Psychiatric Mental Health Nursing 5th Edition By Fortinash
Psychiatric Mental Health Nursing 5th Edition By Fortinash
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Chapter 16: Cognitive Disorders: Delirium, Dementia, and Amnestic Disorders
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | Changing the topic provides diversion. |
| b. | Delusions should be confronted to clarify thinking. |
| c. | Ignoring memory deficit avoids catastrophic reactions. |
| d. | This isn’t lying but rather a way to fill in the memory gaps. |
ANS: D
Confabulation is not lying but rather a method for filling in the memory gaps. Ignoring, using confrontation, and changing the topic would not be as useful as gently reorienting.
DIF: Cognitive Level: Application REF: Page 374
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
| a. | Ask the husband to make an appointment to bring his wife to the clinic for testing. |
| b. | Explain to the husband that accurate data will be sought, and ask him to stay with the grandchildren in another room. |
| c. | Do not perform the test during the assessment (because it will not be valid) and rely on observations and reports from the family. |
| d. | Explain the importance of the testing process and make an appointment for another day when the environment can be better controlled. |
ANS: D
Testing the patient in her home under quieter, less distracting circumstances is the best solution. Asking the husband to leave is likely to increase the patient’s anxiety and alter test results. Use of the MMSE is an integral component of the assessment and must not be deleted. Testing in the more familiar, comfortable surroundings of the home will yield more reliable results.
DIF: Cognitive Level: Application REF: Page 378
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
| a. | Encouraging fluids to minimize constipation |
| b. | Frequently assessing both visual and auditory hallucinations |
| c. | Scheduling frequent changing of position to prevent skin breakdown |
| d. | Dimming the lights to help control eye discomfort resulting from cataracts |
ANS: C
Because of inactivity, hypoactive delirium patients are more likely to develop further complications, including decubiti that could be minimized by frequent repositioning. The remaining options identify interventions that are not generally a result of this diagnosis.
DIF: Cognitive Level: Application REF: Page 377 TOP: Nursing Process: Planning
MSC: NCLEX: Physiological Integrity
| a. | It is a secondary dementia indicated by loss of recent memory and disorientation to time and place. |
| b. | It is a primary dementia that is incurable, irreversible, and fatal. It is caused by the presence of a beta-amyloid protein in the neurons resulting in senile plaques. |
| c. | It is a secondary dementia that is treatable with analysis of the diet and removal of toxic substances from the diet and environment. |
| d. | It is a primary dementia characterized by stepwise decreases in cognitive abilities. It is irreversible but treatable with antihypertensive medications. |
ANS: B
This option provides accurate information about Alzheimer’s disease. Alzheimer’s disease is not a secondary dementia nor is it treated with antihypertensive medications.
DIF: Cognitive Level: Application REF: Pages 367-368
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
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