Chapter 24 Cognitive Disorders

Chapter 24: Cognitive Disorders A client with dementia becomes extremely agitated shortly after being admitted to the psychiatric unit. The nurse is reluctant to use physical restraints to control the client. What is a likely reason the nurse has this reluctance? a. b. c. d. Physical restraints may potentially become fatal for the client. Physical restraints may not be of any use in controlling the client. Physical restraints may cause injury to the client. Physical restraints may increase the client’s agitation. Family members bring an older client, recently diagnosed with Alzheimer disease, to the clinic stating they need placement in a facility for their loved one. Which finding would support further assistance in care giving for this client? a. b. c. d. client preferring to take showers client wandering off age of the client client maintaining stoic affect A nurse is caring for a client with delirium. The nurse assesses the client’s activities of daily living on a daily basis. What is the most likely reason for assessing these so frequently? a. b. c. d. To assess the prognosis of the client after therapy To ensure the client establishes a daily routine To ensure the client is involved in therapy To assess for fluctuation in the client's capabilities The client has early Alzheimer's disease. When asked about family history, the client relates that the client has two children who are both grown and who visit the client around the holidays each year. The nurse subsequently discovers that the client has one child who is currently assigned overseas and who has not been home for 2 years. Which would best describe the client's behavior? a. The client is confabulating, most likely to cover for memory deficit. b. The client is showing signs of agnosia in that the client is unable to name the client's children. c. The client demonstrates aphasia when discussing the client's children. d. The client is confused about the client's children and needs refocusing. 1 A nurse is caring for a client diagnosed with delirium who has been brought for treatment by the client's adult child. While taking the client's history, which question would be most appropriate for the nurse to ask the client's adult child? a. b. c. d. “Are you aware of your parent falling or injuring the head in any way?” “Has your parent had a recent stroke?” “Has your parent experienced any major losses recently?” “Has your parent taken any medications recently?” A group of friends have arrived at the hospital to visit a client recently diagnosed with delirium. The nurse tells the friends they can visit with the client one at a time. What is the likely reason for the nurse to give this instruction? a. b. c. d. The nurse wants the client to maintain an adequate balance of activity and rest. The nurse wants the client to demonstrate good orientation. The nurse wants to prevent increasing the client's confusion. The nurse wants to ensure the client's safety. Which is the primary treatment for delirium? a. b. c. d. Maintain intravenous fluid administration Identify and treat any causal or contributing medical conditions Provide adequate nutritional food and fluid intake Apply physical restraints Which type of hallucination most commonly occurs in clients diagnosed with dementia? a. Auditory b. Gustatory c. Visual d. Olfactory To manage voiding issues, such as incontinence, male clients diagnosed with dementia would best be managed by what? a. b. c. d. Indwelling catheters Condom catheter Use of disposable, adult diapers Intermittent catheterization The nurse receives a report that a 75-year-old client is recovering from surgery. During the shift, the nurse notes that the client is forgetful and restless. Several times, the client calls the nurse the name of the client's daughter. The nurse interprets this behavior as what? 2 a. b. c. d. Signs of delirium Signs of early Alzheimer's disease Normal, given the client's age Normal for the first postoperative day The client is an 84-year-old suffering from delirium. The client has been in a nursing home for the past 2 years but recently is becoming combative and has become a threat to staff. Which medication would the client most likely receive for these symptoms? a. Galantamine b. Tacrine c. Haloperidol d. Rivastigmine The diagnosis of delirium is supported when the nurse notes what about the client? a. The client reports seeing "hundreds of bugs" and is not always oriented to time and place b. The client responds to most assessment questions with "I don't know" and appears apathetic c. The client repeatedly asks where the client is and attempts to drink the water in a flower vase d. The client spends much of the day sleeping in the dayroom and usually denies being hungry An older client has recently finished treatment for a urinary tract infection (UTI) and has now developed changes in behavior resulting in decreased cognition. Which priority intervention(s) should the nurse perform? Select all that apply. a. b. c. d. e. Obtain a repeat urine culture. Contact the health care provider. Maintain adequate hydration. Obtain an order for sedation. Stop the prescribed antibiotic therapy. A client has experienced a gradual flattening of affect, confusion, and withdrawal and has been diagnosed with Alzheimer's disease. Which additional findings would the nurse most likely assess? a. Uncharacteristic use of illicit substances and alcohol 3 b. Personality change, wandering, and inability to perform purposeful movements c. Tremors, unsteady gait, and transient paresthesias d. Transient blindness, slurred speech, and weakness What is the greatest benefit support groups provide to the caregivers of clients diagnosed with dementia? a. b. c. d. provides time away from the client provides interaction with those with similar concerns provides a social outlet provides resources for needed services Which would not be considered a primary goal of nursing care for a client with delirium? a. b. c. d. Meeting physiological and psychological needs Management of confusion Achievement of self-esteem needs Protection from injury A client has vascular neurocognitive disorder. When teaching the family about the cause of this disorder, which would the nurse expect to integrate into the explanation? a. b. c. d. Strands of protein are tangled together. Fragments mix with molecules to make plaques in the brain. Acetylcholine production is decreased. Blood flow in the vessels to the brain are blocked. Which term is used to describe the inability to execute motor functioning, despite intact motor abilities? a. Executive functioning b. Apraxia c. Aphasia d. Agnosia A nurse's aide has rung the call light for assistance while providing a client's twice-weekly bath because the client became agitated and aggressive while being undressed. Knowing that the client has a diagnosis of Alzheimer's disease and is prone to agitation, which measure may help in preventing this client's agitation? a. Decreasing the frequency of the client's baths from two times to one time per week 4 b. Providing all of the client's daily medications early on the day of a scheduled bath c. Reinforcing the facility's zero-tolerance policy for aggressive behavior d. Reminding the client multiple times that he or she will be soon having a bath What is the primary sign of delirium? a. b. c. d. 5 Disturbed sleep-wake cycles Inability to fulfill roles Impaired socialization An altered level of consciousness