CHAPTER 7 Psychological and Cognitive Function

CHAPTER 7 Psychological and Cognitive Function

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

7.1•A 70-year-old client comes into the clinic for his pneumonia vaccine. During the client interview, he seems to have mild difficulty with some words and tells you he forgets the names of people at times. He is alert, and oriented to time, person, and place. His responses seem appropriate. The nurse determines the cognitive changes that the client describes are

1. early symptoms of dementia.
2. indicators of depression in the elderly.
3. normal signs of aging.
4. memory impairment that may be related to cerebral ischemia.

Answer: 3

Rationale: Cognitive changes vary widely in the elderly; however, most older people will not suffer significant memory impairment. Many may experience mild problems with word finding and remembering names. The changes described by this client are normal signs of aging and not symptoms of dementia, depression, or ischemia. Dementia may present with additional symptoms of memory loss related to orientation and completing day-to-day tasks. Depression would show signs of flat affect, or withdrawal, and ischemia may show additional neurological deficits.

Assessment

Physiological Integrity

Analysis

7.2•A 75-year-old client on a medical unit awakens from sleep with confusion about where she is. She insists her daughter is in the other room and wants to see her. The nurse reorients the patient to her surroundings and get the client to return to sleep. In reviewing the client’s record, what data would be considered a source of the patient’s confusion?

1. pain medication received
2. the client’s husband died last month
3. the client’s age
4. history of cardiac disease

Answer: 1

Rationale: Certain medications, such as sleeping pills, tranquilizers, and pain medications, can cause symptoms similar to dementia. Therefore, the client’s medication must be reviewed to determine the effects of drugs and cognitive changes. Although loss of a loved one may result in depression, it is unlikely to be the source of confusion. Age merely does not cause confusion, and cardiac disease alone would not cause confusion.

Assessment

Physiological Integrity

Application

7.3•The nurse is reviewing with a 78-year-old client the discharge instructions for administration of insulin. In order to adjust to the normal changes experienced with aging, the nurse incorporates which activity into the teaching plan?

1. using tools that repeat the information until the information is understood
2. giving written materials to compensate for short-term memory losses
3. providing instruction to relatives so that the client will not need to learn everything
4. considering holding sessions for longer periods than usual so the client can learn

Answer: 1

Rationale: Normal age-related changes include a slowing of information processing, which results in the need for repetition of information. Short-term memory, or primary memory, remains relatively stable. Assuming the client cannot learn everything is stereotypical of the aging process. Another age-related change includes the inability to maintain sustained attention. Therefore, long teaching sessions would not be appropriate.

Planning

Health Promotion and Maintenance

Application

7.4•An 82-year-old client is admitted to the hospital for surgery. During the admission assessment the daughter of the client describes difficulties that she has observed in the client. The daughter tells you that the client used to be a wonderful cook but now cannot even remember for what a blender is used. You consider this finding a

1. cognitive change that requires further assessment.
2. long-term memory loss.
3. short-term memory loss.
4. normal cognitive change in the elderly.

Answer: 1

Rationale: This type of memory loss cannot be determined by the information provided. It is not normal for a healthy individual to forget what the use of a commonly known object is, therefore, further assessment is warranted.

Implementation

Psychosocial Integrity

Analysis