Psychiatric Nursing

(Cognitive Disorders Questions)

Mitj Bryan D. Linatoc
BSN 4y1-44

1. A client with a history of atrial fibrillation has a brain attack, and vascular
dementia (multi-infarct dementia) is diagnosed. When comparing
assessments off clients with vascular dementia and dementia of the
Alzheimer’s type, which factor is unique to a vascular dementia?

a. memory impairment
b. abrupt onset of symptoms
c. difficulty making decisions
d. inability to use words to communicate

ans. a. The signs and symptoms associated with vascular dementia have an
abrupt onset (days to weeks) because of the occlusion of small arteries or
arterioles in the cortex of the brain.

2. A 70 year old retired man has had difficulty remembering his daily
schedule and finding the right words to express himself. He is diagnosed as
having dementia of the Alzheimer’s type. The nurse is aware that symptoms
of this disorder.

a. usually occur fairly rapidly

b. have periods of remission
c. develop a long period
d. frequently begin after a loss of self-esteem

ans. c. dementias such as that of the Alzheimer’s type, result from

pathologic changes of CNS cells producing symptoms that are long term and
progressive.

3. When assessing a client with a cognitive disorder, the nurse identifies a

behavior to an alteration in mood when the client.

a. hoards food
b. tells sexually explicit jokes
c. has delusions and hallucinations
d. reverses day and night activities
ans. a. hoarding food may manifest paranoia, which is related to mood.

4. An 84 year old widow with dementia, who had been living with her
daughter before hospitalization. is being discharged with a referral to the
visiting nurse. When the nurse visits, the client is in bed sleeping at 10 AM.
Her daughter states that she gives her mother sleeping pills to stop her
wandering at night. The nurse should;

a. discuss the possibility of placing the client in a nursing home

b. explore the use of a home health aide to sit with the client at night
c. suggest moving the client among family members on a monthly basis
d. empathize with the daughter but suggest that wrist restraints would be
better

ans. b. this action will reduce the need for sleeping pills, which frequently
add to the older client’s.

5. When the nurse is communicating with a client with substance induced

persisting dementia, the client cannot remember facts and fills in the gaps
with imaginary information. The nurse is aware that this typical of;

a. concretism
b. confabulation
c. flight of ideas
d. associative looseness

ans. b. confabulation, or the filling in of memory gaps with imaginary facts, is

a defense mechanism used by people experiencing memory deficits.

6. When taking a health history from a client who has a moderate level of
cognitive impairment due to dementia, the nurse would expect to note the
presence of;

a. hypervigilance
b. increased inhibition
c. enhanced intelligence
d. accentuated premorbid traits
ans. d. a moderate level of cognitive impairment due to dementia is
characterized by increasing dependence on environmental and social
structure and by increasing psychologic rigidity with accentuated previous
traits and behaviors.
7. An 84 year old woman is admitted to the hospital with a diagnosis of
dementia of the Alzheimer’s type. The nurse recognizes that this disorder is
a;

a. problem that first emerges in the third decade of life

b. nonorganic disorder that occurs in the later years of life
c. disorder that is easily diagnosed through laboratory and psychologic tests
d. cognitive problem that is a slow relentless diffuse deterioration of the
mind

ans. d. dementia of the Alzheimer’s type accounts for 80% of dementias in

older adults; it may be due to a neurotransmitter deficiency.

8. An older client is admitted to the hospital with the diagnosis of dementia

of the Alzheimer’s type and depression. The client has all of the following
signs, Which is unrelated to the depression.

a. Loss of memory
b. neglect or personal hygiene
c. I don’t know answers to questions
d. apathetic response to the environment

ans. a. depression does not cause dementia memory deficits

9. When planning activities for an older nursing home resident with a

diagnosis of vascular dementia, the nurse should;

a. plan varied activities that will keep the resident occupied

b. provide familiar activities that the resident can successfully complete
c. offer challenging activities to maintain the residents contact with reality
d. ensure that the resident actively participates in the units daily activities

10. a client with the diagnosis of dementia of the Alzheimer’s type stage 1 is
living at home with a grown daughter to best address the functional and
behavioral changes associated with this stage. The nurse should encourage
the daughter to;
a. place the mother in a long term care facility
b. provide for the mothers basic physical needs
c. post a schedule of the mothers daily activities
d. perform care so that the mother does not need to make decisions
ans. c. in stage 1 clients have a mild cognitive impairment with short term
memory loss establishing a daily routine posting it and adhering to it
provides a concrete structured approach.