Delirium and Alzheimers Nclex Style
A client diagnosed with Alzheimer's disease is taking Donepezil (Aricept) in order to improve his cognitive functioning. Knowing that this drug can have serious adverse effects, which of the following requires immediate intervention by the nurse? A. Diarrhea B. Drowsiness C. Confusion D. Coffee ground emesis
A client diagnosed with Alzheimer's disease is taking Donepezil (Aricept) in order to improve his cognitive functioning. Knowing that this drug can have serious adverse effects, which of the following requires immediate intervention by the nurse? Answer: D. Coffee ground emesis
A client is newly diagnosed with the second stage Alzheimer's disease. Which cognitive change would a nurse observe? a.) Memory disturbance (Answer) b.) Confabulation c.) Apraxia d.) Inability to plan or organize
A client is newly diagnosed with the second stage Alzheimer's disease. Which cognitive change would a nurse observe? Answer: a.) Memory disturbance
A client with Alzheimer's disease has a self-care deficit related to his cognitive impairment. He has difficulty dressing himself. The best action for the nurse to take is to: A. Have the client wear hospital gowns. B. Explain to the client why he should dress himself. C. Give the client step-by-step instructions for dressing himself. D. Allow enough time for the client to dress himself.
A client with Alzheimer's disease has a self-care deficit related to his cognitive impairment. He has difficulty dressing himself. The best action for the nurse to take is to: Answer: C. Give the client step-by-step instructions for dressing himself.
A male client with delirium becomes disoriented and confused in his room at night. The best initial nursing intervention is to: a. move the client next to the nurse's station b. use and indirect light source and turn off the television c. keep the television and a soft light on during the night d. play soft music during the night and maintain a well lit room
A male client with delirium becomes disoriented and confused in his room at night. The best initial nursing intervention is to: Answer: b. use and indirect light source and turn off the television
A priority nursing diagnosis for the client experiencing altered perception, extreme agitation, and acute confusion is: a.Disturbed sensory perception b.Impaired verbal communication c.Altered role performance d. Risk for injury
A priority nursing diagnosis for the client experiencing altered perception, extreme agitation, and acute confusion is: Answer: D risk for injury
All of the following are autonomic manifestations of delirium EXCEPT: A. Sweating B. Flushed face C. Dilated pupils D. Bradycardia
All of the following are autonomic manifestations of delirium EXCEPT: Answer: D. - bradycardia
An alzheimer patient that talks in confabulatory way is in what stage of Alzheimers? a. Stage 7 b. Stage 6 c. Stage 4 X d. stage 5
An alzheimer patient that talks in confabulatory way is in what stage of Alzheimers? Answer: c. Stage 4
An elderly client, newly admitted to a nursing home, refuses to participate in activities of daily living (ADLs). Which nursing intervention would best help the client to be as independent as possible in meeting self-care needs? a. Assign a variety of caregives so that one person does not do everything for the client. b. Establish a specified amount of time for completion of ADLS. c. Set client expectations at the beginning of each day. d. Structure the ADLs to mirror previous home routines
An elderly client, newly admitted to a nursing home, refuses to participate in activities of daily living (ADLs). Which nursing intervention would best help the client to be as independent as possible in meeting self-care needs? Answer: d. Structure the ADLs to mirror previous home routines
An overabundance of ______ and _______ appear in the brains of individuals with AD. a) Plaques and apolipoprotein E epsilon 4 B) Tartar and Plaques C) Tau protein and Tangles D) Plaques and Tangles
An overabundance of ______ and _______ appear in the brains of individuals with AD. Answer: D) Plaques and Tangles
Clients with delirium differs from dementia in that: 1. Experience a slow, insidious onset of symptoms 2. Are very attentive to their environment 3. Respond to questions appropriately and correctly 4. Have fluctuating consciousness
Clients with delirium differs from dementia in that: Answer: 4. Have fluctuating consciousness
Delerium is different than dementia in that it is characterized by: (select all that apply) a) is a little problem b) can not be fixed c) last for a long time d) lasts a little while e) has many problems f) can be fixed once problem is found
Delerium is different than dementia in that it is characterized by: (select all that apply) Answer: a) is a little problem d) lasts a little while f) can be fixed once problem is found
Delirium has multiple predisposing factors, which of those listed below is NOT a predisposing factor? a. substance-induced b. Huntington's disease c. substance-withdrawal d. general medical conditions, such systemic infections and metabolic disorders
Delirium has multiple predisposing factors, which of those listed below is NOT a predisposing factor Answer: b. Huntington's disease is a predisposing factor of dementia
Delirium is related to which of the following: (select all that apply) A. Impaired hearing B. Chronic Disease C. Brain structure D. Milk allergies E. Sleeping too much
Delirium is related to which of the following: (select all that apply) Answer: A. Impaired hearing B. Chronic Disease C. Brain structure
Dementia is a slow and progressive disorder in which the dementia itself is the major sign of some organic brain disease not directly related to any other organic illness or it could be related to another disease or condition. What is the most common symptom of dementia? a. Ataxia b. Dysarthria c. Amnesia d. Impulsivity e. Non of the above
Dementia is a slow and progressive disorder in which the dementia itself is the major sign of some organic brain disease not directly related to any other organic illness or it could be related to another disease or condition. What is the most common symptom of dementia? Answer: c. Amnesia
In admitting a client who is diagnosed with Alzheimer's to the unit, which is the highest priority? a. Place the client with a roommate b. Place the client without a roommate c. Place the client close to the nurses station d. Place the client away from the nurses station
In admitting a client who is diagnosed with Alzheimer's to the unit, which is the highest priority? Answer: c. Place the client close to the nurses station
Persisting dementia is associated with: A. Imbalanced sodium B. Alcohol C. Sun exposure D. Water intoxication
Persisting dementia is associated with: Answer: B. Alcohol
True/False: The number of people with dementia is growing because more people now survive into middle age and beyond.
The number of people with dementia is growing because more people now survive into middle age and beyond. Answer: True
The physician tells family members that their father, who is experiencing confusion and memory loss, has a reversible form of dementia. Which is the likely cause of this disorder? a) Multiple sclerosis. b) Multiple small brain infarcts. c) Electrolyte imbalance. d) HIV disease
The physician tells family members that their father, who is experiencing confusion and memory loss, has a reversible form of dementia. Which is the likely cause of this disorder? Answer: c) Electrolyte imbalance.
The relevant events that can be associated with delirium are: a.An infection b.Old age c.Depression d.Adolescence
The relevant events that can be associated with delirium are: Answer: A an infection
The term "sundowning" is a phenomenon in which dementia symptoms seem to worsen in the late afternoon and evening. Sundowning is most likely found in which stage of dementia? a. Stage 1 b. Stage 3 c. Stage 5 d. Stage 6
The term "sundowning" is a phenomenon in which dementia symptoms seem to worsen in the late afternoon and evening. Sundowning is most likely found in which stage of dementia? Answer: d. Stage 6
True/False: Cognitive symptoms of depression include confabulation, disoriented to time and place, symptoms get worse as the day progresses and concentration is impaired?
True/False: Cognitive symptoms of depression include confabulation, disoriented to time and place, symptoms get worse as the day progresses and concentration is impaired? Answer: False. Each is listed under dementia on page 435 table 24-1.
True/False: Patients with delirium, dementia, and amnestic disorders have a clinically significant deficit in cognition or memory.
True/False: Patients with delirium, dementia, and amnestic disorders have a clinically significant deficit in cognition or memory. Answer: True
True/False: The initial symptom in Alzheimer's Disease is usually personality change whereas the initial symptom in Pick's diease is memory impairment.
True/False: The initial symptom in Alzheimer's Disease is usually personality change whereas the initial symptom in Pick's diease is memory impairment. Answer: False, the initial symptom in Pick's disease is usually personality change; whereas the initial symptom in AD is memory impairment (p. 429).
True/False: having delirium can increase the length of a hospital stay for non-related issues. true or false? TRUE
True/False: having delirium can increase the length of a hospital stay for non-related issues. Answer: TRUE
What is not a predisposing factor for both delirium and dementia: 1.Multiple etiologies 2. General medical conditions 3. HIV disease 4.Substance induced
What is not a predisposing factor for both delirium and dementia: Answer: 3- HIV disease; it is only a predisposing factor for dementia
What will the nurse commonly note in the clinical picture of dementia? a. Memory loss for events in the distant past. b. Quarrelsome behavior directly related to lack of blood supply to the brain c. increased resistance to change d. Insight into ones situation, its probable cause, and its consequence
What will the nurse commonly note in the clinical picture of dementia? Answer: c. increased resistance to change
Which drug helped lead to deinstituationalization and a larger need for community healthcare for those with mental illness? a.Prozac b.Haldol c. Lithium d.Thorazine
Which drug helped lead to deinstituationalization and a larger need for community healthcare for those with mental illness? Answer: d.Thorazine
Which medicine should not be used in sedating elderly clients? a. Benzodiazepines b. Non-benzodiazepines sedative-hypnotics c. Barbiturates d. Antidepressants
Which medicine should not be used in sedating elderly clients? Ans: C. Barbiturates should not be used in elderly clients (p. 448)
Which of the following help to slow the progression of Alzheimer's disease? (select all that apply) a. Vitamin E b.Lutein c. Fish oil d. Dopamine e.Estrogen
Which of the following help to slow the progression of Alzheimer's disease? (select all that apply) Answer: a. Vitamin E c. Fish oil e.Estrogen
Which of the following is not a predisposing factor of delirium? A. Substance withdrawl B. General Medical Condition C. Genetics D. Substance intoxication
Which of the following is not a predisposing factor of delirium? Answer: C. Genetics
Which of the following may be predisposing factors of dementia? a) Creutzfeldt-Jakob disease b) Huntington's disease c) Parkinson's disease d) all of the above e) none of the above
Which of the following may be predisposing factors of dementia? Answer:d) all of the above > Creutzfeldt-Jakob disease Huntington's disease Parkinson's disease
Which of the following outcome criteria is appropriate for the client with dementia? a. The client will return to an adequate level of self-functioning. b. The client will learn new coping mechanisms to handle anxiety. c. The client will seek out resources in the community for support. d. The client will follow an establishing schedule for activities of daily living.
Which of the following outcome criteria is appropriate for the client with dementia? Answer: d. The client will follow an establishing schedule for activities of daily living.
Which of the following symptoms is not seen in dementia of the Alzheimer's type? 1. Agoraphobia 2. Apraxia 3. Aphasia 4. Agnosia
Which of the following symptoms is not seen in dementia of the Alzheimer's type? ANSWER: 1:Agoraphobia
Who created the mental health reform of establishing a number of hospitals for the mentally ill? a. Linda Richards b. Dorthea Dix c. Benjamin Rush d. William Tuke
Who created the mental health reform of establishing a number of hospitals for the mentally ill? Aswer: b. Dorthea Dix
those with delirium have a ............ higher probability of developing dementia? 23% 43% 63% 83%
those with delirium have a ............ higher probability of developing dementia? Answer: 63%
