Dementia Details
What is the most common type of dementia?
What is Alzheimer’s disease?
Alzheimer’s accounts for 60–80% of dementia cases, making it the most prevalent form.
What is a key clinical feature that differentiates delirium from dementia?
Delirium has an acute onset and fluctuating course
Unlike dementia (Chronic & Progressive), delirium develops quickly and symptoms often vary throughout the day.
Parkinson’s disease primarily affects which area of the brain?
The basal ganglia, specifically the substantia nigra, where dopamine-producing neurons degenerate.
What is one benefit of maintaining consistent caregivers for a client with dementia?
It promotes trust, reduces confusion, and supports communication through familiarity.
Consistency is key for clients with memory impairment.
Name one simple environmental change that can reduce fall risk for clients with dementia.
Remove throw rugs and clutter
Ensure adequate lighting (especially at night)
Use non-slip footwear
Keep assistive devices (e.g., walker) within reach
Use night lights or motion-sensor lights
Ensure furniture is arranged to allow safe pathways
These low-effort adjustments support orientation and safety in home and care settings.
A client in a Long-Term Care facility with moderate-stage dementia begins wandering at night. What nursing action would best reduce fall risk and promote client safety?
Use a motion-sensor alarm and ensure pathways are clear and well-lit
This balances client autonomy with safety, and helps staff respond quickly to movement.
What screening tool is commonly used by nurses to identify delirium in hospitalized clients?
The Confusion Assessment Method (CAM) or CAM-ICU
CAM and CAM-ICU are validated tools used to screen for delirium, especially in acute care and ICU settings.
List the four hallmark motor symptoms of Parkinson’s Disease.
Bradykinesia
Resting tremor
Rigidity
Postural instability
These are the core motor manifestations used to support diagnosis.
What is a common emotional experience of family caregivers of clients with dementia, often resulting from prolonged caregiving demands?
Caregiver role strain.
This may include stress, fatigue, guilt, or feeling overwhelmed, and is a key nursing concern.
Describe two risks associated with the use of physical restraints in older adults with cognitive impairment.
Increased agitation and behavioral escalation
Physical injury (e.g., bruises, skin tears, falls when attempting to escape)
Other considerations include increased confusion, social isolation, and loss of dignity.
Which of the following best describes communication strategies for a client with late-stage dementia?
A. Use open-ended questions
B. Speak quickly to keep attention
C. Offer visual cues and short phrases
D. Avoid touch to prevent overstimulation
Offer visual cues and short phrases
Clear, simple communication supports comprehension; visual cues are especially helpful.
Which of the following clients is at highest risk for developing delirium?
A. 72-year-old with mild hearing loss and stable CHF
B. 68-year-old admitted for elective knee surgery
C. 75-year-old with a UTI and multiple recent medication changes
D. 80-year-old who lives alone and has a history of controlled hypertension
C. 75-year-old with a UTI and multiple recent medication changes
Infection and polypharmacy are well-known delirium triggers in older adults. (Slide 49)
Which of the following nursing interventions best promotes safe feeding in a client with Parkinson’s disease?
A. Encourage the client to eat quickly before fatigue sets in
B. Offer large meals with high protein for nutritional support
C. Position the client upright and allow ample time to chew and swallow
D. Limit fluid intake during meals to prevent aspiration
C. Position the client upright and allow ample time to chew and swallow.
Clients with PD are at risk for dysphagia. Upright positioning and pacing reduce aspiration risk.
Which of the following statements best demonstrates the use of validation therapy?
A. “You’re not going to work today—you’ve been retired for years.”
B. “It’s okay. Tell me about what you used to do at work.”
C. “Let’s focus on the here and now.”
D. “Remember, your family said you shouldn’t go outside alone.”
B. “It’s okay. Tell me about what you used to do at work.”
Validation therapy supports the client’s emotional reality, rather than correcting them.
Which of the following medication categories and examples should be used with caution in older adults due to increased fall risk and cognitive side effects?
A. Non-opioid Pain relievers – Acetaminophen
B. Anticholinergics – Diphenhydramine
C. Lipid-lowering agents – Simvastatin
D. Antihypertensives – Lisinopril
B. Anticholinergics – Diphenhydramine
Anticholinergics can impair cognition, cause sedation, urinary retention, and increase fall risk in older adults.
A nurse administers donepezil to a client with dementia. What assessment finding should prompt immediate follow-up?
Bradycardia
Donepezil, a cholinesterase inhibitor, may cause bradycardia—monitoring HR is essential.
Which class of medications is sometimes used to manage severe agitation in clients with delirium when non-drug strategies are ineffective?
Atypical antipsychotics
Although not first-line, atypical antipsychotics like quetiapine and risperidone may be used for short-term management of agitation in delirium when safety is a concern.
Identify at least four fall prevention strategies for a hospitalized client with Parkinson’s disease.
Maintain a wide-base stance when ambulating or assisting the client
Keep frequently used items within reach
Ensure pathways are clear of clutter
Use assistive devices (e.g., walkers) as appropriate
Provide scheduled toileting
Use bed/chair alarms
Monitor for orthostatic hypotension
Encourage slow position changes
Install/use a toilet seat riser to ease transfers
List at least four ways nurses can support family caregivers of clients with dementia.
Provide emotional support and active listening
Offer education about disease progression
Connect caregivers with respite care or support groups
Encourage realistic expectations
Include caregivers in care planning
Reinforce that it’s okay to ask for help
Screen for caregiver role strain
List four fall prevention strategies for a client with dementia at home or in a care facility.
Maintain a wide-base stance when assisting with mobility
Use grab bars and raised toilet seats
Keep pathways well-lit and clutter-free
Ensure assistive devices are within reach
Remove rugs and trip hazards
Schedule regular toileting
Keep frequently used items within reach
Orient client frequently to surroundings
A client with moderate dementia is admitted to a hospital unit. Identify 4 strategies the nurse can use to structure the environment to promote orientation and reduce anxiety.
Place a photo of the client on their door
Keep personal items (e.g. glasses, hairbrush) in consistent locations
Use a calendar and large-face clock
Provide a communication board or handheld device for routine and orientation info
Place familiar photos or objects from home at the bedside
Cover or remove mirrors if distressing
Reduce environmental noise and visual distractions
Ensure non-glare, adequate lighting without harsh shadows
Follow a consistent daily routine
Explain changes in routine in advance and just before they occur
Promote undisturbed nighttime sleep
Avoid wall art or decorations that could be misinterpreted as people or animals
Identify 3 strategies the nurse can use to help prevent delirium in a hospitalized older adult.
Promote early mobility and ambulation
Maintain a sleep-wake cycle with quiet nights
Monitor and manage pain
Ensure use of sensory aids (glasses, hearing aids)
Provide hydration and nutrition
Use non-drug alternatives for sleep and agitation
Remove or camouflage tubes when possible
Provide cognitive stimulation and personalized activities
Encourage family presence
Use motion sensor alarms and frequent rounding
Keep the environment calm and appropriate for sensory needs
List four important teaching points for caregivers of clients with Parkinson’s Disease related to medication use and symptom monitoring.
Take medications (e.g., levodopa) at the same time daily
Be aware of potential side effects (e.g., dyskinesias, hallucinations)
Do not suddenly stop medications
Monitor for “on-off” periods or fluctuations in mobility
Encourage tracking symptom patterns
Coordinate with providers if medication timing needs adjustment
Be alert for signs of depression or changes in cognition
Identify 4 considerations for communicating with clients experiencing late-stage dementia.
Approach slowly from the front and maintain eye level
Use touch gently and respectfully
Speak in a calm, reassuring tone
Use visual cues and gestures
Pause after speaking to allow processing time
Focus on emotional validation rather than facts
Respect nonverbal communication (facial expressions, body tension)
List four strategies for assessing and managing pain in clients with late-stage dementia who are nonverbal.
Use a validated tool (e.g., PAINAD scale)
Observe facial expressions, body movements, and vocalizations
Monitor vital signs (e.g., HR, BP) for changes
Look for changes in behavior (e.g., aggression, withdrawal)
Offer scheduled pain medications and reassess regularly
Involve caregivers who know the client’s baseline