361: Chapter 24: Cognitive Disorders

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

Achievement of self-esteem needs

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? Acetylcholine Epinephrine Serotonin Norepinephrine

Acetylcholine

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

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? Aphasia Apraxia Agnosia Disturbance of executive function

Agnosia

__________ disease is characterized by atrophy of cerebral neurons, the presence of senile plaque deposits, and enlargement of the third and fourth ventricles.

Alzheimer

What is the primary sign of delirium? An altered level of consciousness Impaired socialization Disturbed sleep-wake cycles Inability to fulfill roles

An altered level of consciousness

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

Apraxia

When conducting a nursing assessment of a client experiencing moderate cognitive dysfunction, the nurse can best prepare for an effective interview by ensuring what? Asking a family member to be present during the assessment Being sure the client is well rested before beginning the interview Sitting beside the client and using touch to be supportive Breaking up the assessment into several short periods rather than a continuous one

Asking a family member to be present during the assessment

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? Strands of protein are tangled together. Blood flow in the vessels to the brain are blocked. Fragments mix with molecules to make plaques in the brain. Acetylcholine production is decreased.

Blood flow in the vessels to the brain are blocked.

__________ is the tendency for individuals with dementia to make up answers to fill gaps in their memory.

Confabulation

An older client has recently finished treatment for a urinary tract infection (UTI) and has now developed changes in behavior resulting in decreased cognition. Which priority intervention(s) should the nurse perform? Select all that apply. Stop the prescribed antibiotic therapy. Contact the health care provider. Maintain adequate hydration. Obtain an order for sedation. Obtain a repeat urine culture.

Contact the health care provider. Maintain adequate hydration. Obtain a repeat urine culture.

The ability to plan, abstractly think, and monitor or stop complex behavior is known as __________ functioning.

Executive

True or False: Agnosia is the impaired ability to execute motor functions despite intact motor abilities.

False

True or False: Delirium is an irreversible condition that has a slow onset.

False

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? Gastrointestinal (GI) symptoms Skin rashes Syncope Bruising

Gastrointestinal (GI) symptoms

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? Tacrine Rivastigmine Haloperidol Galantamine

Haloperidol

A client is exhibiting signs of mild delirium such as occasional confusion about why the client is in the hospital and what day of the week it is. When developing a care plan, the nurse identifies several strategies to improve the client's cognitive function. Which intervention will be helpful to the client? Keep the television on to provide stimulation. Have someone play checkers with the client. Make up a daily calendar with the date and the times of scheduled activities. Have the client rest.

Make up a daily calendar with the date and the times of scheduled activities.

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? Physical restraints may cause injury to the client. Physical restraints may not be of any use in controlling the client. Physical restraints may potentially become fatal for the client. Physical restraints may increase the client's agitation.

Physical restraints may increase the client's agitation.

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

Risk for injury related to confusion and cognitive deficits

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

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

A nurse's 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 Alzheimer's disease and is prone to agitation, which measure may help in preventing this client's agitation? Decreasing the frequency of the client's baths from two times to one time per week Reminding the client multiple times that he or she will be soon having a bath Reinforcing the facility's zero-tolerance policy for aggressive behavior Providing all of the client's daily medications early on the day of a scheduled bath

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

An effective intervention with dementia is __________ therapy, which involves aiding the client to think about or personally relate to significant past experiences.

Reminiscence

The nurse receives a report that a 75-year-old client is recovering from surgery. During the shift, the nurse notes that the client is forgetful and restless. Several times, the client calls the nurse the name of the client's daughter. The nurse interprets this behavior as what? Normal for the first postoperative day Normal, given the client's age Signs of early Alzheimer's disease Signs of delirium

Signs of delirium

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

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? The client will demonstrate increased feelings of self-worth. The client will identify life areas that require alterations due to illness. The client will demonstrate decreased agitation. The client will remain free from injury.

The client will remain free from injury

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? The nurse wants to ensure the client's safety. The nurse wants to prevent increasing the client's confusion. The nurse wants the client to demonstrate good orientation. The nurse wants the client to maintain an adequate balance of activity and rest.

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? To ensure the client is involved in therapy To ensure the client establishes a daily routine To assess the prognosis of the client after therapy To assess for fluctuation in the client's capabilities

To assess for fluctuation in the client's capabilities

True or False: Adult children who care for parents with dementia can experience role reversal, which increases the risk of their developing a mental health concern.

True

True or False: In caring for a confused client with dementia, the nurse can use distraction by shifting the client's attention and energy to a more neutral topic.

True

True or False: Traumatic brain injury can cause dementia as a direct pathophysiological consequence of head trauma.

True

An individual with __________ dementia demonstrates a pattern of abrupt changes in functioning alternating with plateaus in functioning.

Vascular

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? Auditory Visual Gustatory Olfactory

Visual

Family members bring an older client, recently diagnosed with Alzheimer disease, to the clinic stating they need placement in a facility for their loved one. Which finding would support further assistance in care giving for this client? age of the client client maintaining stoic affect client wandering off client preferring to take showers

client wandering off

An older adult client develops delirium secondary to an infection. Which would be the most likely cause? Pneumonia Cellulitis Low platelet count Appendicitis

pneumonia

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

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? the adolescent who is hitting and biting because he or she was given time out for disobeying unit rules the young adult who is expressing concern about the "police being aliens" the middle-aged adult who is convinced that the electrical cords are really snakes the older widower who is worried about his wife not being able to visit because of the snow

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

Which type of hallucination is most commonly seen in clients diagnosed with delirium? Visual Auditory Gustatory Autonomic

visual