Ch 24 PrepUs: Cognitive Disorders

A client is diagnosed with Alzheimer's disease. While assessing the client, the nurse notes that the client has trouble identifying objects such as a key and spoon. The nurse would document this as what? 1.Agnosia 2.Disturbance of executive function 3.Apraxia 4.Aphasia

1.Agnosia

A nurse is assessing a client diagnosed with Alzheimer's disease. As part of the assessment, the nurse asks the client to identify common objects. The nurse is assessing for what? 1.Agnosia 2.Aphasia 3.Executive functioning 4.Apraxia

1.Agnosia

A client has vascular neurocognitive disorder. When teaching the family about the cause of this disorder, which would the nurse expect to integrate into the explanation? 1.Blood flow in the vessels to the brain are blocked. 2.Acetylcholine production is decreased. 3.Strands of protein are tangled together. 4.Fragments mix with molecules to make plaques in the brain.

1.Blood flow in the vessels to the brain are blocked.

Which is an infection-related cause of delirium? 1.Pneumonia 2.Sleep deprivation 3.Renal failure 4.Lithium toxicity

1.Pneumonia

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? 1.Reminding the client multiple times that he or she will be soon having a bath 2.Decreasing the frequency of the client's baths from two times to one time per week 3.Providing all of the client's daily medications early on the day of a scheduled bath 4.Reinforcing the facility's zero-tolerance policy for aggressive behavior

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

Which nursing diagnosis would be the priority for the client experiencing acute delirium? 1.Risk for injury related to confusion and cognitive deficits 2.Fall precautions related to acute confusion 3.Risk for self-mutilation related to confusion and cognitive deficits 4.Acute confusion related to delirium of known/unknown etiology

1.Risk for injury related to confusion and cognitive deficits

A client is diagnosed with dementia that has progressed significantly. Which would be the priority for this client? 1.Safety 2.Education 3.Cognitive interventions 4.Support

1.Safety

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? 1.The client is confabulating, most likely to cover for memory deficit. 2.The client is showing signs of agnosia in that the client is unable to name the client's children. 3.The client demonstrates aphasia when discussing the client's children. 4.The client is confused about the client's children and needs refocusing.

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

An 82-year-old client with a diagnosis of vascular dementia has been admitted to the geriatric psychiatry unit of the hospital. In planning the care of this client, which outcome should the nurse prioritize? 1.The client will remain free from injury. 2.The client will demonstrate decreased agitation. 3.The client will identify life areas that require alterations due to illness. 4.The client will demonstrate increased feelings of self-worth.

1.The client will remain free from injury.

The nurse preparing an educational program on dementia should include which information? 1.The onset of symptoms of dementia is gradual 2.Delirium involves progressive deterioration of intellect 3.Dementia has many different causes 4.Delirium is the most debilitating condition seen in the older population

1.The onset of symptoms of dementia is gradual

To manage voiding issues, such as incontinence, male clients diagnosed with dementia would best be managed by what? 1.Use of disposable, adult diapers 2.Indwelling catheters 3.Condom catheter 4.Intermittent catheterization

1.Use of disposable, adult diapers

Which type of hallucination is most commonly seen in clients diagnosed with delirium? 1.Visual 2.Gustatory 3.Auditory 4.Autonomic

1.Visual

An 80-year-old client with Alzheimer's disease is prescribed donepezil. Which teaching points should the nurse provide to the client's spouse about the new medication? 1."The drug won't improve the client's symptoms but it will make the client much more compliant and easier to manage." 2."The drug won't cure the client's Alzheimer's, but it has the potential to slow down the progression of the disease." 3."It's important to closely follow the administration schedule for this drug if it is to make the client recover." 4."This drug will help the client sleep much better at night and stay awake during the day."

2."The drug won't cure the client's Alzheimer's, but it has the potential to slow down the progression of the disease."

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? 1.Norepinephrine 2.Acetylcholine 3.Serotonin 4.Epinephrine

2.Acetylcholine

Which term is used to describe the inability to execute motor functioning, despite intact motor abilities? 1.Aphasia 2.Apraxia 3.Agnosia 4.Executive functioning

2.Apraxia

The spouse caregiver of a client with dementia tells the nurse that the client has been agitated lately. The spouse states, "I don't know how to handle this. The client was always such a gentle person!" Which interventions should the nurse suggest? 1.Leave the client in a safe place in the house and go to another area until the client calms down. 2.Distract the client with family photos and discuss the events pictured. 3.Give the client a sedative when the client begins to get agitated. 4.Distract the client by turning on the television or watching a video.

2.Distract the client with family photos and discuss the events pictured.

The client is an 84-year-old suffering from delirium. The client has been in a nursing home for the past 2 years but recently is becoming combative and has become a threat to staff. Which medication would the client most likely receive for these symptoms? 1.Galantamine 2.Haloperidol 3.Rivastigmine 4.Tacrine

2.Haloperidol

The psychiatric nurse documents that the cognitively impaired client is exhibiting "confabulation" when observed doing what? 1.Asking where the cats are when told it's "raining cats and dogs" 2.Telling other clients that the client "was a dairy farmer" when the client actually ran a small grocery store 3.Pacing nervously and resisting the staff's request to "get ready for bed" 4.Telling the staff repeatedly that "my name is George and I'm hungry"

2.Telling other clients that the client "was a dairy farmer" when the client actually ran a small grocery store

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? 1.Auditory 2.Visual 3.Gustatory 4.Olfactory

2.Visual

What is the greatest benefit support groups provide to the caregivers of clients diagnosed with dementia? 1.provides time away from the client 2.provides interaction with those with similar concerns 3.provides a social outlet 4.provides resources for needed services

2.provides interaction with those with similar concerns

The nurse should consider the intervention referred to as "going along with" when managing the care of which client? 1.the adolescent who is hitting and biting because he or she was given time out for disobeying unit rules 2.the older widower who is worried about his wife not being able to visit because of the snow 3.the young adult who is expressing concern about the "police being aliens" 4.the middle-aged adult who is convinced that the electrical cords are really snakes

2.the older widower who is worried about his wife not being able to visit because of the snow

The nurse is assessing a client who has received a tentative diagnosis of delirium. The nurse is explaining to the family about the major cause of the client's condition. Which statement by the nurse would be most appropriate? 1."The client's exposure to an infectious agent led us to determine the diagnosis." 2."Basically, this diagnosis is based on the client's inability to talk normally." 3."The client's diagnosis is primarily based on the rapid onset of the change in consciousness." 4."Your report of gradually developing confusion over time was the basis for the diagnosis."

3."The client's diagnosis is primarily based on the rapid onset of the change in consciousness."

After teaching a group of nursing students about dementia, the instructor determines a need for additional teaching when the students identify which as a primary goal of nursing care? 1.Addressing physiological and psychological needs 2.Management of confusion 3.Achievement of self-esteem needs 4.Protection from injury

3.Achievement of self-esteem needs

When assessing a client with dementia, the nurse notes that the client is having difficulty identifying common items, such as a ball or book. The nurse interprets this finding as what? 1.Apraxia 2.Disturbance of executive function 3.Agnosia 4.Aphasia

3.Agnosia

A nurse is providing education to the care provider of a cognitively impaired client who is prescribed a cholinesterase inhibitor. Which information about medication side effects should the nurse be sure to include? 1.Syncope 2.Skin rashes 3.Gastrointestinal (GI) symptoms 4.Bruising

3.Gastrointestinal (GI) symptoms

Delirium can be differentiated from many other cognitive disorders in which way? 1.It is characterized by a period of disorganization and confusion. 2.It is much less responsive to pharmacologic treatment than the other disorders. 3.It has a rapid onset and is highly treatable if diagnosed quickly. 4.It has as a slow onset, but if caught early it can be treated with medications.

3.It has a rapid onset and is highly treatable if diagnosed quickly.

The nurse is assessing a client who is diagnosed with delirium. Which presenting sign in the client indicates to the nurse that the client may may have a diagnosis of dementia? 1.Visual hallucinations 2.Impaired consciousness 3.Remote memory loss 4.Irrelevant speech

3.Remote memory loss

Which type of hallucination most commonly occurs in clients diagnosed with dementia? 1.Olfactory 2.Auditory 3.Visual 4.Gustatory

3.Visual

Which would not be considered a primary goal of nursing care for a client with delirium? 1.Meeting physiological and psychological needs 2.Protection from injury 3.Management of confusion 4.Achievement of self-esteem needs

4.Achievement of self-esteem needs

A client diagnosed with Alzheimer's disease has an alteration in language ability. This alteration would be documented as what? 1.Akinesia 2.Apraxia 3.Agnosia 4.Aphasia

4.Aphasia

A client was admitted to an inpatient unit with a diagnosis of dementia. A nursing assessment and interview of the client would include what? 1.Electroencephalogram, X-rays, blood chemistries, and skull series 2.Early parent-child conflict and relational patterns 3.Assessment of deep tendon reflexes and muscle strength 4.Intellectual ability, health history, and self-care ability

4.Intellectual ability, health history, and self-care ability

A client with dementia becomes extremely agitated shortly after being admitted to the psychiatric unit. The nurse is reluctant to use physical restraints to control the client. What is a likely reason the nurse has this reluctance? 1.Physical restraints may not be of any use in controlling the client. 2.Physical restraints may potentially become fatal for the client. 3.Physical restraints may cause injury to the client. 4.Physical restraints may increase the client's agitation.

4.Physical restraints may increase the client's agitation.

The client is 42 years old, married, and has two children, ages 16 and 18. The client is also caring for the client's parent, who is in the late stages of Alzheimer's disease. The nurse would want to assess the client for what? 1.Signs of dominance 2.Early signs of Alzheimer's disease 3.Likelihood to engage in elder abuse 4.Signs of stress

4.Signs of stress

A group of friends have arrived at the hospital to visit a client recently diagnosed with delirium. The nurse tells the friends they can visit with the client one at a time. What is the likely reason for the nurse to give this instruction? 1.The nurse wants the client to maintain an adequate balance of activity and rest. 2.The nurse wants to ensure the client's safety. 3.The nurse wants the client to demonstrate good orientation. 4.The nurse wants to prevent increasing the client's confusion.

4.The nurse wants to prevent increasing the client's confusion.

A nurse is caring for a client with delirium. The nurse assesses the client's activities of daily living on a daily basis. What is the most likely reason for assessing these so frequently? 1.To assess the prognosis of the client after therapy 2.To ensure the client is involved in therapy 3.To ensure the client establishes a daily routine 4.To assess for fluctuation in the client's capabilities

4.To assess for fluctuation in the client's capabilities

A nurse is studying the medical chart of a client with delirium. The nurse finds that the client was given haloperidol. What would be the most likely reason for administering this drug to the client? 1.To sedate the client 2.To minimize the effects of alcohol withdrawal 3.To improve dietary intake 4.To decrease agitation

4.To decrease agitation