Chapter 24: Delirium, Dementia, and Amnestic Disorders

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____       1)   A geriatric nurse is teaching student nurses about the risk factors for the development of delirium in older adults. Which student statement indicates that learning has occurred?

A.	“Taking multiple medications may lead to adverse interactions or toxicity.”
B.	“Age-related cognitive changes may lead to alterations in mental status.”
C.	“Lack of rigorous exercise may lead to decreased cerebral blood flow.”
D.	“Decreased social interaction may lead to profound isolation and psychosis.”

 

 

____       2.   A client diagnosed with vascular dementia is discharged to home under the care of his wife. Which information should cause the nurse to question the client’s safety?

A.	His wife works from home in telecommunication.
B.	The client has worked the night shift his entire career.
C.	His wife has minimal family support.
D.	The client smokes one pack of cigarettes per day.

 

 

____       3.   A client diagnosed with Alzheimer’s dementia can no longer ambulate, does not recognize family members, and communicates with agitated behaviors and incoherent verbalizations. The nurse recognizes these symptoms as indicative of which stage of the illness?

A.	Late confusion
B.	Early dementia
C.	Middle dementia
D.	Late dementia

 

 

____       4.   A client is diagnosed with late-stage Alzheimer’s dementia. To address the client’s symptoms, which nursing intervention should take priority?

A.	Improve cognitive status by encouraging involvement in social activities.
B.	Decrease social isolation by providing group therapies.
C.	Promote dignity by providing comfort, safety, and self-care measures.
D.	Facilitate communication by providing assistive devices.

 

 

____       5.   A client is experiencing progressive changes in memory that have interfered with personal, social, and occupational functioning. The client exhibits poor judgment and has a short attention span. A nurse should recognize these as classic signs of which condition?

A.	Mania
B.	Delirium
C.	Dementia
D.	Parkinsonism

 

 

____       6.   A nursing instructor is teaching about donepezil (Aricept). A student asks, “How does this work? Will this cure Alzheimer’s dementia?” Which is the appropriate instructor reply?

A.	“This medication delays the destruction of acetylcholine, a chemical in the brain necessary for memory processes. Although most effective in the early stages, it serves to delay, but not stop, the progression of the dementia.”
B.	“This medication encourages production of acetylcholine, a chemical in the brain necessary for memory processes. It delays the progression of the disease.”
C.	“This medication delays the destruction of dopamine, a chemical in the brain necessary for memory processes. Although most effective in the early stages, it serves to delay, but not stop, the progression of the dementia.”
D.	“This medication encourages production of dopamine, a chemical in the brain necessary for memory processes. It delays the progression of the disease.”

 

 

____       7.   Which symptom should a nurse identify that would differentiate clients diagnosed with dementia from clients diagnosed with mood disorders?

A.	Altered sleep
B.	Altered concentration
C.	Impaired memory
D.	Impaired psychomotor activity

 

 

____       8.   At what time during a 24-hour period should a nurse expect clients diagnosed with Alzheimer’s dementia to exhibit more pronounced symptoms?

A.	When they first awaken
B.	In the middle of the night
C.	At twilight
D.	After taking medications

 

 

____       9.   A client diagnosed with Alzheimer’s dementia exhibits progressive memory loss, diminished cognitive functioning, and verbal aggression upon experiencing frustration. Which nursing intervention is most appropriate?

A.	Schedule structured daily routines.
B.	Minimize environmental lighting.
C.	Organize a group activity to present reality.
D.	Explain the consequences for aggressive behaviors.

 

 

____     10.   After 1 week of continuous mental confusion, an elderly African American client is admitted with a preliminary diagnosis of Alzheimer’s dementia. What should cause the nurse to question this diagnosis?

A.	Alzheimer’s dementia does not typically occur in African American clients.
B.	The symptoms presented are more indicative of Parkinsonism.
C.	Alzheimer’s dementia does not develop suddenly.
D.	There has been no T3 or T4 level evaluation ordered.

 

 

____     11.   A client diagnosed with Alzheimer’s dementia has impairments of memory and judgment and is incapable of performing activities of daily living. Which nursing intervention should take priority?

A.	Present evidence of objective reality to improve cognition
B.	Design a bulletin board to represent the current season
C.	Label the client’s room with name and number
D.	Assist with bathing and toileting

 

 

____     12.   A client diagnosed with dementia is exhibiting behavioral problems on a daily basis. At change of shift, the client’s behavior escalates from pacing to screaming and flailing. Initially, which action should a nurse implement in this situation?

A.	Consult the psychologist regarding behavior-modification techniques.
B.	Medicate the client with prn antianxiety medications.
C.	Assess environmental triggers and potential unmet needs.
D.	Anticipate the behavior and restrain when pacing begins.

 

 

____     13.   A client with a history of cerebrovascular accident (CVA) is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client’s assessment data, which diagnosis would the nurse expect the physician to assign?

A.	Delirium due to adverse effects of cardiac medications
B.	Vascular dementia
C.	Altered thought processes
D.	Alzheimer’s dementia

 

 

____     14.   An older client has recently moved to a nursing home. The client has trouble concentrating and socially isolates. A physician believes the client would benefit from medication therapy. Which medication should the nurse expect the physician to prescribe?

A.	Haloperidol (Haldol)
B.	Donepezil (Aricept)
C.	Diazepam (Valium)
D.	Sertraline (Zoloft)

 

 

____     15.   A client diagnosed with dementia is disoriented, ataxic, and wanders. Which is the priority nursing diagnosis?

A.	Disturbed thought processes
B.	Self-care deficit
C.	Risk for injury
D.	Altered health-care maintenance

 

 

____     16.   Which symptom should a nurse identify that would differentiate clients diagnosed with dementia disorders from clients diagnosed with amnesic disorders?

A.	Dementia disorders involve disorientation that develops suddenly, whereas amnestic disorders develop more slowly.
B.	Dementia disorders involve impairment of abstract thinking and judgment, whereas amnestic disorders do not.
C.	Dementia disorders include the symptom of confabulation, whereas amnestic disorders do not include these symptoms.
D.	Both dementia disorders and profound amnesia typically share the symptom of disorientation to place, time, and self.