Chapter 28: Cognitive Disorders

A nurse is making a home visit to a client who has Alzheimer's disease to assess the home for safety. Which of the following are appropriate suggestions to decrease the client's risk for injury? A. Install childproof door locks. B. Place rugs over electrical cords. C. Mark cleaning supplies with colored tape. D. Place the client's mattress on the floor. E. Install light fixtures above stairs.

A, D, E

Which assessment data represents a risk for vascular dementia? A. Blood pressure of 180/110 mm Hg B. Head trauma that resulted in unconsciousness C. History of Pick disease D. Open-angle glaucoma

A. Blood pressure of 180/110 mm Hg The major risk factors for vascular dementia are hypertension, diabetes mellitus, previous stroke, cardiac arrhythmias, coronary artery disease, tobacco use, and alcohol or substance abuse.

Which behavior demonstrated by a patient diagnosed with Alzheimer disease supports the nurse's documentation that the patient is experiencing somatic preoccupation? A. Responds to all questions by answering, "I have a headache." B. Becomes restless and agitated each afternoon just before dinner. C. Consistently insists that a child's doll is a real baby. D. Believes that all strangers are aliens from another planet.

A. Responds to all questions by answering, "I have a headache." When all questions are answered with a statement regarding a physical complaint, the patient is demonstrating a somatic preoccupation.

10. An older adult patient diagnosed with delirium is anxious, agitated, and experiencing visual hallucinations. The nurse entering the room to assess vital signs should: a. announce his or her name and title, and what is happening. b. silently take the vital signs to minimize stimulation. c. ask the patient to identify place, person, and time. d. turn on all lights in the room.

ANS: A A patient who is anxious, confused, and experiencing sensory perceptual alterations needs help coping with the environment. Nurses should identify themselves whenever entering the room, giving both their name and title, and provide simple explanations and directives. The other options are inadvisable.

24. A newly admitted patient diagnosed with AD has demonstrated apraxia. The nurse should assist the patient with: a. grooming and hygiene. b. visual acuity. c. word finding. d. orientation.

ANS: A Apraxia is the inability to carry out motor activities despite intact motor function. The patient activity that would be altered by lack of motor function is grooming and hygiene.

2. A nurse assesses a newly admitted patient with possible delirium. Which aspect of the history contributes to confirmation of the diagnosis? a. Acute onset of cognitive symptoms b. Unchanging level of consciousness c. Loss of ability to think abstractly d. Paranoid delusions

ANS: A Delirium develops rapidly, as opposed to dementia, which has an insidious onset. Other symptoms of delirium include fluctuating level of consciousness, logical thoughts alternating with illogical thoughts, presence of visual hallucinations, and day-night sleep reversal. Loss of ability to abstract is also seen in dementia. Delusions are common to dementia.

3. Donepezil (Aricept) reduces symptoms for patients diagnosed with mild to moderate Alzheimer's disease (AD) by: a. enhancing acetylcholine (Ach) function. b. inhibiting serotonin reuptake. c. anti-oxidizing free radicals. d. reducing GABA action.

ANS: A In AD, the level of ACh in the brain is reduced. ACh is the primary neurochemical that affects memory and the ability to acquire new information. Donepezil is an anticholinesterase inhibitor and improves symptoms by making more ACh available. The drug does not have any of the actions mentioned in the other options.

11. Which assessment finding would be expected in a patient in the later stages of Huntington's disease? a. Jerking movements b. Cogwheel rigidity c. Withdrawal d. Irritability

ANS: A Myoclonic jerking, as well as cognitive dysfunction, characterize the later stages of Huntington's disease (HD). The distracters are seen in Parkinson's disease, are not part of the clinical picture of HD, or are characteristic of earlier stages.

13. The nurse teaches a family who provides in-home care for a patient diagnosed with dementia. Which measure to facilitate environmental safety should the nurse include? a. Install gates at the tops and bottoms of stairs. b. Store medications in a clearly visible place. c. Vary the daily schedule to provide variety and stimulation. d. Include daily activities that call for use of higher cognitive functions.

ANS: A Patients with dementia often have difficulty negotiating stairs and fall. Providing gates prevents the patient from entering the stairs and falling. The other options do not apply, because they do not promote safety or might produce demands that exceed the patient's ability to function.

21. A patient has coronary artery disease, type 2 diabetes, and hypertension. The patient has risk factors for: a. vascular dementia. b. Parkinson's dementia. c. diffuse Lewy body disease. d. frontotemporal lobe dementia.

ANS: A Risk factors for strokes causing dementia include hypertension, coronary artery disease, cardiac arrhythmias, and diabetes. These health problems are not associated with the other dementias mentioned.

20. A patient diagnosed with vascular dementia gets more confused, agitated, and anxious in the evening. This behavior represents: a. sundowning. b. moonlighting. c. differentiating. d. misinterpreting.

ANS: A The sundown syndrome is the name given to behavior that occurs late in the afternoon or early evening when a patient with dementia becomes more confused. It is sometimes called "sundowning." Moonlighting refers to working a second job. Differentiating refers to making distinctions between or among things. Misinterpreting refers to incorrectly perceiving the environment.

6. An older adult patient has fluctuating levels of awareness, anxiety, and appears to be picking things out of the air. The patient says, "I saw my granddaughter standing at the foot of the bed last night." The nurse should suspect: a. delirium. b. dementia. c. schizophrenia. d. bipolar disorder.

ANS: A The symptoms presented are consistent with the symptoms of delirium. Fluctuating levels of consciousness are not characteristic of dementia, schizophrenia, or bipolar disorder.

16. What is the nursing care priority for a patient diagnosed with Stage 7 Alzheimer's disease? a. Nutrition and hydration b. Promoting self-care activities c. Supporting attempts to communicate d. Preserving problem-solving abilities

ANS: A When dementia is severe, the individual is incapable of independently meeting nutrition and hydration needs and must receive assistance. The other options refer to inappropriate emphases for care.

1. Which aspects of assessment are most important for a patient with diffuse Lewy body disease who is agitated? Select all that apply. a. Medications recently administered b. Objective signs of pain c. Sleep disturbances d. Urinary output e. Heart sounds

ANS: A, B, C, D Patients with dementia who exhibit disruptive behavior might be delirious, confused, or in pain. Because they cannot make their needs known, the nurse should investigate all possible causes. Agitation may result from urinary retention. Heart sounds are not likely to be affected.

23. A patient diagnosed with dementia is watching a crime story on television. Suddenly, the patient begins to yell, "Stop! He's got a gun." What is the nurse's best intervention? a. Administer a PRN dose of an atypical antipsychotic medication. b. Turn off the television and tell the patient, "You are safe." c. Reassure the patient that there are no guns nearby. d. Provide a snack, and put the patient in bed.

ANS: B Patients with cognitive deficits might be overwhelmed by stimuli and might misperceive something on television as occurring in reality. If this occurs, stimuli should be reduced to simplify the environment. The other measures would be somewhat less effective, because they do not include removing the offending stimulus (the television).

17. Which assessment finding would be expected in a patient in the early stage of HD? a. Cogwheel rigidity b. Irritability c. Apraxia d. Aphasia

ANS: B Personality changes are often evident in increased irritability in early HD. The distracters are seen in Parkinson's disease or dementia.

22. A patient with vascular dementia does not remember family members' names. The family insistently reorients the patient, and the patient becomes more agitated. What is the most likely reason for the patient's reaction? The patient is: a. using agitation to distract the family from the cognitive deficits. b. overstimulated by the reorientation and reacting negatively. c. reliving family chaos that was previously unresolved. d. experiencing guilt about the memory deficits.

ANS: B Reorientation in this case presents a demand that exceeds the patient's capacity to function and creates stress. In this situation, it would be more humane to visit the patient and communicate love and acceptance without being concerned about whether or not the patient can remember names.

7. An older adult patient is admitted with a diagnosis of delirium secondary to a urinary tract infection. The family asks whether or not the patient will recover. Select the nurse's best response. a. "The healthcare provider is the best person to answer your question." b. "The confusion will probably get better as we treat the infection." c. "Unfortunately, delirium is a progressively disabling disorder." d. "I will be glad to contact the chaplain to talk with you."

ANS: B Usually, as the underlying cause of the delirium is treated, the symptoms of delirium clear. The distracters mislead the family.

19. Last year a patient had a subtotal gastrectomy after being diagnosed with stomach cancer. Now the patient says, "I'd rather take vitamin pills than shots." Which information should the nurse provide to this patient? a. Most patients have difficulty remembering to take the vitamins. Deficits can precipitate a recurrence of the cancer. b. Injections are needed, because the loss of stomach tissue reduces absorption of vitamin B12. c. Injections will eventually be replaced with pills, but it is too soon after the gastrectomy. d. Injections prevent development of NPH and delirium.

ANS: B Vitamin B12 is absorbed in the stomach, aided by intrinsic factor. Deficiency leads to dementia. Regular supplementation of vitamin B12 prevents the deficiency and development of cognitive symptoms. The injections will be needed for life.

5. An older adult with dementia describes a pencil as "that thing that writes" and a water faucet as "the thing you turn." The nurse documents which problem? a. Echolalia b. Apraxia c. Agnosia d. Amnesia

ANS: C Agnosia is defined as failure to recognize or identify objects despite intact sensory function. Apraxia refers to inability to carry out motor activities. Echolalia is repeating what others say. Amnesia refers to learning and recalling information.

4. The focus of nursing care for a patient diagnosed with dementia is: a. individualizing care. b. improving cognition. c. maintaining optimum function. d. promoting self-confidence and self-esteem.

ANS: C Because memory is impaired, an individual with dementia cannot learn easily, so maintaining functioning as long as possible is important. The patient's abilities are expected to decline over time. Use of the word "optimum" suggests the changing nature of the level of functioning. Individualizing care and promoting esteem and confidence are of lesser importance than maintaining optimal function.

15. A nurse gives anticipatory guidance to the family of a patient diagnosed with mild AD. Which problem common to that stage should be addressed? a. Violent outbursts b. Emotional disinhibition c. Communication deficits d. Inability to feed or bathe self

ANS: C Families should be made aware that the patient will have difficulty concentrating and following or carrying on in-depth or lengthy conversations. The other symptoms are usually seen at later stages of the disease.

9. An older adult patient developed delirium secondary to diphenhydramine (Benadryl) use. The patient usually took this drug for allergies but recently added a cough syrup that also contained the drug. What information is most important to teach the family? a. Older adults are more prone to delirium. b. The patient is now susceptible to progressive cognitive decline. c. Toxic medication levels often occur because of slower metabolism in older adults. d. The older adult brain has fewer neurotransmitters than the brain of a younger person.

ANS: C Older adult patients metabolize drugs more slowly as a result of declining liver function. Excretion might also be slowed. Drugs might accumulate until toxic levels are reached and cognitive symptoms appear. Anticholinergic drugs, antihistamines, and antiarrhythmia drugs are of particular concern. For this reason, families need to be aware of the drugs that older adults are using and the possible interactions among the drugs, and be alert for early symptoms of cognitive disturbance. Although older adults are more prone to delirium, it's important to provide more specific information to the family. None of the other options are correct.

25. Which vector is associated with transmission of variant Creutzfeldt-Jakob disease? a. Dog ticks b. Mosquito bites c. Airborne particles d. Contaminated meat

ANS: D Contaminated meat is the vector for variant Creutzfeldt-Jakob disease. Dog ticks are the vector for Rocky Mountain spotted fever and Lyme disease. Mosquitoes are the vector for encephalitis. Airborne particles spread tuberculosis.

12. A patient diagnosed with delirium stares at the corner of the room, wrings hands, and says, "I'm scared those snakes will bite me." The nurse should document: a. agnosia. b. disorientation. c. confabulation. d. visual hallucinations.

ANS: D Seeing objects that are not visible to another person can be documented as having visual hallucinations, rather than any of the other choices.

14. The family of a patient diagnosed with AD is concerned about the patient's occasional urinary incontinence. The nurse should give which suggestion? a. Use adult diapers. b. Put a sign on the bathroom door. c. Limit fluid intake to 1,000 ml daily. d. Take the patient to the bathroom every 2 hours.

ANS: D Seeing to it that the patient goes to the bathroom every 2 hours will minimize episodes of incontinence. Severe dementia might require adult diapers. Limiting fluids is never advised. Placing a sign on the bathroom door is effective only when the patient recognizes the need to void but is unable to find the bathroom.

18. An older adult suddenly develops urinary incontinence. A family member says the patient "started walking oddly, like stepping on a sticky floor." Which problem would the nurse suspect? a. Pick's disease b. Parkinson's disease c. HD d. Normal-pressure hydrocephalus (NPH)

ANS: D The classic triad of symptoms associated with NPH is urinary incontinence, ataxic gait, and dementia. Early dementia might be manifested by impairment in activities of daily living, dulling of personality, and lack of motivation. NPH is treatable with ventro-peritoneal shunting.

A nurse is caring for a client who has Alzheimer's disease and is beginning to experience noticeable short-term memory loss. When discussing a new prescription for donepezil (Aricept), the nurse should include which of the following in the teaching? A. "You should avoid taking over-the-counter acetaminophen while on donepezil." B. "You can expect the progression of cognitive decline to slow with donepezil." C. "You will be screened for underlying kidney disease prior to starting donepezil." D. "You should stop taking donepezil if you experience nausea or diarrhea."

B

A nurse is performing an admission assessment for a client who has delirium related to an acute urinary tract infection. Which of the following are expected findings? (Select all that apply.) A. History of gradual memory loss B. Family report of personality changes C. Hallucinations D. Unaltered level of consciousness E. Restlessness

B, C, E

Which behavior demonstrated by a patient diagnosed with Alzheimer disease supports the nurse's documentation that the patient is experiencing "Sundowning"? A. Responds to all questions by answering, "I have a headache." B. Becomes restless and agitated each afternoon just before dinner. C. Consistently insists that a child's doll is a real baby. D. Believes that all strangers are aliens from another planet.

B. Becomes restless and agitated each afternoon just before dinner. "Sundowning" is manifested in physical and emotional agitation that regularly happens at a similar time each day, often after 4:30 P.M.

What assessment data confirms the presence of early, noticeable cognitive dysfunction generally noted in patients diagnosed with dementia? A. Claims having problems "finding the right word" B. Unable to remember date and day of the week C. Has a short attention span D. Usually is unable to recognize children or spouse

B. Unable to remember date and day of the week Memory loss is the most noticeable effect initially. Impairment of short-term memory usually occurs first but is eventually followed by long-term memory loss as well.

A nurse is making a home visit to a client who is in the late stage of Alzheimer's disease. The client's spouse, who is the primary caregiver, wishes to discuss concerns about the client's nutrition and the stress of providing care. Which of the following is an appropriate action by the nurse? A. Verify that a current power of attorney document is on file. B. Instruct the client's spouse to offer finger foods to increase oral intake. C. Provide information on resources for respite care. D. Schedule the client for placement of an enteral feeding tube.

C

An older adult who is diagnosed with dementia says, "I can't find my purse, and I think someone stole it!" What is the nurse's most therapeutic response? A. "How much money did you lose?" B. "You sound suspicious of the staff." C. "I will help you look for your purse." D. "Keep looking for it; I am sure you will find it."

C. "I will help you look for your purse." Helping the patient avoids arguing and goes along with the concern followed by therapeutic distraction.

Which behavior demonstrated by a patient diagnosed with Alzheimer disease supports the nurse's documentation that the patient is experiencing illusions? A. Responds to all questions by answering, "I have a headache." B. Becomes restless and agitated each afternoon just before dinner. C. Consistently insists that a child's doll is a real baby. D. Believes that all strangers are aliens from another planet.

C. Consistently insists that a child's doll is a real baby. An illusion is a misinterpretation of something that really does exist. Thinking a doll is a real baby is an example of an illusion.

In adapting interaction strategies while working with an individual with early Alzheimer disease, what is the priority nursing intervention? A. Speaking loudly and clearly B. Giving instructions slowly and repeatedly C. Using a calm and matter-of-fact tone D. Regularly providing reality orientation and reminders

C. Using a calm and matter-of-fact tone A calm approach works best with approaching such an individual; it avoids projection of anxiety from the nurse to the patient. Loud volume may create agitation. Giving instructions slowly is appropriate for process needs in the individual, but repeated instructions can serve to remind the individual of his or her deficits and is considered counterproductive. Constant reminders may be non-therapeutic and unsupportive of the individual struggling with memory deficits.

A nurse in a long-term care facility is caring for a resident who has major neurocognitive disorder and attempts to wander out of the building. The client states, "I have to get home." Which of the following is an appropriate response by the nurse? A. "You have forgotten that this is your home." B. "You cannot go outside without a staff member." C. "Why would you want to leave? Aren't you happy with your care?" D. "I am your nurse. Let's walk together to your room."

D

Which nursing intervention would benefit an individual diagnosed with dementia who experiences short-term memory difficulties? A. An exercise group B. A reminiscence group C. A menu of favorite foods D. A daily activity schedule

D. A daily activity schedule A daily schedule would support the memory of such an individual, with prompts and reminders thus serving as an anchoring technique to refer to as needed.

Which behavior demonstrated by a patient diagnosed with Alzheimer disease supports the nurse's documentation that the patient is experiencing delusions? A. Responds to all questions by answering, "I have a headache." B. Becomes restless and agitated each afternoon just before dinner. C. Consistently insists that a child's doll is a real baby. D. Believes that all strangers are aliens from another planet.

D. Believes that all strangers are aliens from another planet. Delusions are misconceptions that have no basis in reality, such as the existence of alien beings.

The pathophysiology of which diagnosis will be the first to present a need for 24-hour patient care? A. Alzheimer disease B. Parkinson disease dementia C. Dementia with Lewy bodies D. Frontotemporal lobe dementia (FLD; Pick disease)

D. Frontotemporal lobe dementia (FLD; Pick disease) The outcome for individuals with FLD is poor, as the disease may progress rapidly, requiring either institutional or 24-hour care.

A patient diagnosed with vascular dementia is engaged in a conversation with the nurse in the dayroom. When the nurse observes that he is becoming agitated, which intervention will help de-escalate the situation? A. Joke with the patient to defuse his anger. B. Bring other staff into the conversation to distract him. C. Turn the television on while redirecting his attention. D. Stop talking, and slowly back away from him.

D. Stop talking, and slowly back away from him. If an interaction is going poorly, stop, walk away (providing it is safe to do so), and return in a few minutes with a fresh start. Do not use sarcasm, jokes, and metaphors because the patient's loss of abstract thinking makes understanding these language subtleties almost impossible. Lots of chatter can be confusing, because patients struggle to track one conversation when several are going on around them. The television would only serve to agitate the patient more.

2. A nurse assesses a newly admitted patient with possible delirium. Which aspect of the history provides by family members contributes to confirmation of the diagnosis? a. "He became confused all of a sudden." b. "He is always conscious and alert." c. "He doesn't seem to understand jokes anymore." d. "He is so distrustful of everyone now."

a. "He became confused all of a sudden."

7. An older adult presents with symptoms of delirium. The family says, "Everything was fine until yesterday." What is the most important assessment information the nurse should gather? a. A list of medications the patient currently takes. b. Whether or not the patient has experienced any recent losses. c. Whether or not the patient has ingested aged or fermented foods. d. The patient's recent personality characteristics and changes.

a. A list of medications the patient currently takes.

3. What is the expected outcome for donepezil therapy prescribed for a client diagnosed with mild-to-moderate Alzheimer disease (AD)? a. Better daily function than without treatment b. Temporary interruption of disease process c. Remissions of varying lengths of time d. Marked decrease in memory impairment

a. Better daily function than without treatment

10. Effective management of a client diagnosed with Huntington disease is best demonstrated by which documentation made by the nurse? a. Bilateral lung sounds clear with no signs of dyspnea. b. Client denies any visual hallucinations. c. Disorientation noted only in the evenings. d. Client denies any hearing limitations.

a. Bilateral lung sounds clear with no signs of dyspnea.

5. An older adult patient has fluctuating levels of awareness, anxiety, and appears to be picking things out of the air. The patient says, "I saw my granddaughter standing at the foot of the bed last night." The nurse should suspect which disorder? a. Delirium b. Dementia c. Schizophrenia d. Bipolar disorder

a. Delirium

20. A newly admitted patient diagnosed with Alzheimer disease (AD) has demonstrated apraxia. The nurse should assist the patient with which activity? ' a. Grooming and hygiene b. Reading written material c. Word finding d. Orientation

a. Grooming and hygiene

4. What assessment data suggest that a client is at risk for the development of vascular dementia? (Select all that apply.) a. History of type 2 diabetes b. Currently prescribed antihypertensive medication c. Presents early signs/symptoms of Parkinson disease d. Being treated for atrial fibrillation e. 2 pack a day cigarette habit

a. History of type 2 diabetes b. Currently prescribed antihypertensive medication d. Being treated for atrial fibrillation e. 2 pack a day cigarette habit

What is the nursing care priority for a patient diagnosed with stage 7 Alzheimer disease? a. Nutrition and hydration b. Promoting self-care activities c. Supporting attempts to communicate d. Preserving problem-solving abilities

a. Nutrition and hydration

3. Which nursing interventions are appropriate for the management of a client demonstrating the behaviors associated with dementia-related "sundowning"? (Select all that apply.) a. Staff is trained to de-escalate an agitated client. b. Frequent reorientation to time and place helps minimize the effects of sundowning. c. Client is closely monitored during the late afternoon and evening hours. d. The client is provided with a safe place to pace. e. The client's family is educated to the fact that this behavior is a result of overstimulation.

a. Staff is trained to de-escalate an agitated client. c. Client is closely monitored during the late afternoon and evening hours. d. The client is provided with a safe place to pace.

Which interventions are appropriate for inclusion into the plan of care for a client diagnosed with Parkinson's disease? (Select all that apply.) a. Speech therapy for language skills impairment b. Falls risk precautions c. Frequent depression screening d. Monitoring for obsessive-compulsive disorder (OCD) tendencies e. Education concerning risks associated with prescribed atypical antipsychotic medication therapy

b. Falls risk precautions c. Frequent depression screening e. Education concerning risks associated with prescribed atypical antipsychotic medication therapy

18. A patient diagnosed with vascular dementia does not remember family members' names. The family insistently reorients the patient, and the patient becomes more agitated. What is the most likely reason for the patient's reaction? a. He or she is using agitation to distract the family from the cognitive deficits. b. He or she is overstimulated by the reorientation and reacting negatively. c. He or she is reliving family chaos that was previously unresolved. d. He or she is experiencing guilt about the memory deficits.

b. He or she is overstimulated by the reorientation and reacting negatively.

17. An older patient had a subtotal gastrectomy after being diagnosed with stomach cancer. What long-term mental health risk related to this procedure should the nurse discuss with the patient? a. The increased risk of depression b. The risk of vitamin B12-related dementia. c. The risk of postsurgical delirium d. The increased risk of Parkinson disease

b. The risk of vitamin B12-related dementia.

19. A patient diagnosed with dementia is watching a crime story on television. Suddenly, the patient begins to yell, "Stop! He's got a gun." What is the nurse's best intervention? a. Administer a PRN dose of an atypical antipsychotic medication. b. Turn off the television and tell the patient, "You are safe." c. Reassure the patient that there are no guns nearby. d. Provide a snack, and put the patient in bed.

b. Turn off the television and tell the patient, "You are safe."

1. An older adult diagnosed with dementia is documented as demonstrating agnosia. Which client statements support this documentation? (Select all that apply.) a. "My hands seem to shake all the time." b. "I can't hold that cup without spilling the coffee." c. "I signed my name with that thing that writes." d. "I don't remember ever meeting you before." e. "The water came out of that thing you turn."

c. "I signed my name with that thing that writes." e. "The water came out of that thing you turn."

4. The focus of nursing care for a patient diagnosed with dementia is best demonstrated by which nursing statement? a. "The client's plan of care is individualized to meet his or her specific needs." b. "I think that reminiscence therapy will help the client remember past events better." c. "If we give the client enough time they can dress themselves appropriately each morning." d. "The client was so proud when they talked about their war experiences."

c. "If we give the client enough time they can dress themselves appropriately each morning."

8. An older adult patient developed delirium secondary to diphenhydramine use. The patient usually took this drug for allergies but recently added a cough syrup that also contained the drug. What information is most important to teach the family? a. Older adults are more prone to delirium. b. The patient is now susceptible to progressive cognitive decline. c. Toxic medication levels often occur because of slower metabolism in older adults. d. The older adult brain has fewer neurotransmitters than the brain of a younger person.

c. Toxic medication levels often occur because of slower metabolism in older adults.

21. Which vector is associated with transmission of variant Creutzfeldt-Jakob disease? a. Dog ticks b. Mosquito bites c. Airborne particles d. Contaminated meat

d. Contaminated meat

16. What information should the nurse provide the family of a client diagnosed with normal-pressure hydrocephalus (NPH)? a. It eventually develops into Pick disease b. There is currently no treatment for this condition c. Few clients regain cognitive abilities d. The related dementia is potentially reversible

d. The related dementia is potentially reversible