Answer Options:
a. Aphasia
b. Apraxia
c. Agnosia
d. Memory impairment
Answer: c. Agnosia
Question: A patient diagnosed with moderate to severe Alzheimer’s disease has a dressing and grooming self-care deficit. Designate the appropriate interventions to include in the patient’s plan of care. (Select all that apply.)
Answer Options:
a. Provide clothing with elastic and hook-and-loop closures.
Answer: a. Provide clothing with elastic and hook-and-loop closures.
Question: Goals for treatment of an older adult patient experiencing delirium caused by fever and dehydration would include which actions? (Select all that apply.)
Answer Options:
a. Reducing environmental stimuli.
b. Demonstrating motor responses to noxious stimuli.
c. Exerting control over responses to perceptual distortions.
Answer: a. Reducing environmental stimuli.
Question: Two patients in a residential care facility are diagnosed with dementia. One shouts to the other, “Move along, you’re blocking the road.” The other patient turns, shakes a fist, and shouts, “I know what you’re up to; you’re trying to steal my car.” What is the nurse’s best action?
Answer Options:
a. Administer one dose of an antipsychotic medication to both patients.
b. Reinforce reality. Say to the patients, “Walk along in the hall. This is not a traffic intersection.”
c. Separate and distract the patients. Take one to the day room and the other to an activities area.
d. Step between the two patients and say, “Please quiet down. We do not allow violence here.”
Answer: c. Separate and distract the patients. Take one to the day room and the other to an activities area.
Question: During morning care, an assistive personnel asks a patient diagnosed with dementia, “How was your night?” The patient replies, “It was lovely. I went out to dinner and a movie with my friend.” Which term applies to the patient’s response?
Answer Options:
a. Sundown syndrome
b. Confabulation
c. Perseveration
d. Delirium
Answer: b. Confabulation
Question: A patient diagnosed with dementia no longer recognizes family members. The family asks how long it will be before their family member recognizes them when they visit. What is the nurse’s best reply?
Answer Options:
a. “Your family member will never again be able to identify you.”
b. “I think that is a question the health care provider should answer.”
c. “One never knows. Consciousness fluctuates in persons with dementia.”
d. “It is disappointing when someone you love no longer recognizes you.”
Answer: d. “It is disappointing when someone you love no longer recognizes you.”
Question: When used for treatment of patients diagnosed with Alzheimer’s disease, which medication would be expected to antagonize N-methyl-D-aspartate (NMDA) channels rather than cholinesterase?
Answer Options:
a. Donepezil
b. Rivastigmine
c. Memantine
d. Galantamine
Answer: c. Memantine
Question: A patient diagnosed with stage 2 moderate Alzheimer’s disease does not recognize family members in person or in photos. Which phenomenon can describe this?
Answer Options:
a. Aphasia
b. Hyperorality
c. Apraxia
d. Agnosia
Answer: d. Agnosia
Question: When making a distinction as to whether a patient is experiencing confusion related to depression or dementia, what information would be most important for the nurse to consider?
a. The patient with dementia is persistently angry and hostile.
b. Early morning agitation and hyperactivity occur in dementia.
c. Confusion seems to worsen at night when dementia is present.
d. A patient who is depressed is preoccupied with somatic symptoms.
Answer: C
Question: Which nursing intervention is appropriate to use for patients diagnosed with either delirium or dementia?
Answer Options:
a. Speak in a loud, firm voice.
b. Touch the patient before speaking.
c. Reintroduce the health care worker at each contact.
d. When the patient becomes aggressive, use physical restraint instead of medication.
Answer: c. Reintroduce the health care worker at each contact.
Question: An older adult diagnosed with moderate-stage Alzheimer’s disease forgets where the bathroom is and has episodes of incontinence. Which intervention should the nurse suggest to the patient’s family?
Answer Options:
a. Labeling the bathroom door
b. Taking the older adult to the bathroom hourly
c. Placing the older adult in disposable adult diapers
Answer: a. Labeling the bathroom door
Question: An older adult, diagnosed with Alzheimer’s disease, lives with family and has multiple bruises. The home health nurse talks with the older adult’s daughter, who becomes defensive and says, “My mother often wanders at night. Last night she fell down the stairs.” Which nursing diagnosis has priority?
Answer Options:
a. Risk for injury, related to cognitive impairment and lack of caregiver supervision
b. Noncompliance, related to confusion and disorientation as evidenced by lack of cooperation
c. Impaired verbal communication, related to brain impairment as evidenced by the confusion
d. Insomnia, related to cognitive impairment as evidenced by wandering at night
Answer: a. Risk for injury, related to cognitive impairment and lack of caregiver supervision
Question: A patient diagnosed with severe dementia no longer recognizes family members and becomes anxious and agitated when they attempt reorientation. Which alternative could the nurse suggest to the family members?
Answer Options:
a. Wear large name tags.
b. Focus interaction on familiar topics.
c. Frequently repeat the reorientation strategies.
d. Strategically place large clocks and calendars.
Answer: b. Focus interaction on familiar topics.
Question: A nurse should anticipate that which symptoms of Alzheimer’s disease will become apparent as the disease progresses from stage 3, moderate to severe to stage 4, late stage? (Select all that apply.)
Answer Options:
a. Agrapahia
b. Hyperorality
c. Fine motor tremors
d. Hypermotamorphosis
e. Improvement of memory
Answer: a. Agrapahia
b. Hyperorality
d. Hypermotamorphosis
Question: A hospitalized patient experiencing delirium misinterprets stimuli and a patient diagnosed with dementia wanders about the home. Which outcome is the priority in both scenarios?
Answer Options:
a. Patient will remain safe in the environment.
b. Patient will participate actively in self-care.
c. Patient will communicate verbally.
d. Patient will acknowledge reality.
Answer: a. Patient will remain safe in the environment.