Chapter 22: Delirium and Dementia

Chapter 22: Delirium and Dementia

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. The family of a patient with Alzheimer disease asks the nurse, “When will my mother quit being so confused?” On what information regarding dementia should the nurse base a response?

a.	It is a short-term confusional state that is typically reversible.
b.	It is a state of confusion caused primarily by medications.
c.	It is a state of confusion that usually begins abruptly and lasts a short period.
d.	It is a syndrome that is chronic and irreversible.

 

 

ANS:  D

Alzheimer disease is a type of dementia that is chronic and irreversible. Delirium is a short-term confusional state that has a sudden onset and is typically reversible.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 336             OBJ:   1

TOP:   Dementia       KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Psychosocial Integrity: Basic Care and Comfort

 

2. A nurse is admitting a patient who has been diagnosed as having confusion. What is the most important observation that the nurse should make regarding this patient?

a.	Eating, drinking, and sleeping patterns
b.	Behavior, orientation, memory, and sleeping habits
c.	Urinary and bowel elimination habits
d.	Talking, walking, and sleeping patterns

 

 

ANS:  B

The first step in assessing a confusional state is to observe the patient’s behavior, orientation, memory, and sleeping habits.

 

DIF:    Cognitive Level: Comprehension     REF:   p. 339             OBJ:   6

TOP:   Confusion Assessment                     KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Psychosocial Integrity: Coping and Adaptation

 

3. While a nurse is dressing a patient who has dementia as a result of Huntington disease, the patient states, “I don’t want to wear clothes today” and begins to resist help putting on her clothes. What is the nurse’s most appropriate action?

a.	Tell the patient that she must wear clothes or she cannot see her family later.
b.	Get another nurse to help her force the patient to get dressed.
c.	Talk to the patient about her family coming this afternoon and continue to assist the patient gently with dressing.
d.	Let the patient go without clothes but make her stay in her room.

 

 

ANS:  C

When patients with dementia resist activities such as bathing or dressing, avoiding confrontations and diverting their attention elsewhere are best.

 

DIF:    Cognitive Level: Application           REF:   p. 344-345      OBJ:   6

TOP:   Resisting Care                                 KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Psychosocial Integrity: Psychosocial Adaptation

 

4. What are the adaptations to interventions that the Cognitive Developmental Approach (CDA) to caring for patients with dementia designed to achieve?

a.	Increase cognitive abilities.
b.	Adapt environment to patient.
c.	Offer a wide variety of choices.
d.	Abolish irrational fears.

 

 

ANS:  B

The CDA adapts implementations based on the patient’s cognitive abilities as they are, modifies the environment, and offers limited choices.

 

DIF:    Cognitive Level: Knowledge            REF:   p. 345             OBJ:   6

TOP:   Cognitive Developmental Approach

KEY:  Nursing Process Step: Implementation

MSC:  NCLEX: Psychosocial Integrity: Psychosocial Adaptation

 

5. A nurse is gathering information from the family of a patient who is experiencing confusion. What important question should the nurse ask the family?

a.	“Are you sure she is confused? Maybe she just didn’t hear what you were saying.”
b.	“When did you first think she might be confused? Tell me exactly what happened.”
c.	“Did something bad happen to her during her childhood?”
d.	“How can you say she is confused? She knows who she is.”

 

 

ANS:  B

Family members may be able to provide helpful information when the patient cannot. The nurse should ask when the symptoms of confusion started and whether the confusion is constant or intermittent.

 

DIF:    Cognitive Level: Application           REF:   p. 339             OBJ:   6

TOP:   Assessing Confusion                       KEY:  Nursing Process Step: Assessment

MSC:  NCLEX: Psychosocial Integrity