Chapter 22: Alzheimer's Disease

Chapter 22: Alzheimer’s Disease

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1. A nurse is teaching a class on Alzheimer’s disease. The class demonstrates understanding of the disease when they agree that the only two established risk factors for Alzheimer’s disease are

a.	obesity and illicit drug use.
b.	high socioeconomic status and Caucasian race.
c.	advancing age and family history.
d.	alcoholism and hypertension.

 

 

ANS:   C

The major known risk factor for Alzheimer’s disease is advancing age. In 90% of patients, the age of onset is 65 years or older. The only other known risk factor is a family history of Alzheimer’s disease.

Obesity and illicit drug use are not established risk factors.

High socioeconomic status and Caucasian race are not risk factors for Alzheimer’s disease.

Alcoholism and hypertension are not known risk factors for Alzheimer’s disease.

 

DIF:    Cognitive Level: Application             REF:    p. 199

TOP:    Nursing Process: Diagnosis

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

 

2. The spouse of a patient with advanced Alzheimer’s disease confides to the nurse that the patient’s wandering, pacing, and agitation seems to get worse in the evening. The nurse correctly explains this phenomenon to the spouse as

a.	evening psychosis.
b.	sundowner’s syndrome.
c.	drug toxicity.
d.	new onset of psychosis.

 

 

ANS:   B

Between 70% and 90% of patients with Alzheimer’s disease develop wandering, pacing, agitation, and screaming. Symptoms may intensify in the evening, a phenomenon known as “sundowner’s syndrome.”

Evening psychosis is not a phenomenon associated with Alzheimer’s disease.

The phenomena reported are symptoms of Alzheimer’s disease and are not related to drug toxicity.

New-onset psychosis is not appropriate, and the nurse could not offer that diagnosis.

 

DIF:    Cognitive Level: Application             REF:    p. 199

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Physiological Adaptation

 

3. A nurse is teaching a class on Alzheimer’s disease to a group of nurses. One of the nurses asks how a cholinesterase inhibitor drug works in the Alzheimer’s patient. The nurse’s best response would be

a.	“It helps the healthier nerve cells transmit impulses better.”
b.	“It promotes excretion of neurotoxins.”
c.	“It reverses central nervous system cell degeneration.”
d.	“It helps grow new nerve cells to replace damaged ones in the brain.”

 

 

ANS:   A

Cholinesterase inhibitors prevent the breakdown of acetylcholine by acetylcholinesterase. In patients with Alzheimer’s disease, the result is enhanced transmission by central cholinergic neurons that have not yet been destroyed.

A cholinesterase inhibitor does not promote the excretion of neurotoxins.

A cholinesterase inhibitor does not reverse central nervous system degeneration.

A cholinesterase inhibitor does not stimulate new nerve cell growth.

 

DIF:    Cognitive Level: Application             REF:    p. 200

TOP:    Nursing Process: Implementation

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

 

4. An Alzheimer’s patient has been taking a cholinesterase inhibitor for a week. What anticipated side effects (signs and symptoms) related to the medication would the nurse anticipate in the patient?

a.	Numbness and tingling in the extremities
b.	Headache and confusion
c.	Nausea, vomiting, and diarrhea
d.	Tinnitus, vertigo, and hearing loss

 

 

ANS:   C

By elevating acetylcholine in the periphery, all cholinesterase inhibitors can cause typical cholinergic side effects, including nausea, vomiting, dyspepsia, and diarrhea.

Numbness and tingling of the extremities are not expected side effects of cholinesterase inhibitors.

Headache and confusion are not expected side effects of cholinesterase inhibitors.

Tinnitus, vertigo, and hearing loss are not expected effects of cholinesterase inhibitors.

 

DIF:    Cognitive Level: Application             REF:    p. 201

TOP:    Nursing Process: Assessment

MSC:   NCLEX Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies