Question 1

The nurse identifies which symptoms differentiate clients diagnosed with NCD from clients with pseudodementia (depression)?

Accepted Answer

Clients with neurocognitive disorders (NCD) often have altered task performance due to cognitive decline, whereas clients with pseudodementia (depression) may have impaired attention and concentration but can perform tasks when motivated.

Question 2

A nursing instructor is teaching about donepezil (Aricept).A student asks,"How does this work? Will this cure Alzheimer's disease (AD)?" Which is the appropriate instructor reply?

Accepted Answer

Donepezil (Aricept) works by delaying the destruction of acetylcholine, a chemical in the brain necessary for memory processes. It is most effective in the early stages of Alzheimer's disease and serves to delay, but not stop, the progression of the disease. It does not cure Alzheimer's disease.

Question 3

A client is in the late stage of Alzheimer's disease.To address the client's symptoms,which nursing intervention should take priority?

Accepted Answer

In the late stage of Alzheimer's disease, the priority nursing intervention should be promoting dignity by providing comfort, safety, and self-care measures. This is because the client's cognitive status will have significantly declined, making it difficult for them to participate in social activities or benefit from group therapies. Additionally, communication is also likely to be impaired at this stage, so assistive devices may not be effective. Therefore, the priority should be on ensuring that the client receives proper care and support to maintain their dignity and quality of life.

Question 4

A 36-year old female is admitted to the emergency department at 2:20 a.m.with a severe laceration to her forehead,with incoherent speech.Paramedics report that they picked up the patient at a local bar,and the bartender on site said,"She seemed just fine when she came in.She must have had a lot to drink before she came here." Witness reports onsite confirmed that the woman fell off a bar stool and hit her head on the bar rail.Based on the information provided,a blood alcohol test was administered with a result of a 0.01 blood alcohol level.The woman's weight was recorded at 145 pounds.Incoherent speech is most likely attributed to which of the following?

Accepted Answer

Given the low blood alcohol level (0.01) and the severe laceration to the forehead accompanied by incoherent speech, it is more likely that the symptoms are due to a secondary neurocognitive disorder (NCD) caused by the head injury rather than alcohol intoxication or fatigue. Primary NCDs are typically chronic and progressive, not acute and caused by an injury.

Question 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.The nurse recognizes these as classic signs of which condition?

Accepted Answer

The progressive changes in memory and poor judgment with short attention span are classic signs of neurocognitive disorders such as Alzheimer's disease or other forms of dementia. Mania is a mood disorder characterized by elevated, expansive, or irritable mood, while delirium is characterized by acute changes in cognition and consciousness. Parkinsonism is a movement disorder that may also affect cognition, but it does not typically present with progressive memory changes as the main symptom.

Question 6

A female client was admitted to the hospital after being treated in the emergency room for seizures following a head trauma.Within a few minutes of arriving on the floor,the admitting nurse noticed that the client had a difficult time sustaining attention and did not know where she was.What is the most likely reason for the abnormal behavior?

Accepted Answer

The client's difficulty sustaining attention and confusion about her location suggest a cognitive impairment, which is consistent with delirium. This acute onset of cognitive symptoms, combined with the history of head trauma and seizures, suggests that the delirium may be related to the client's medical condition. Systemic illness, dehydration, and major NCD may also cause cognitive symptoms, but based on the information provided, delirium is the most likely explanation.

Question 7

After 1 week of continuous mental confusion,an elderly African American client is admitted with a preliminary diagnosis of Major NCD due to Alzheimer's disease.Which of the following would cause the nurse to question this diagnosis?

Accepted Answer

Major Neurocognitive Disorder (NCD) due to Alzheimer's disease typically develops gradually, not suddenly, which would cause the nurse to question the diagnosis if symptoms appeared abruptly.

Question 8

The nurse notices that Martha,the primary caregiver for her husband with Alzheimer's disease,seems distracted and she asked how Martha was doing."I'm doing okay," said Martha."I'm just so overwhelmed.I can't seem to get anything done.Just when I think I'm handling everything,something else comes up.Hopefully things will settle down soon and I can get a break." Which of the following would most help Martha cope with the caregiver strain she's expressing?

Accepted Answer

Referring Martha to support services for Alzheimer's disease would provide her with additional help and resources in managing her husband's care, which could alleviate some of her feelings of being overwhelmed and provide her with a much-needed break. A and B focus on providing information about Alzheimer's disease, which may be helpful but does not directly address Martha's current struggles. D is not necessarily appropriate or necessary at this time, as Martha has not indicated that she is considering placing her husband in a facility.

Question 9

The nurse identifies which symptoms differentiate clients diagnosed with NCDs from clients diagnosed with amnestic disorders.

Accepted Answer

NCDs (Neurocognitive Disorders) often involve broader cognitive impairments including difficulties with abstract thinking and judgment, which are not typically seen in amnestic disorders. Amnestic disorders primarily involve memory issues without the extensive cognitive deficits seen in NCDs.

Question 10

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?

Accepted Answer

The answer of A client with a history of cerebrovascular...

Question 11

A client diagnosed with NCD due to Alzheimer's disease can no longer ambulate,does not recognize family members,and communicates with agitated behaviors and incoherent verbalizations.The nurse recognizes that these symptoms indicate which stage of the illness?

Accepted Answer

The symptoms described in the question indicate that the client is in the late stage of Alzheimer's disease. In this stage, individuals lose the ability to ambulate, recognize family members, and communicate effectively. They may exhibit agitated behaviors and incoherent verbalizations. Confabulation stage is not a recognized stage of Alzheimer's disease. Early stage is characterized by mild memory loss and difficulties with problem-solving and decision-making. Middle stage is marked by more significant cognitive decline, including difficulty with basic activities of daily living.

Question 12

A client diagnosed with NCD due to Alzheimer's disease has impairments of memory and judgment and is incapable of performing ADLs.Which intervention is the nurse's priority?

Accepted Answer

The priority intervention for a client with NCD due to Alzheimer's disease who has impairments in memory and judgment and is unable to perform ADLs is to assist with activities of daily living such as bathing and toileting. This promotes the client's physical health, safety, and comfort. The other options may also be beneficial interventions for clients with NCD, but are not the priority in a situation where the client is incapable of performing basic self-care tasks.

Question 13

At what time during a 24-hour period should a nurse expect clients with Alzheimer's disease to exhibit more pronounced symptoms?

Accepted Answer

Clients with Alzheimer's disease often experience an increase in confusion, agitation, and other symptoms during twilight hours, a phenomenon known as sundowning. This typically occurs around sunset but can vary depending on the individual's sleep-wake cycle.

Question 14

A client diagnosed with NCD due to Alzheimer's disease is disoriented,ataxic,and wanders.Which is the priority nursing diagnosis?

Accepted Answer

The client's ataxia and wandering puts them at high risk for falls and injury, making "Risk for injury" the top priority nursing diagnosis. Disturbed thought processes, self-care deficit, and altered health-care maintenance may also be applicable diagnoses, but they are not as urgent as ensuring the client's safety.

Question 15

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

Accepted Answer

Taking multiple medications can increase the risk for delirium due to potential adverse interactions or toxic effects on the body. This statement shows the student understands this risk factor. The other options are not directly related to the development of delirium.

Question 16

A client diagnosed with Lewy Body Dementia has been prescribed an antipsychotic medication to manage a decline in mental capacities.Why should the nurse question this prescription?

Accepted Answer

Clients with Lewy body dementia are highly sensitive to extrapyramidal effects of antipsychotic medications, which can worsen motor symptoms, cause confusion and disorientation, and increase the risk of falls. Therefore, the nurse should question this prescription and consider alternative treatment options.

Question 17

An elderly client recently moved to a nursing home.The client is having trouble concentrating and is isolating from others.A physician believes the client would benefit from medication therapy.Which medication should the nurse expect the physician to prescribe?

Accepted Answer

Sertraline (Zoloft) is an antidepressant that can help with symptoms of depression, which may include trouble concentrating and social withdrawal.

Question 18

A client diagnosed with Vascular Dementia is discharged to home under the care of his wife.Which information causes the nurse to question the client's safety?

Accepted Answer

Smoking is a risk factor for cardiovascular disease and can exacerbate vascular dementia. Therefore, the fact that the client smokes one pack of cigarettes per day causes concern for his safety at home.

Question 19

A client diagnosed with NCD has progressive memory loss,diminished cognitive functioning,verbal aggression,and is experiencing frustration.Which nursing intervention is most appropriate?

Accepted Answer

People with NCD benefit from structured daily routines which provide consistency and familiarity, as their short-term memory may be impaired. Additionally, having a schedule can also minimize confusion and anxiety, and reduce frustration that can lead to verbal aggression.

Question 20

A client diagnosed with a NCD is exhibiting behavioral problems every day.At change of shift,the client's behavior escalates from pacing to screaming and flailing.Which action should the nurse implement first?

Accepted Answer

Before taking any other action, it is important to assess the client's environment for any triggers that may be causing the behavioral problems. This could include sensory overload, unmet physical or emotional needs, or other stressors. By identifying and addressing these triggers, the nurse may be able to prevent or minimize the escalation of the behavior. Consulting a psychologist or medicating the client may be appropriate interventions at some point, but should not be the first action taken. Restraint should never be used as a first-line intervention for behavioral problems.

Quiz 22: Neurocognitive Disorders

The nurse identifies which symptoms differentiate clients diagnosed with NCD from clients with pseudodementia (depression) ?

A nursing instructor is teaching about donepezil (Aricept) .A student asks,"How does this work? Will this cure Alzheimer's disease (AD) ?" Which is the appropriate instructor reply?