Gero Chapter 21: Cognitive Impairment

4. Which assessment parameter should the nurse use to differentiate between delirium and depression in an older adult? a. Orientation c. Course over the morning hours b. Activity d. Psychomotor activity

a. Orientation

1. Which types of exercise programs are better for older adults with AD for improving mood and function? (Select all that apply.) a. Balance b. Walking c. Self-paced d. Endurance e. Muscle strength f. Lasting 16 weeks or longer

a. Balance d. Endurance e. Muscle strength f. Lasting 16 weeks or longer

11. Which medication administered for delirium under a controlled environment can reduce the duration and severity of delirium for high-risk patients? a. Haloperidol (Haldol) b. Thioridazine (Mellaril) c. Fluphenazine (Prolixin) d. Chlorpromazine (Thorazine)

a. Haloperidol (Haldol)

4. The nurse working in a long-term care facility completes her morning assessment on a new postoperative patient and notes a change in cognitive status from the previous day? The nurse recognizes which of the following as a precipitating factor for delirium? (Select all that apply.) a. Major medical treatment b. Poor sleep habits c. Admission to long-term care d. Pharmacological agents

a. Major medical treatment c. Admission to long-term care d. Pharmacological agents

10. An older woman has a wound infection 5 days after a below-the-knee amputation brought about by diabetes mellitus. Which of the following is the nurses priority intervention to prevent cognitive dysfunction and postoperative complications in this older adult? a. Remove invasive devices as soon as possible. b. Minimize the administration of opioid analgesics. c. Allow for self-care and independent activities. d. Administer short-acting benzodiazepines as needed.

a. Remove invasive devices as soon as possible.

2. Which of the following is(are) the risk factors for vascular dementia (VaD) after a stroke? (Select all that apply.) a. Smoking b. Male sex c. Hypertension d. Advancing age e. Hyperlipidemia f. African American

a. Smoking c. Hypertension e. Hyperlipidemia

12. When differentiating the characteristics of depression, delirium, and dementia, the nurse recognized which of the following as an indicator of delirium? a. Sudden onset b. Recent loss c. Insidious d. Life change

a. Sudden onset

2. At 10 PM, an older male resident attempts to climb over the bedrails. Which intervention should the nurse implement first? a. Talk to the resident about his behavior. b. Call the physician, and ask for a sedative. c. Apply a vest restraint on the resident. d. Get a companion to keep him in the bed.

a. Talk to the resident about his behavior.

9. Which of the following should the nurse use to assess a nonverbal older adult for delirium? a. Cranial nerves XI and XII b. Confusion Assessment Method c. MMSE-2 d. Controlled Word Association Test

b. Confusion Assessment Method

8. An older woman is recovering from a bowel resection in the intensive care unit but remains intubated and on a mechanical ventilator. Which of the following should the nurse implement to help prevent delirium in this woman? a. Assess cognition with MMSE-2. b. Provide uninterrupted periods of rest and sleep. c. Maintain adequate sedation and pain management. d. Cover the patients eyes with protective ophthalmic ointment.

b. Provide uninterrupted periods of rest and sleep.

3. A definitive diagnosis of Alzheimer disease (AD) can be made by detecting or using which one of the following methods? a. Clinical observation of dementia b. Inability to speak with relevance c. Development of neurofibrillary tangles d. Computed axial tomographic (CAT) scan

c. Development of neurofibrillary tangles

5. The nurse recognizes which of the following displays may indicate hyperactive delirium? a. Lethargy b. Withdrawn behavior c. Nonpurposeful repetitive movements d. Decreased psychoactive activity

c. Nonpurposeful repetitive movements

3. The community health nurse is preparing for an educational session on AD for a group of seniors. Which modifiable risk factors should the nurse include? (Select all that apply.) a. Family history b. Sex c. Smoking d. Obesity

c. Smoking d. Obesity

7. A man who is 60 years of age and lives in the British Isles develops dementia. Which qualities of dementia does the nurse assess to prevent patient injury related to the type of dementia this man most likely has? a. Visual hallucinations b. Unilateral tremors c. Visuospatial problems d. Clumsy movements

d. Clumsy movements

6. Which of the following approaches to hygienic care is beneficial for a patient with dementia? a. Schedule the patients full shower at 7 AM, three mornings every week. b. Have a team give the bath with each member washing a different body area. c. Wash the perineal region first to remove potentially infectious material. d. Explain each step as you go, and keep the patient covered as much as possible while bathing.

d. Explain each step as you go, and keep the patient covered as much as possible while bathing.

1. Which of the following statements is true about cognitive impairments in older adults? a. Loss or interruption of sleep can lead to delirium. b. Confusion is a normal and unavoidable consequence of aging. c. Older patients who are agitated often have a lower cognitive status than those who are quietly sitting. d. The Mini-Mental State Examination2nd edition (MMSE-2) should be administered on admission to detect delirium.

d. The Mini-Mental State Examination2nd edition (MMSE-2) should be administered on admission to detect delirium.