Chapter 47: Care of Patients with Cognitive Disorders

Chapter 47: Care of Patients with Cognitive Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which percentage of the population that is 85 years of age and older has some stage of Alzheimer disease (AD)?

a.	10%
b.	20%
c.	35%
d.	50%

 

 

ANS:  D

AD is the most common degenerative disease of the brain. Approximately 5.3 million Americans have AD (Alzheimer Association, 2010), and there is no known cause or cure. AD typically affects people over 65 years of age, but can also strike younger people. The 85-year-old and over age group is currently the fastest-growing age group in the United States. It is estimated that 50% of this age group have AD.

 

PTS:   1                    DIF:    Cognitive Level: Knowledge            REF:   1094

OBJ:   1 (theory)       TOP:   AD: Incidence

KEY:  Nursing Process Step: Planning        MSC:  NCLEX: Health Promotion and Maintenance

 

2. An 85-year-old man is admitted to the hospital with gastroenteritis and dehydration. He receives a dose of meclizine hydrochloride, an anticholinergic, for vomiting. He begins to hallucinate and talk to his wife, who has been dead for 10 years. Which explanation best describes this behavior?

a.	Dementia related to advanced age
b.	Delirium related to dehydration
c.	Dementia related to early Alzheimer’s disease (AD)
d.	Delirium related to side effect of anticholinergic

 

 

ANS:  D

Anticholinergic drugs can cause sudden confusion in older adults. There is nothing in the history that suggests that the behavior would be related to AD or any other dementia as dementias progress slowly. Dehydration would increase the effect of the anticholinergic.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   1093

OBJ:   2 (theory)       TOP:   Delirium: Etiology

KEY:  Nursing Process Step: Assessment   MSC:  NCLEX: Health Promotion and Maintenance

 

3. The nurse is aware that the older adult is at risk for drug-induced delirium. Which age-related change contributes to this risk?

a.	Slower bowel motility
b.	Reduced fluid intake
c.	Overall reduced metabolism
d.	Sedentary lifestyle

 

 

ANS:  C

Slower renal and liver clearance of drugs allows the drugs to accumulate in the system of the older adult.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension

REF:   1093, Older Adult Care Points         OBJ:   2 (theory)

TOP:   Drug-Induced Delirium: Older Adult

KEY:  Nursing Process Step: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

4. Memory lapses seen in early stages of Alzheimer disease (AD) are related to the pathophysiology of which condition?

a.	Frontal lobe atrophy
b.	Overproduction of neurotransmitters
c.	Pituitary disorders
d.	Inadequate clearance of metabolic toxins

 

 

ANS:  A

Loss of neurons in the frontal and temporal lobes results in atrophy and the many signs of AD, memory deficits being one of the earliest.

 

PTS:   1                    DIF:    Cognitive Level: Comprehension     REF:   1094

OBJ:   3 (theory)       TOP:   AD: Pathophysiology

KEY:  Nursing Process Step: Planning

MSC:   NCLEX: Physiological Integrity: Physiological Adaptation