse is being unfaithful to me with a colleague from work."The nurse interprets the client's statements as suggesting which type of delusion?

Persucatory/paranoid

A nurse is caring for a client during barbiturate therapy. The client receiving this drug should be evaluated for which condition?

Physical dependence

A nurse is conducting an in-service education program for a group of nurses transitioning to the pediatric unit of the facility. The nurse is describing the various theories of growth and development. The nurse determines that the teaching was successful when the group identifies the stages of cognitive devleopment by Piaget. Place the stages listed below in the correct sequence from first to last that would demonstrate the group's learning.

Sensorimotor Pre-operational Concrete operational Formal operational

A nurse is assessing a client who is reporting the sensation of "bugs crawling under the skin" and intense itching and burning. The client states, "I know bugs have invaded my body." There is no evidence to support the client's report. The nurse interprets this as which type of delusion?

Somatic

When developing the plan of care for a client with schizophrenia who is in the acute phase of illness, the nurse understands that the client is at high risk for what?

Suicide

The nurse is assessing a client with vascular dementia. As a result of this cognitive deficit, the client is unable to provide many of the data that are required. How should the nurse best proceed with this assessment?

Supplement the client's information by speaking with family or friends.