Chapter 13: Neurocognitive Disorders

Essentials of Psychiatric Mental Health Nursing 7th Edition By Mary C

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Chapter 13: Neurocognitive Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A geriatric nurse is teaching the client’s family about the possible cause of delirium. Which statement by the nurse is most accurate?

1. “Taking multiple medications may lead to adverse interactions or toxicity.”
2. “Age-related cognitive changes may lead to alterations in mental status.”
3. “Lack of rigorous exercise may lead to decreased cerebral blood flow.”
4. “Decreased social interaction may lead to profound isolation and psychosis.”

 

 

____     2.   A client diagnosed with vascular neurocognitive disorder (NCD) is discharged to home under the care of his wife. Which information should cause the nurse to question the client’s safety?

1. His wife works from home in telecommunication.
2. The client has worked the nightshift his entire career.
3. His wife has minimal family support.
4. The client smokes one pack of cigarettes per day.

 

 

____     3.   A client diagnosed with Alzheimer’s disease (AD) can no longer ambulate, does not recognize family members, and communicates with agitated behaviors and incoherent verbalizations. The nurse recognizes these symptoms as indicative of which stage of the illness?

1. Stage 4: Mild-to-Moderate Cognitive Decline
2. Stage 5: Moderate Cognitive Decline
3. Stage 6: Moderate-to-Severe Cognitive Decline
4. Stage 7: Severe Cognitive Decline

 

 

____     4.   A client is diagnosed in stage 7 of AD. To address the client’s symptoms, which nursing intervention should take priority?

1. Improve cognitive status by encouraging involvement in social activities.
2. Decrease social isolation by providing group therapies.
3. Promote dignity by providing comfort, safety, and self-care measures.
4. Facilitate communication by providing assistive devices.

 

 

____     5.   Which is the reason for the proliferation of the diagnosis of NCDs?

1. Increased numbers of neurotransmitters have been implicated in the proliferation of NCD.
2. Similar symptoms of NCD and depression lead to misdiagnoses, increasing numbers of NCD.
3. Societal stress contributes to the increase in this diagnosis.
4. More people now survive into the high-risk period for neurocognitive disorders.

 

MULTIPLE CHOICE

 

  1. ANS:  1

Chapter: Chapter 13, Neurocognitive Disorders

Objective: Discuss predisposing factors implicated in the etiology of NCDs.

Page: 249

Heading: Predisposing Factors

Integrated Processes: Teaching and Learning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Cognition

Difficulty: Moderate

 

  Feedback
1 The nurse should identify that taking multiple medications that may lead to adverse reactions or toxicity is a risk factor for the development of delirium in older adults.
2 Age-related cognitive changes do not lead to delirium.
3 Lack of vigorous exercise does not lead to delirium.
4 Decreased social interaction does not lead to delirium.

 

 

PTS:   1                    CON:  Cognition

 

  1. ANS:  4

Chapter: Chapter 13, Neurocognitive Disorders

Objective: Identify topics for client and family teaching relevant to NCDs.

Page: 267

Heading: Client/Family Education

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Collaboration

Difficulty: Moderate

 

  Feedback
1 Working from home does not suggest that the client could be injured.
2 Working the night shift does not suggest that the client could be injured.
3 Minimal family support does not suggest that the client could be injured.
4 The nurse should question the client’s safety at home if the client smokes cigarettes. Patients with this disorder become confused and are at risk for injury.

 

 

PTS:   1                    CON:  Collaboration

 

  1. ANS:  4

Chapter: Chapter 13, Neurocognitive Disorders

Objective: Describe clinical symptoms and use the information to assess clients with NCDs.

Page: 252–253

Heading: Clinical Findings, Epidemiology, and Course

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Nursing

Difficulty: Moderate

 

  Feedback
1 The client’s symptoms do not indicate stage 4 of the illness.
2 The client’s symptoms do not indicate stage 5 of the illness.
3 The client’s symptoms do not indicate stage 6 of the illness.
4 The nurse should recognize that a client exhibiting these symptoms is in the severe cognitive decline, seventh stage, of AD.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  3

Chapter: Chapter 13, Neurocognitive Disorders

Objective: Describe clinical symptoms and use the information to assess clients with NCDs.

Page: 253

Heading: Clinical Findings, Epidemiology, and Course

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Nursing

Difficulty: Moderate

 

  Feedback
1 Encouraging involvement in social activities does not address the client’s symptoms.
2 Decreasing social isolation does not address the client’s symptoms.
3 The most appropriate intervention in the seventh stage of AD is to promote the client’s dignity by providing comfort, safety, and self-care measures. Stage 7 is characterized by severe cognitive decline in which the client is unable to recognize family members and is most commonly bedfast and aphasic.
4 Facilitating communication does not address the client’s symptoms.

 

 

PTS:   1                    CON:  Nursing

 

  1. ANS:  4

Chapter: Chapter 13, Neurocognitive Disorders

Objective: Discuss predisposing factors implicated in the etiology of NCDs.

Page: 250

Heading: Clinical Findings, Epidemiology, and Course

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Nursing

Difficulty: Moderate

 

  Feedback
1 The increased number of neurotransmitters is not the reason for the proliferation of the diagnosis of NCDs
2 Similar symptoms of NCD and depression does not lead to increasing numbers of NCD.
3 Societal stress does not contribute to the increase in this diagnosis.
4 The proliferation of NCD has occurred because more people now survive into the high-risk period for neurocognitive disorder, which is middle age and beyond. Previously, many more people died in their 50s, 60s, and early 70s.

 

 

PTS:   1                    CON:  Nursing

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