question

The nurse is caring for a client with Alzheimer's disease. The nurse observes that the client's pacing and mumbling to himself increase at mealtime and shift change. Which of the following interventions should the nurse implement first?

answer

Move the client to a quieter area during these times.

question

The primary sign of delirium is

answer

An altered level of consciousness

question

An 80-year-old is brought to the clinic by his wife. He has a history of peripheral vascular disease and Type 2 diabetes. The wife states that he hasn't seemed himself for the preceding few days, noting that he has been lethargic and mildly confused at times and has been incontinent of urine. She reports that his blood glucose levels have been elevated. The nurse considers which of the following as the most likely explanation for the client's change in mental status?

answer

Delirium related to underlying medical problem

question

Delirium results from multiple causes. Which of the following is a metabolic cause of delirium?

answer

Hypoglycemia

question

Jennifer is a 79-year-old woman who has been showing signs of dementia. While she has some cognitive delays during the day, she becomes increasingly irritable and experiences hallucinations at night. This phenomenon is known as which of the following?

answer

Sundowning

question

Keisha is a 42-year-old married woman with two children, ages 16 and 18. She is also caring for her mother, who is in the late stages of Alzheimer's disease. The nurse would want to assess Keisha for which of the following?

answer

Signs of stress

question

The psychiatric nurse documents that the cognitively impaired client is exhibiting "confabulation" when observed

answer

Telling other clients that he "was a dairy farmer" when he actually ran a small grocery store

question

A client with Alzheimer's disease has a nursing diagnosis of risk for injury related to memory loss, wandering, and disorientation. Which nursing intervention should appear in this client's care plan to prevent injury?

answer

Remove hazards from the environment.

question

A client is exhibiting signs of mild delirium such as occasional confusion about why he 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 of the following interventions will be helpful to the client?

answer

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

question

Which of the following terms is used to describe deterioration in language function?

answer

Aphasia

question

Cognitive mental disorders are characterized by which of the following?

answer

Impaired attention, memory, and abstract thinking

question

When giving tacrine (Cognex) to an elderly client, the nurse must be aware that

answer

because the liver is most vulnerable to tacrine, liver function tests must be done periodically.

question

Which type of therapy encompasses thinking about or relating personally significant past experiences?

answer

Reminiscence therapy

question

While the nurse is caring for a hospitalized client in the advanced stages of Alzheimer's disease, the client begins to have a catastrophic reaction to feeding himself. Which of the following should the nurse do first?

answer

Remain calm and reassuring.

question

Which of the following is the most consistent and dramatic cognitive impairment seen in dementia?

answer

Memory

question

Paul is an 84-year-old man suffering from delirium. He has been in a nursing home for the past 2 years, but recently is becoming combative and has become a threat to staff. Which of the following medication would Paul most likely receive for these symptoms?

answer

Haloperidol (Haldol)

question

Which type of therapy involves shifting the client's attention and energy to a more neutral topic?

answer

Distraction

question

A client with Alzheimer's disease says, "I'm so afraid. Where am I? Where is my family?" How should the nurse respond?

answer

"You are in the hospital, and you're safe here. Your family will return at 10 o'clock, which is 1 hour from now."

question

The nurse is caring for a client with dementia. The client's brain images show atrophy of cerebral neurons and enlargement of the third and fourth ventricles. What is the cause of dementia in this client?

answer

Alzheimer's disease

question

Changes that are found during the mental status examination of a patient diagnosed with delirium include which of the following?

answer

Difficulty focusing

question

The nurse can distinguish delirium from dementia by knowing which of the following?

answer

Dementia has a gradual onset and is progressive in course.

question

A client with Alzheimer's disease is confused and mumbling incoherently and rambling. To help redirect the client's attention, the nurse should encourage the client to

answer

Fold towels

question

When planning care for a client newly diagnosed with Alzheimer's disease, the nurse should focus on

answer

Providing a safe, structured environment

question

When conducting a nursing assessment on a client experiencing moderate cognitive dysfunction, the nurse best prepares for an effective interview by

answer

Asking a family member to be present during the assessment

question

Which of the following is the hallmark of beginning mild dementia?

answer

Forgetfulness

question

A patient diagnosed with Alzheimer's disease has an alteration in language ability. This alteration would be documented as which of the following?

answer

Aphasia

question

A client has been diagnosed with delirium. Which of the following is the priority intervention for a client diagnosed with delirium?

answer

Maintenance of safety

question

Research has confirmed that dementia with Lewy bodies involves

answer

Ineffective chemical action of acetylcholine and dopamine

question

A client with moderate Alzheimer's disease is living with her grown daughter. Which of the following statements by the daughter would indicate the need for intervention by the nurse?

answer

"Mother won't let anyone else do anything for her."

question

A client has been admitted to an inpatient unit for treatment of delirium. Which of the following is the primary treatment for delirium?

answer

Identify and treat any causal or contributing medical conditions

question

Which type of therapy encompasses thinking about or relating personally significant past experiences?

answer

Reminiscence therapy

question

A client is being evaluated for decline in cognitive function. The client's wife asks the nurse to explain the term dementia to her. The nurse bases her response on the knowledge that dementia is which of the following?

answer

A primary brain pathology

question

Which of the following is the priority intervention for a client diagnosed with delirium?

answer

Maintenance of safety

question

A client is admitted to the psychiatric unit after taking various medications and illegal substances to get "high." In addition to his underlying diagnosis of bipolar disorder, the client is diagnosed with delirium. Currently he is experiencing mild hallucinations and confusion. Which intervention should the nurse do first?

answer

Arrange for an unlicensed assistant to sit with the client.

question

Which of the following terms describes an inability to recognize or name objects despite intact sensory abilities?

answer

Agnosia

question

A client has been diagnosed with delirium. Which of the following is the priority intervention for a client diagnosed with delirium?

answer

Maintenance of safety

question

Major goals for the nursing care of clients with dementia include that the client will

answer

be safe; be physiologically stable; have infrequent episodes of agitation.

question

The nurse preparing an educational program on dementia includes that

answer

Dementia symptomology has a gradual onset

question

Which of the following is the primary treatment for delirium?

answer

Identify and treat any causal or contributing medical conditions

question

Which of the following nursing diagnoses would be the priority for the client experiencing acute delirium?

answer

Risk for Injury related to confusion and cognitive deficits

question

A nurse is caring for a client with delirium. The client sees a thermometer on the nurse's table and shouts, "Don't stab me!" and cowers. Which feature of delirium is this client exhibiting?

answer

Illusion

question

Which of the following terms is used to describe the inability to execute motor functioning, despite intact motor abilities?

answer

Apraxia

question

When a client who is generally pleasant and cooperative begins to show aggressive behavior toward most members of the milieu, the nurse suspects he has experienced cerebral trauma to the

answer

Frontal lobes

question

A client with Alzheimer's disease is admitted to the acute care facility for treatment of an infection. Assessment reveals that the client is anxious. When developing the client's plan of care, which of the following would be least appropriate to include?

answer

Frequently provide reality orientation.

question

Clients diagnosed with delirium frequently experiences misinterpretations, illusions, and hallucinations. Which type of hallucination is most commonly seen in clients diagnosed with delirium?

answer

Visual

question

Parkinson's disease is thought to be caused by

answer

a decreased number of brain cells in the substantia nigra, resulting in dopamine depletion.

question

In patients with Alzheimer's disease, neurotransmission is reduced, neurons are lost, and the hippocampal neurons degenerate. Which neurotransmitter is involved in cognitive functioning?

answer

Acetylcholine

question

Jean has early Alzheimer's disease. When asked about her family history, she relates that she has two children who are both grown and who visit her around the holidays each year. The nurse subsequently discovers that Jean has one child who is currently assigned overseas and has not been home for 2 years. Which of the following would best describe Jean's behavior?

answer

Jean is confabulating, most likely to cover for her memory deficit.

question

An older client comes to the clinic for a yearly physical exam. During the assessment, the client tells the nurse that he sometimes has begun feeling anxious about his forgetfulness. The nurse notes the client may have mild dementia. Which finding would lead the nurse to conclude this?

answer

The client has difficulty finding words

question

Which of the following is an infection-related cause of delirium?

answer

Pneumonia

question

The most effective intervention for clients with delirium is which of the following?

answer

Managing environmental stimuli

question

The nurse, aware that the human brain experiences changes with age, recognizes that diagnostic studies of a 75 year old will show (Select all that apply.)

answer

• Brain weight has decreased in last 5 years • Decrease in gray matter • Decrease in white matter

question

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?

answer

"His diagnosis is primarily based on the rapid onset of his change in consciousness."

question

Which of the following would not be considered a primary goal of nursing care for a client with delirium?

answer

Achievement of self-esteem needs

question

The diagnosis of delirium is supported when the nurse documents that the client

answer

Is convinced that she sees "hundreds" of bugs and is not always oriented to time and place

question

A 35-year-old woman is delirious after being lost in the woods for several days and becoming severely dehydrated. At 9:00 PM she tells the nurse to get her clothes because she has to get home to her family. Which of the following responses by the nurse is most therapeutic?

answer

"You're in the hospital. You did not drink for several days, but you're getting better now."

question

Delirium is different from many other cognitive disorders in that it

answer

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

question

Which type of hallucination is most commonly seen in patients diagnosed with dementia?

answer

Visual

question

Henry is a 68-year-old man who has been showing signs of Alzheimer's disease, including visual hallucinations and disturbed behaviors. When he was placed on antipsychotic medications, Henry suffered significant adverse reactions. This could indicate that Henry does not have Alzheimer's disease, but which of the following conditions?

answer

Lewy body disease

question

The hallmark of amnestic disorders is

answer

short-term memory loss.

question

The nurse receives a report that a 75-year-old client recovering from surgery is awake, alert, and oriented to person, place, and time. During the shift, the nurse notes that the client is forgetful and restless. Several times, the client calls the nurse Audrey, which is the name of the client's daughter. The nurse interprets this behavior as which of the following?

answer

Signs of delirium

question

A client has been diagnosed with dementia and is exhibiting several cognitive disturbances. Which of the following terms is used to describe the inability to execute motor functioning despite intact motor abilities?

answer

Apraxia

question

The nurse is caring for a client diagnosed with delirium who has been brought for treatment by his son. While taking the client's history, which question would be most appropriate for the nurse to ask the client's son?

answer

"Has your father taken any medications recently?"

question

A client is admitted to the psychiatric unit after taking various medications and illegal substances to get "high." In addition to his underlying diagnosis of bipolar disorder, the client is diagnosed with delirium. Currently he is experiencing mild hallucinations and confusion. Which intervention should the nurse do first?

answer

Arrange for an unlicensed assistant to sit with the client.

question

Tacrine (Cognex) is a drug that is used in clients with cognitive disorders. Tacrine works mainly by

answer

elevating levels of acetylcholine (ACH) in the system by decreasing binding sites of acetylcholinesterase.

question

The nurse documents that a client diagnosed with dementia of the Alzheimer's type is exhibiting agnosia when she is observed being unable to

answer

Identify a picture of a car

question

A nurse is caring for a client with delirium. The nurse assesses the client's activities of daily living (ADLs) on a daily basis. What is the most likely reason for assessing these so frequently? Choose the best answer.

answer

To assess for fluctuation in the client's capabilities

question

Which type of hallucination is most commonly seen in clients diagnosed with delirium?

answer

Visual

question

A client has vascular dementia. Which of the following explanations will assist the family to understand the cause of this type of dementia?

answer

Blood vessels in the brain are bleeding.

question

Susan has advanced Alzheimer's disease and becomes confused at mealtimes. She has agnosia, apraxia, and disturbed executive functioning. Which of the following is the most appropriate nursing intervention?

answer

Provide Susan with her tray, opening containers for her.

question

The wife caregiver of a client with dementia tells the nurse that her husband has been agitated lately. She states, "I don't know how to handle this. He was always such a gentle person!" Which of the following interventions should the nurse suggest?

answer

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

question

Currently, regardless of the cholinesterase inhibitor the cognitively impaired is prescribed, the nurse educates the caregiver in regard to the possibility of

answer

Gastrointestinal (GI) symptoms

question

When assessing a client with dementia, the 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?

answer

Visual

question

Which of the following is a metabolic cause of delirium?

answer

Hypoglycemia

question

Debra is suffering from dementia related to Parkinson's disease. While at a doctor's visit, a cholinesterase inhibitor is prescribed for Debra. The nurse knows that this type of medication would be prescribed for Debra to do which of the following?

answer

Slow deterioration of memory and function

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