Chapter 17: Cognitive Impairment, Alzheimer’s Disease, and Dementia

Chapter 17: Cognitive Impairment, Alzheimer’s Disease, and Dementia

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A 75-year-old male client is brought to the clinic by his son. The son states, “Ever since Mom died, Dad hasn’t been the same. At first he just seemed sad, but now he seems to get mixed up about everything.” The nurse is aware that based on the client’s history, the source of confusion is most likely:

ANS:  B

Depression in the elderly population is often a cause of confusion. The son’s description of the behaviors of his father since his wife’s death indicate that he became depressed, which has been followed by confusion. Dementia is a gradual onset of confusion, hypoxia is the result of brain injury, and delirium is sudden. Even though it appears that the confusion is caused by the depression, a thorough examination is warranted to confirm the cause.

DIF:    Cognitive Level: Application           REF:   Page 179        OBJ:   2

TOP:   The Five “Ds” of Confusion             KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

2. An elderly female client on the mental unit suddenly becomes upset because she can’t remember where she is and she says, “I can’t think straight.” The staff has never witnessed this behavior in the client, and this type of complaint is not documented in the nursing history. What is the client most likely experiencing?

ANS:  D

Delirium is characterized by a sudden onset of signs and/or symptoms such as disorientation, disorganized thinking, and decreased attention span. Delirium has various causes, such as medical conditions, drug reactions or interactions, and electrolyte imbalances. If the cause is determined early in the process, delirium is reversible. Hallucinations refer to perceptual alterations of the senses, dementia is a chronic condition of confusion related to disease, and delusions are irrational thoughts or beliefs that cannot be changed by rational explanations.

DIF:    Cognitive Level: Application           REF:   Page 180        OBJ:   2

TOP:   Clients with Delirium                      KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

3. Vascular dementia is more common in individuals living in:

ANS:  B

The incidence of vascular dementia is more common in Japan for unknown reasons. Japanese citizens who move to the United States have been found to have a decreased rate of vascular dementia.

DIF:    Cognitive Level: Knowledge            REF:   Page 182        OBJ:   5

TOP:   Causes of Dementia                         KEY:  Nursing Process Step: Assessment

MSC:  Client Needs: Psychosocial Integrity

4. A 91-year-old female client with dementia is being seen by the home health nurse. Both she and her husband, who is 92 years old, were very active until her dementia became debilitating. Since that time, the client does not recognize her husband or children, forgets how to eat and dress, and wanders about the house day and night. Her husband wants to keep her at home to care for her, but the nurse notices that he is increasingly tired with each visit. What is the nurse’s priority intervention for the nursing diagnosis of caregiver role strain?

ANS:  A

Although all the interventions relate to caregiver role strain, the highest-priority intervention for this situation, given the ages and circumstances, is to coordinate care and other responsibilities to family members or other health caregivers such as home health aides.

DIF:    Cognitive Level: Application           REF:   Page 189        OBJ:   9

TOP:   Caregiver Support                           KEY:  Nursing Process Step: Intervention

MSC:   Client Needs: Psychosocial Integrity