Ch 24- Congnitive Disorders

Ch 24- Congnitive Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

1. During the change of shift report in the intensive care unit, the nurse learns that a client
has developed signs of delirium over the past 8 hours. Which behavior documented in
the nursing notes would be consistent with delirium?
A) Unable to identify a water pitcher
B) Unable to transfer to sitting position
C) Difficulty with verbal expression
D) Disoriented to person
Ans: D
Feedback:
Delirium usually develops over a short period, sometimes a matter of hours, and
fluctuates, or changes, throughout the course of the day. Clients with delirium have
difficulty paying attention, are easily distracted and disoriented, and may have sensory
disturbances such as illusions, misinterpretations, or hallucinations. Dementia symptoms
include aphasia (deterioration of language function), apraxia (impaired ability to execute
motor functions despite intact motor abilities), and agnosia (inability to recognize or
name objects despite intact sensory abilities).
2. A nurse working in an assisted living facility is holding an in-service for the nursing
assistants. The nurse reviews common behaviors associated with cognitive deterioration
associated with dementia. Which would cause the nurse to know that the assistants
correctly understood if it were expressed during a posttest?
A) The clients should be able to ask us for items they need.
B) The clients may not recognize their family when they come to visit.
C) The clients who are ambulatory can still carry out activities of daily living
independently.
D) The clients should know when to come to the dining room for meals.
Ans: B
Feedback:
Dementia is a mental disorder that involves multiple cognitive deficits, primarily
memory impairment, and at least one of the following cognitive disturbances: (1)
aphasia, which is deterioration of language function; (2) apraxia, which is impaired
ability to execute motor functions despite intact motor abilities; (3) agnosia, which is
inability to recognize or name objects despite intact sensory abilities; and (4)
disturbance in executive functioning, which is the ability to think abstractly and to plan,
initiate, sequence, monitor, and stop complex behavior.
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3. Which is believed to be a risk factor specific to the development of delirium?
A) Increased severity of physical illness
B) Older age
C) Baseline cognitive impairment
D) Gradual decline in functioning
Ans: A
Feedback:
An estimated 10% to 15% of people in the hospital for general medical conditions are
delirious at any given time. Onset is sudden. Delirium is common in older, acutely ill
clients. Risk factors for delirium include increased severity of physical illness, older
age, and baseline cognitive impairment such as that seen in dementia. Children may be
more susceptible to delirium, especially that related to a febrile illness or certain
medications such as anticholinergics. Delirium usually develops over a short period,
sometimes a matter of hours, and fluctuates, or changes, throughout the course of a day.
Prevalence of dementia also rises with age, and progression is gradual.
4. Which patient is most likely suffering from dementia?
A) A 90-year-old male who has experienced progressive mental decline that started
with forgetfulness
B) An 80-year-old female who has been in excellent health until she was admitted
through the emergency department with a severe urinary tract infection and is now
very anxious and is threatening staff
C) A 6-year-old child who has just been administered conscious sedation for a closed
reduction of a fractured wrist and says that her parents have three sets of eyes
D) A 22-year-old male who was involved in a motorcycle crash without wearing a
helmet now unable to remember where he is
Ans: A
Feedback:
Memory impairment is the prominent early sign of dementia. The course of dementia is
usually progressive. A 90-year-old gentleman who has experienced progressive mental
decline that started with forgetfulness is most likely suffering from dementia. An 80-
year-old lady who has been in excellent health until she was admitted through the
emergency department with a severe urinary tract infection is likely experiencing
delirium. Delirium almost always results from an identifiable physiologic, metabolic, or
cerebral disturbance or from drug intoxication or withdrawal. The 6-year-old who has
just been administered conscious sedation is likely delirious. A 22-year-old male who
was involved in a motorcycle crash without wearing a helmet and now cannot remember
where he is likely experiencing an amnestic disorder.