Psych Ch 23

A patient diagnosed with Alzheimer's disease looks confused when the phone rings and cannot recall many common household objects by name. What term will the nurse use to document this loss of function?

Agnosia

Which type of dementia has a clear genetic link?

Alzheimer's Disease

An elderly patient is hospitalized with pneumonia and treated with multiple antibiotics. After two days, the patient becomes irritable and restless, and says to the nurse, "My pet parakeet flew across the room." A family member says the patient has been healthy and living independently but does not own a pet. What is the most likely analysis of this scenario?

The patient is experiencing illusions secondary to delirium

A Chinese-American patient has been diagnosed with dementia. What should the nurse keep in mind when addressing the needs of the family caregivers? Select all that apply.

They do not seek help from others. They believe dementia is due to fate. They associate dementia with stigma. They feel obligated to sacrifice individual needs. They believe memory loss in early dementia is not a mental disease.

To confirm the diagnosis of dementia, the nurse would anticipate which diagnostic test to be prescribed? Select all that apply.

Thyroid function Electrolyte Vitamin B12 level Liver function

A nurse explains the methods of improving self-care in the patient with dementia to one of the patient's family members. What action from the family member best indicates effective grasp of the teaching and the ability to help the patient be more self-sufficient?

Use name tags on the patient's clothes for easy recognition.

A nurse communicates with a diabetic patient during their regular check-up. The nurse finds that the patient is showing symptoms of Alzheimer's disease. Which response by the patient supports the nurse's diagnosis?

"I regularly meet Mr. Abraham Lincoln during my walk.

Which assessment question would be asked of either the patient or her family to determine the presence of delirium? Select all that apply.

"When did you first notice that your mother seemed confused?" "Would you please tell me the names of your grandchildren?" "What did you mean when you said that your mom has always been a little confused?"

A nurse assists a patient diagnosed with moderately severe stage 5 Alzheimer's disease at mealtime. Which statement should the nurse use?

"Would you like bread or cheese?"

The nurse is teaching the family caregivers how to communicate with a patient who has dementia. What communication strategy can improve orientation of the patient?

Call the person by name every time you see him or her

Which question should be asked when considering the evaluation of outcomes for a patient experiencing cognitive dysfunction? Select all that apply.

Are the stated outcomes measureable? Is the patient capable of achieving the outcomes? Are the patient's cognitive skills deteriorating? When were the patient's outcomes last evaluated?

Which nursing intervention would be most appropriate for an older individual suspected of being at risk for the development of the unique symptoms of delirium?

Assessing orientation to person, place, and time every two hours

The family members of a patient with stage 1 Alzheimer's disease have jobs and cannot provide adequate supervision for the patient. A reasonable alternative for the nurse to explore with them would be

Day Care

Which change in neurotransmission occurs in Alzheimer's disease?

Decreased acetylcholine

Which statement about Alzheimer's disease (AD) is correct?

Hypertension, diminished activity, and head injury increase the risk of AD.

Which statement supports the diagnosis of mild cognitive decline? Select all that apply.

I can't seem to find the right word when I'm talking "My children think I'm having problems remembering things." "Mother told me she can't remember where she put her wedding ring.

A patient is diagnosed with dementia. Which symptoms is the patient likely to manifest? Select all that apply.

Impaired judgment No emotional expression

The nurse is caring for a patient with Alzheimer's disease who tends to get frightened and cries out at night. What nursing intervention is most appropriate for this patient?

Keep the area well-lighted at night

A nursing diagnosis appropriate for a patient with Alzheimer's disease, regardless of the stage, would be

Risk for injury

What is the best nursing intervention to help orient a patient experiencing confusion associated with a neurocognitive disorder?

Offer a consistent daily routine and easy-to-read clocks

A nurse is caring for a patient with dementia. What patient behavior is typical of dementia?

Patient demands attention from the nurse

A patient with cognitive impairment is diagnosed with aphasia. Which symptom is the nurse most likely to find in the patient?

Patient talks rapidly and foolishly

What is the usual development of Alzheimer's disease?

Progressive Deterioration

The nurse gives instructions to family members who provide home care for an 86-year-old patient diagnosed with moderate stage Alzheimer's disease. Which interventions are important and beneficial to teach the family? Select all that apply.

Select clothing with easy fasteners to facilitate dressing. Encourage the family to use support resources such as adult day care or respite care. When the patient becomes upset, listen briefly, provide support, and then change the topic.

patient diagnosed with delirium strikes out physically at a staff member. What is the most likely cause of this behavior?

State of fear

Which event would a patient with early stage 4 Alzheimer's disease have greatest difficulty remembering?

What he ate for breakfast

Based on current research, which patient is most likely to develop dementia?

A former boxer who is now a trainer

The nurse caring for a patient with Alzheimer's disease can anticipate that the family will need information about therapy with

Acetylcholinesterase inhibitors

When educating the family of an individual who is displaying characteristics of delirium, the nurse stresses that the individual may:

Act in an impulsive, inappropriate manner.

A delirious patient insists that a vacuum hose is a large, poisonous snake. What term will the nurse use to describe what the patient is demonstrating?

An illusion

The family caregivers of an elderly Alzheimer's disease patient are feeling overburdened and overwhelmed by the situation and wish to admit the patient to an assisted care facility. What could be the primary reason?

Caregiver role strain

An elderly postoperative patient at a well-maintained health care facility is terrified and reports seeing "giant spiders crawling over the bedclothes." Analyze the situation and select the most appropriate statement.

Delirium....

Based on research regarding possible postdelirium complications, what assessment will be the focus of a follow-up appointment for a patient who experienced postsurgical delirium?

Depression

Dementia in an older adult is often a misdiagnosis for

Depression

Which behavior is associated with typical age-related cognitive changes? Select all that apply.

Failing to pay the credit card bill while away on vacation. Taking 30 minutes to find one's misplaced car keys. Forgetting the address of the first apartment you rented. Experiencing difficulty recalling a synonym for happy.

A patient with Alzheimer's disease has very mild memory loss and no symptoms of dementia. Which drug is included in the treatment plan of the patient?

Galantamine (Razadyne)

The nurse is assessing a patient suspected of Alzheimer's disease (AD). What action by the patient does the nurse identify as a sign of agnosia?

Has problem in identifying familiar sounds like the telephone ringing

A patient on selective serotonin reuptake inhibitors has symptoms of delirium. What interventions are appropriate when caring for the patient? Select all that apply.

Nurse notes sleeping time of patient Performs regular assessment of patient Nurse places a calendar and watch beside bed

Review the following information. Which intervention will best meet the nursing unit's need for evidence-based nursing practice based on the findings of the research project?

Providing regular in-services focused on assessing of both the risks and signs of delirium.

Which practice demonstrates a proactive approach to minimizing the stress commonly experienced by nursing staff caring for the cognitively impaired patient? Select all that apply.

Realistic patient outcomes Thorough understanding of the disorder Reasonable expectations of patient abilities

A 75-year-old patient is hospitalized with sudden onset confusion and disorientation. The patient wanders and becomes agitated without any apparent stimulus. What is the highest priority nursing diagnosis?

Risk for Injury

A patient diagnosed with Alzheimer's disease has become more forgetful and has difficulty performing familiar tasks like bathing and dressing. The nurse would assess the patient as being in the stage of Alzheimer's disease labeled

Stage 3, Moderate-to-severe

Which medication is aimed at preventing the breakdown of acetylcholine? Select all that apply.

Tacrine (Cognex) Donepezil (Aricept) Rivastigmine (Exelon) Galantamine (Razadyne)

A patient with Alzheimer's disease tends to wander at night. What appropriate measures does the nurse follow to ensure patient safety?

The nurse makes the patient wear a bright vest.

A nurse is caring for a patient who has stage 5 Alzheimer's disease. What patient behaviors support this diagnosis? Select all that apply.

The patient does not solve simple mental arithmetic. The patient has to be assisted in selecting clothing. The patient does not remember his or her phone number.

The nurse is assessing a person with dementia. What problem does the nurse document as a problem related to apathy?

The patient engages in very little conversation

A nurse was assigned to select patients with Alzheimer's disease for a clinical trial of a new drug from a geriatric population. Based on what appropriate symptoms does the nurse select the patients? Select all that apply.

The patient has difficulty in conversing with others. The patient has poor judgment and decision-making.

A patient with Parkinson's disease reports that bugs are crawling on his bed. The nurse checks the bed and finds peanuts on the bed. What does the nurse conclude from the patient's behavior?

The patient has impaired environmental interpretation syndrome.

The term "perceptual disturbance" refers to difficulty accomplishing what task?

The processing of information about one's internal and external environment

The nurse is expected to perform an assessment of a patient suspected to be in stage 2 of Alzheimer's disease. What finding would be out of character if the patient truly has stage 2 Alzheimer's disease?

Willingness to respond directly to questions posed by nurse

A nurse assists a patient with moderate stage Alzheimer's disease at mealtime. Which statement should the nurse use?

Would you like Beans or potatoes?

As part of a clinical study, the nurse has to select elderly hospitalized patients for whom delirium is their most frequent complication. Based on what cardinal features does the nurse select the patients? Select all that apply.

Acute onset and fluctuating course Reduced ability to direct, focus, and sustain attention Disorganized thinking Disturbed consciousness

In a workshop for dementia, the nurse provides information about the different types of services available for dementia patients. What appropriate community services does the nurse mention?

Adult day care

A patient with Alzheimer's disease is prescribed Donepezil (Aricept). What appropriate suggestion does the nurse give to the patient's family?

Avoid Administering NSAIDS

A nurse is caring for a dementia patient. What appropriate action does the nurse take for an effective patient-nurse communication?

Avoid asking for more information.