Alzheimer's/Dementia
1. Unlicensed assistive personnel (UAP) working for a home care agency report a change in the alertness and language of an 82-yr-old female patient. The home care nurse plans a visit to evaluate the patient’s cognitive function. Which assessment would be most appropriate?
A.Glasgow Coma Scale (GCS)
B.Confusion Assessment Method (CAM)
C.Mini-Mental State Examination (MMSE)
D.National Institutes of Health Stroke Scale (NIHSS)
C.Mini-Mental State Examination (MMSE)
6. Which patient should receive a depression assessment first?
A. A patient in the early stages of Alzheimer’s disease
B. A patient who is in the final stage of Alzheimer’s disease
C. A patient experiencing delirium secondary to dehydration
D. A patient who has become delirious following an atypical drug response
A. A patient in the early stages of Alzheimer’s diseas
11. The home care nurse is visiting patients in the community. Which patient is exhibiting an early warning sign of Alzheimer’s disease (AD)?
A. A 65-yr-old male patient does not recognize his family members and close friends
B. A 59-yr-old female patient misplaces her purse and jokes about having memory loss
C. A 79-yr-old male patient is incontinent and not able to perform hygiene independently.
D. A 72-yr-old female patient is unable to locate the address where she has lived for 10 years.
D. A 72-yr-old female patient is unable to locate the address where she has lived for 10 years.
16. Name one Cholinesterase Inhibitor (Anti-Alzheimer Agents)
Aricept (donepezil)
Razadyne (galantamin)
Namenda (memantine HCl)
Exelon (rivastigmine)
Name the D & E causes of delirum.
Dementia, dehydration
Electrolyte imbalances, emotional stress
2. The nurse has administered a dose of risperidone (Risperdal) to a patient with delirium. What finding demonstrates the intended effect of the medication?
A.Lying quietly in bed
B.Alleviation of depression
C.Reduction in blood pressure
D.Disappearance of confusion
A.Lying quietly in bed
7. Which patient has the greatest risk of developing delirium?
A. An older patient whose recent CT scan shows brain atrophy.
B. A patient with fibromyalgia whose chronic pain has worsened.
C. A patient with a fracture who spent the night in the emergency department.
D. An older patient who takes multiple medications to treat various health problems.
D. An older patient who takes multiple medications to treat various health problems.
12.
A 59-yr-old female patient with a frontotemporal lobar dementia has difficulty with verbal expression. While her husband was at work, she walked to the gas station for a soda but did not understand the request for payment. What can the nurse suggest to keep the patient safe?
A. Adult day care
B. Assisted living
C. Advance directives
D. Monitor for behavioral changes
A. Adult day care
17. Name one medication used to treat Delirium
Treated with low-dose antipsychotics
Haloperidol (Haldol)
Risperidone (Risperdal)
Olanzapine (Zyprexa)
Quetiapine (Seroquel)
Short-acting benzodiazepines
(e.g., lorazepam [Ativan])
Name the L causes of delirium.
Lung, liver, heart, kidney
3.When caring for a patient with Alzheimer’s disease, which task could be delegated to the LPN/VN on the team?
A.Administer enteral feedings via a gastrostomy tube.
B.Teach patient and caregivers memory enhancement aids.
C.Use bed alarms and frequent monitoring to decrease fall risk.
D.Make referrals for community services such as adult day care.
A. Administer enteral feedings via a gastrostomy tube.
8.
A patient is diagnosed with the mild cognitive impairment stage of Alzheimer’s disease. What nursing intervention is most appropriate for the nurse use with the patient?
A. Communicate using a letter or picture board.
B. Treat disruptive behavior with antipsychotic drugs.
C. Use a calendar and family pictures as memory aids.
D. Apply a wander guard mechanism to keep the patient in the area.
C. Use a calendar and family pictures as memory aids.
13.
The nurse in the long-term care facility cares for a 70-yr-old man with late-stage dementia who is undernourished and has problems chewing and swallowing. What should the nurse include in the plan of care for this patient?
A. Limit fluid intake during mealtimes to prevent aspiration.
B. Turn on the television to provide a distraction during meals.
C. Provide thickened fluids and moist foods in bite-size pieces.
D. Allow the patient to select favorite foods from the menu choices.
C. Provide thickened fluids and moist foods in bite-size pieces.
18. Name the first medication often used to treat Parkinson's disease
Levodopa/Carbidopa (Sinemet)
Name the I causes of delirium.
Infection, ICU
4.
Benzodiazepines are indicated in the treatment of delirium caused by which condition?
A. Polypharmacy
B. Cerebral hypoxia
C. Alcohol withdrawal
D. Electrolyte imbalances
C. Alcohol withdrawal
9.
A 78-yr-old woman was transferred to the intensive care unit after emergency abdominal surgery. The nurse notes the patient is disoriented and confused, has incoherent speech, is restless, and agitated. Which action by the nurse is most appropriate?
A. Reorient the patient.
B. Document the findings.
C. Notify the health care provider.
D. Administer lorazepam (Ativan).
A. Reorient the patient.
14.
Which statement by the wife of a patient with Alzheimer’s disease demonstrates an accurate understanding of her husband’s medication regimen?
A. “I’m really hoping his medications will slow down his mental losses.”
B. “We’re both holding out hope that this medication will cure his disease.”
C. “The medications might prevent a bodily decline while he declines mentally.”
D. “If we follow his medication schedule, he may not have any physical effects of his disease.”
A. “I’m really hoping his medications will slow down his mental losses.”
19. Name a medication used to treat hypomobility in Parkinson's disease.
Apomorphine (Apokyn)
Name the R & I causes of delirium.
Rx Drugs
Injury, immobility
5. Which nursing intervention is most appropriate when caring for patients with dementia?
A. Avoid direct eye contact.
B. Lovingly call the patient “honey” or “sweetie.”
C. Give simple directions, focusing on one thing at a time.
D. Treat the patient according to their age-related behavior.
C. Give simple directions, focusing on one thing at a time.
10. The patient is having some increased memory and language problems. What diagnostic tests will be done before this patient is diagnosed with Alzheimer’s disease? (Select all that apply.)
A. Urinalysis
B. Chest x-ray
C. MRI of the head
D. Liver function tests
E. Neuropsychologic testing
F. Blood urea nitrogen and serum creatinine
A. Urinalysis
C. MRI of the head
D. Liver function tests
E. Neuropsychologic testing
F. Blood urea nitrogen and serum creatinine
15. When providing community health care teaching about the early warning signs of Alzheimer’s disease (AD), which signs should the nurse ask family members to report? (Select all that apply.)
A. Misplacing car keys
B. Losing sense of time
C. Difficulty performing familiar tasks
D. Problems with performing basic calculations
E. Momentarily forgets an acquaintance’s name
F. Becoming lost in a usually familiar environment
B. Losing sense of time
C. Difficulty performing familiar tasks
D. Problems with performing basic calculations
F. Becoming lost in a usually familiar environment
20. Name three additional medications or medication types used to treat Parkinson's disease.
Anticholinergics
Antihistamines with anticholinergic or β-adrenergic blockers are used to manage tremors
Antiviral agent amantadine
MAO-B inhibitors, selegiline, and rasagiline may be combined with Sinemet.
Entacapone and tolcapone block the enzyme that breaks down levodopa in the peripheral circulation.
Name the U & M causes of delirium.
Untreated pain, unfamiliar environment
Metabolic disorders