Gerontological Nursing The Essential Guide to Clinical Practice, 2nd Edition by Patricia A.
Gerontological Nursing The Essential Guide to Clinical Practice, 2nd Edition by Patricia A.
$2.99
Chapter 33- Delirium and Dementia
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
| 1. | Which of the following older adults is most likely to have his or her health problem characterized as delirium rather than dementia? | |
| A) | Mr. L, whose wife has brought him to the emergency department because of the forgetfulness and confusion that he has exhibited over the last 48 hours. | |
| B) | Mrs. O, whose children state that her personality has changed markedly and who has difficulty finding words lately. | |
| C) | Mr. J, who has developed an unsteady and awkward gait coupled with uncoordinated motor skills in recent months. | |
| D) | Mrs. Y, who was diagnosed with a brain tumor and who has experienced consequent changes in behavior and cognition. | |
| Ans: | A | |
| Feedback: | ||
| A rapid onset of cognitive changes is indicative of delirium. Personality and language changes, deterioration in motor skills, and changes attributable to an organic change such as a tumor are more closely associated with dementia. | ||
| Origin: Chapter 33- Delirium and Dementia, 2
Chapter: 33 Client Needs: A2 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing process Objective: 1 Page and Header: 443, Delirium |
||
| 2. | An elderly man is admitted to the hospital for surgery. A day later, he seems confused and disoriented. He imagines there is a trapdoor in the ceiling above his bed. His wife panics, telling a nurse that several of her husband’s relatives have had Alzheimer’s disease but that until now he has seemed “sharp as a tack.” What should the nurse do first? | |
| A) | Control environmental temperatures and noises. | |
| B) | Check the patient’s chart for medications that can cause delirium. | |
| C) | Have the patient evaluated for Alzheimer’s disease. | |
| D) | Tell the wife there is nothing to worry about. | |
| Ans: | B | |
| Feedback: | ||
| The rapid onset and the delusion make it likely that this is delirium rather than dementia. The man’s medication should be checked immediately, as painkillers used after surgery may have this effect. Controlling the environment may be helpful, but removing the cause of delirium is of the most importance. The wife is quite right to be concerned, but she should be told about the likelihood of delirium in this situation. Evaluation for Alzheimer’s disease can take place later if that seems desirable. | ||
| Origin: Chapter 33- Delirium and Dementia, 3
Chapter: 33 Client Needs: A1 Cognitive Level: Application Difficulty: Moderate Integrated Process: Nursing process Objective: 1 Page and Header: 443, Delirium |
||
| 3. | As per her routine, the daughter of an 82-year-old patient recovering from a prostate resection has come to the hospital in the morning to be with her father at the bedside. The daughter has approached her father’s nurse and stated that he is uncharacteristically difficult to rouse this morning, with his only verbal response being occasional nonsensical muttering. What is the care team’s most appropriate response? | |
| A) | Diagnostic imaging to determine the location of any organic brain changes. | |
| B) | Assessment of the patient’s mood and current stressors. | |
| C) | Assessment to determine the cause of his delirium. | |
| D) | Screening for risk factors that would suggest Alzheimer’s disease. | |
| Ans: | C | |
| Feedback: | ||
| The patient’s rapid onset and obtunded level of consciousness are most indicative of delirium rather than dementia or depression. | ||
| Origin: Chapter 33- Delirium and Dementia, 4
Chapter: 33 Client Needs: A1 Cognitive Level: Application Difficulty: Difficult Integrated Process: Nursing process Objective: 1 Page and Header: 443, Delirium |
||
| 4. | A 79-year-old female patient, admitted for hip replacement surgery, complained of insomnia the night before and was administered lorazepam, a benzodiazepine. She began displaying signs of delirium shortly thereafter, a situation that has persisted until the morning change of shift. Which of the following guidelines should the night nurse provide to the nurse coming on shift to care for the patient? | |
| A) | “Make sure you get a sedative order from her doctor this morning.” | |
| B) | “Try to keep her level of stimulation as low as you can when you are working with her.” | |
| C) | “Make sure you let the family know that there are effective drug treatments that will resolve her delirium.” | |
| D) | “Work with the discharge-planning nurse to help the family reassess her living arrangement after discharge.” | |
| Ans: | B | |
| Feedback: | ||
| Older adults with delirium benefit from minimal stimulation. Administration of a sedative would not be a preferred intervention and resolution of the problem would not depend on pharmacological interventions. Given the temporary nature of the problem, a reassessment of the patient’s living arrangement would not be required. | ||
Original price was: $80.00.$60.00Current price is: $60.00.
Original price was: $90.00.$60.00Current price is: $60.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $25.00.$15.00Current price is: $15.00.
Original price was: $30.00.$20.00Current price is: $20.00.
Original price was: $30.00.$20.00Current price is: $20.00.