alzheimers Test 2

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a,e

A 70-year-old woman with Alzheimer disease becomes agitated every evening, pacing and insisting on leaving to go "home." Which of the following are the most appropriate nursing interventions to assist this client? (Select all that apply.) a Turn on the television and encourage her to watch it with you. b Allow her to pace and inform her that she is at home. c Take her to her room, turn the lights out, and leave her alone. d Put the client in a room with other clients and leave her. e Touch her in a gentle way and speak in a low tone of voice.

d Rationale: While all of these are appropriate nursing diagnoses for the client with Alzheimer, the primary concern for this client is safety and the risk for injury.

A client with Alzheimer disease has a disturbed sleep pattern and tends to get up several times during the night. Which nursing diagnoses are appropriate for this client? a Impaired memory b Impaired social interaction c Risk for Aspiration d Risk for Injury e Self-care deficit f Chronic confusion

a,c,e,f Rationale: Management of the illness is an important topic for the family. Key ideas include client safety, nutrition, medication administration, and daily activities. The nature of the cognitive impairment is an important topic for the family; it is helpful to them to know the causes and symptoms of the illness. The family may need assistance with support services such as financial, legal, and home health services. The availability of respite care is also helpful information. Intellectually stimulating activities and exercise regimens are not relevant for the client with Alzheimer disease. Nursing Process: Implementation Client Need: Physiological Integrity Cognitive Level: Analyzing

A family is caring for their parent with Alzheimer disease. Which topics should the nurse include in the family education? (Select all that apply.) a Nature of the cognitive impairment b Intellectually stimulating activities for the client c Management of the illness d Exercise regimens for the client e Causes and symptoms of the illness f Support services for the client

D

An elderly client experiences nighttime confusion wanders from his room into the room of another client. The nurse can best help decrease his confusion by: a. assigning a NA to sit with him until he falls asleep b. allowing the client to room with another elderly client c. administering a bed time sedative d. leaving a night light on during the evening and night shifts

a,d Rationale: Symptoms of overdose include severe nausea and vomiting, sweating, salivation, hypotension, bradycardia, convulsions, and increased muscle weakness, including respiratory muscles. Tachycardia, hypertension, emotional withdrawal, tachypnea, and increased muscle strength are not associated with overdose of these drugs. Nursing Process: Assessment

An overdose of drugs to treat Alzheimer disease may occur if they are taken improperly or if decreased liver or renal function occurs. The nurse assesses the client for signs of overdose, which include: (Select all that apply.) a nausea and vomiting. b tachycardia and hypertension. c emotional withdrawal and tachypnea. d bradycardia and muscle weakness. e hypotension and increased muscle strength.

b apraxia is the inability to use objects appropriately. agnosia is the loss of sensory comprehension anomia is the inability to find the right words aphasia is the inability to speak

The client with Alzheimers disease is being assisted with ADLS when the nurse notes that the client uses her toothbrush to brush her hair. The nurse is aware the client is exhibiting: a. agnosia b. apraxia c. anomia d. aphasia

a

The nurse discussed the disease process of Alzheimer disease with the client and caregiver. What does the nurse explain is the cause of Alzheimer disease? a The cause is unknown. Amyloid plaques and neurofibrillary tangles have been found in the brain at autopsy. b The cause is unknown. Chronic small intracranial bleeds have been found on CT scans. c Loss of dopamine receptors is thought to occur as a part of the aging process. d Loss of circulation to the brain has been found on CT scans.

b agnosia(failing to recognize familiar objects) occurs in stage III. memory loss is stage I, wandering at night is stage II, failing to communicate is stage IV

The nurse is caring for a client with stage III Alzheimer's disease. A characteristic of this stage is: a. memory loss b. failing to recognize familiar objects c. wandering at night d. failing to communicate

b,d,e Rationale: Therapies used by interdisciplinary teams may include diagnostic testing to rule out potential causes of symptoms of AD in the client, pharmacologic therapy, nonpharmacologic therapy, complementary, and alternative therapy. The nurse must understand how pharmacologic therapy works. Encouraging the client to take supplements is beyond the nurse's scope of practice. Nursing Process: Implementation Client Need: Psychosocial Integrity Cognitive Level: Analyzing

The nurse is working with the family of a client newly diagnosed with Alzheimer disease. The nurse explains that treatment therapies can include: (Select all that apply.) a encouraging the client to take supplements to help manage symptoms. b occupational therapy to help the client maintain the ability to perform activities of daily living. c pharmacologic therapy with NMDA receptor antagonists to boost levels of acetylcholine.A955 d diagnostic testing to rule out potential causes of a client's AD symptoms. e music therapy to help fight depression and anxiety in the client.

b,c,d

The nurse understands that potential expected outcomes for the client with Alzheimer disease includes the following: (Select all that apply.) a The client does not need to rely on memory aids, such as lists or calendars. b The client maintains and follows her medication regimen. c The client remains free from injury. d The caregiver utilizes community resources, such as respite care services. e The client eats very little at meals in order to avoid weight gain.

a,c,d,e Rationale: Increasing age is one of the most common risk factors for Alzheimer disease. Individuals who experience moderate to severe head trauma are more likely to develop the disease. Frequent, mild head trauma also increases the risk. . Eating a healthy diet, avoiding obesity, and remaining mentally and socially active can help prevent the disease. Nursing Process: Assessment Client Need: Physiological Integrity Cognitive Level: Analyzing

The nurse understands that the following statements about Alzheimer disease are true: (Select all that apply.) a Individuals who experience severe head injury are more likely to develop Alzheimer disease. b Individuals who experience frequent yet mild head injury are less likely to develop Alzheimer disease. c Increasing age is one of the most common risk factors for Alzheimer disease. d Staying mentally and socially active reduces the risk of developing Alzheimer disease. e Eating a diet low in cholesterol and saturated fat may help limit the risk of developing Alzheimer disease.

c Medications to treat dementia include acetylcholine​ precursors, cholinergic​ agonists, and cholinesterase​ inhibitors, such as donepezil​ (Aricept), rivastigmine​ (Exelon), and galantamine​ (Reminyl). Beta-blockers, proton pump​ inhibitors, and antiemetics are not used for the treatment of dementia. Next Question

Which medication is used to treat clients with​ dementia? ​a Beta-blockers b Antiemetics c Acetylcholine precursors d Proton pump inhibitors

d The medication that the nurse would administer with food is rivastigmine tartrate​ (Exelon). Tacrine hydrochloride​ (Cognex) should be administered one hour before a meal. Donepezil hydrocholoride​ (Aricept) is administered at bedtime. There are no specific guidelines for administering memantine​ (Namenda) with food.

Which medication would the nurse administer with food for a client who is diagnosed with Alzheimer disease​ (AD)? a Memantine​ (Namenda) b Tacrine hydrochloride​ (Cognex) c Donepezil hydrochloride​ (Aricept) d Rivastigmine tartrate​ (Exelon)

b tremors are a EPS

a client with advanced Alzheimer's has been prescribed haldol. which clinical manifestations suggests the client is experiencing side effects from this med? a. cough b. tremors c. diarrhea d. pitting edema

b a side effect is dizziness. The med should be taken at bed time with no regard to meals the pill can DECREASE HR

a client with alzheimers has been prescribed donepezil (aricept) Which information should the nurse include in the teaching plan for the client on aricept? a. take the med with meals b. the medicine can cause dizziness so rise slowly c. if a dose is skipped take two the next time d. the pill can increase heart rate

c

a client with history of cocaine abuse is experienceing tactile hallucinations. The symptom is known as: a dyskinesia b. confabulation c. formication d. dystonia

b

a client with paranoid schizophrenia is brought to the hospital by her elderly parents. During the assessment the client's mother states "sometimes she is more than we can handle" based on the mother's statement, the most appropriate nursing diagnoses is : a, Ineffective family coping related to parental role conflict b. caregiver role strain related to chronic situational stress c. altered family process related to impaired social interaction d. altered parenting related to impaired growth and development

1,4,5,6 ( a client may with Alzheimers may have difficulty remembering to call for help)

a nurse is caring for a client diagnosed with Alzheimers disease who scored a 7 (high risk) on the fall score assessment. Which nursing interventions would the nurse implement? select all that apply 1. implement a bed alarm 2. request a low dose sedative 3. instruct the client to request help before ambulating 4. maintain the bed at the lowest position 5. offer toileting every 2-3 hrs 6. advise family to notify staff when leaving


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