Neurocognitive Disorder (Alzheimer’s Disease) HESI Case Study

This exam includes which component

When the nurse is assessing Mary’s cognitive function…
A. Ask Mary to list three different types of fruits, colors, and animals.
E. Give Mary a photo of a circle and ask her to fill in the times of the clock.
F. Ask Mary what she would do if she smelled gas in the house.

Which example represents the forgetfulness of…
Forgetting to serve dinner after preparing the meal.

Which response by the nurse is best?
Changes in behavior and personality often occur in early Alzheimer’s disease

Which question is best to ask Mary and her husband to elicit info about possible risk factors for AD
Does anyone in your family have AD

What is the best response by the nurse
The healthcare provider is looking…

How should the nurse explain this information to Mary and her husband
Normal lab test results help rule out other causes of the symptoms

How should the nurse explain the therapeutic effect of donepezil (Aricept) to the couple?
Stabilizes cognitive decline

How should the nurse respond?
“This medication provides the most benefit to person…”

What lab test should be scheduled?
Serum liver enzymes

Which information indicates the trazodone (Desyrel) is having the desired effect?
Mary sleeps through the night

Which information indicates possible serious side effects of trazodone (Desyrel)
A. Mary is also taking MAOIs
B. Mary is complaining of perineal pain
E. Mary has a history of cardiac disease

Which intervention should the nurse include in the client and family teaching?
Help Mary to recognize the strong emotions that she is feeling

What is the best response by the nurse?
You are right to balance her feelings with the need to promote reality

Which technique is most useful in helping a client with AD recognize the bathroom
Place a picture of a toilet on the bathroom door

The nurse’s response should be based on which understating about AD
AD is a chronic disease that can progress with no set sequence and that has a typical lifespan of 5 to 20 years

Which is the best response by the nurse?
Every person responds differently to the disease, but it is likely that her ability to function will continuo to decline.

Which action(s) are most important for Sam to initiate (select all that apply)
A. Keep a commode at the bedside
C. Take Mary to the bathroom every 2 hours
E. Establish a toileting schedule at the same time daily.

Which instruction should be included when teaching Sam some appropriate measures to reduce this problem
A. provide Mary with a relaxing backrub at bedtime
B. Keep some light on in the bedroom at night
E. Provide a calm atmosphere during the day

Which question are most important to ask Sam before developing the plan of care?
A. how are your children coping with Mary’s disease
B. What do you find most stressful in your daily life
E. What activities do you attend outside your home.

Which option provides the best respite for Sam
Adult day care for Mary

How should the nurse respond to this person’s joking behavior
Encourage all group members to use humor as a coping mechanism

To promote the well-being of a group of clients with AD, which goals are important of the nurse-mananger of an adult care center to include in the plan of care
A. Provide forms of moderate sensory stimulation
B. Ensure opportunities for physical activity
C. Maintain a calm, consistent environment
D. Encourage group involvement
F. Incorporate pet therapy

What action should the nurse implement
Provide a snack that the client can eat

What action should the nurse implement first?
Redirect Mary’s attention to holding a stuffed animal

What is the best response by the nurse?
A.”Mary needs to be calmed down immediately. her husband is upset”
B. The medication will prevent Mary from harming herself.
C. We may not need to administer a medication. let me try to calm her
E. Mary says her hip hurts; she has a prescription for pain med.

How many tablets…

What action should the nurse take?
Evaluate Mary’s vital signs before transferring her to her bed

After the nurse assists Mary to the bed, which nursing action has the highest priority?
Educate about arising slowly after sitting

Which task can be delegated to the licensed LPN
D. Administer the first scheduled dose of the prescribed oral antibiotic
E. Calculate Mary’s intake and output for the shift

Which member of the home care team should be assigned to revise Mary’s plan of care to reflect her changing condition?
The home health nurse who visit every other week.

Which response is best for the nurse to provide?
You have many conflicting emotions right now

What initial intervention should the nurse implement
Remain seated next to Sam while he is crying

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