Chapter 10: Cognition and Perception My Nursing Test Banks

Wold: Basic Geriatric Nursing, 5th Edition

Chapter 10: Cognition and Perception

Test Bank

MULTIPLE CHOICE

1. The nurse clarifies that perception differs from cognition in that perception refers mainly to:

a.

intellect.

b.

memory.

c.

judgment.

d.

interpretation.

ANS: D

Perception refers mainly to the ability to interpret situations in the environment.

DIF: Cognitive Level: Comprehension REF: 180 OBJ: 1

TOP: Perception vs. Cognition KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

2. The nurse suspects the presence of cataracts in the older adult when the patient:

a.

holds the newspaper a good distance away while attempting to read small print.

b.

seeks an area in a room that is free from glare in order to read the newspaper.

c.

holds a hand over one eye while attempting to read small print.

d.

uses only peripheral vision while attempting to read a newspaper.

ANS: B

Cataracts blur the vision and increase the sensitivity to glare.

DIF: Cognitive Level: Analysis REF: 181 OBJ: 2

TOP: Cataracts KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The nurse approaching a patient who has profound hearing loss should:

a.

knock on the door before entering.

b.

touch the patient on the hand to gain attention.

c.

give the patient a list of interventions that the nurse plans to perform.

d.

speak in a higher tone of voice.

ANS: B

Touching on the hand to gain attention before giving care is thoughtful. Giving a lengthy list is not necessary. Knocking on the door may be futile, and speaking in higher tones is not helpful because the hearing-impaired lose the ability to hear high tones first.

DIF: Cognitive Level: Comprehension REF: 183 OBJ: 7

TOP: Hearing Impairment KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

4. When attempting to communicate with a patient who is hearing-impaired, the nurse should remember to:

a.

keep the message simple.

b.

provide lengthy explanations and information.

c.

assume understanding if the patient does not ask for clarification.

d.

use many hand gestures.

ANS: A

Keeping the message simple will assist the hard of hearing to understand. Long explanations and the use of many hand gestures may be confusing. It is the responsibility of the nurse to check to confirm understanding.

DIF: Cognitive Level: Comprehension REF: 183 OBJ: 7

TOP: Communication with the Hearing-Impaired

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. In adapting the environment for a person with right-sided hemianopsia, the nurse should:

a.

approach the patient from the right side.

b.

arrange personal articles on the left side of the bed.

c.

remind the patient to avoid turning his or her head to reduce added perceptual problems.

d.

touch the patient on the right side to get his or her attention.

ANS: B

Arrangement of personal items on the good left side is supportive to independence.

DIF: Cognitive Level: Application REF: 184 OBJ: 7

TOP: Hemianopsia KEY: Nursing Process Step: Planning

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

6. The night nurse hears a high whistling noise coming from the hearing aids that are lying on the bedside table of the sleeping patient. The nurse should:

a.

replace the hearing aids in the patients ears.

b.

turn off the hearing aids.

c.

place the hearing aids in a drawer to prevent loss.

d.

ask that an audiologist be notified of the problem.

ANS: B

The noise is feedback between the two active hearing aids. They should be turned off to preserve the batteries.

DIF: Cognitive Level: Application REF: 185 OBJ: 7

TOP: Hearing Aids KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

7. The nurse interprets a patients behavior changes as being characteristic of delirium because:

a.

the onset of the behavior was rapid.

b.

there is no change in the level of consciousness.

c.

of the absence of disorientation.

d.

of the absence of hallucinations.

ANS: A

Delirium comes on suddenly and is accompanied by a change in the level of consciousness, disorientation, and hallucinations.

DIF: Cognitive Level: Application REF: 186, Table 10-1

OBJ: 4 TOP: Delirium KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

8. The nurse is aware that conditions that can cause delirium in the older adult include:

a.

uncontrolled pain.

b.

death of a loved one.

c.

relocation to a long-term care facility.

d.

altered sleep patterns.

ANS: A

Delirium results from physiological influences such as uncontrolled pain, metabolic disturbances, or drug toxicity.

DIF: Cognitive Level: Analysis REF: 186 OBJ: 3

TOP: Delirium KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

9. The nurse recognizes a cardinal indicator that the patient with stage 1 dementia has deteriorated to stage 2 by the presence of:

a.

inability to communicate.

b.

incontinent episodes.

c.

total dependency.

d.

forgetfulness.

ANS: B

Incontinent episodes are indicative of stage 2 dementia.

DIF: Cognitive Level: Application REF: 188 OBJ: 4

TOP: Stages of Dementia KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

10. The nurse can provide continuity for the demented patient in a general hospital by:

a.

keeping the patient in the room.

b.

reducing environmental stimuli such as the TV or radio.

c.

assigning the same personnel every day for care.

d.

attaching a bed alarm to the patient.

ANS: C

Assigning the same personnel helps the demented patient have continuity of care.

DIF: Cognitive Level: Application REF: 189 OBJ: 7

TOP: Dementia KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

11. When the demented resident in a long-term care facility becomes combative when being prepared for a bath in the shower, the nurse should:

a.

call for assistance to complete the shower.

b.

say, I understand you dont want a shower, so Ill give you a sponge bath.

c.

medicate the patient with a sedative and complete the bath when the patient is more cooperative.

d.

say, Okay. Its your right to remain dirty.

ANS: B

Focusing on feelings or offering an alternative is helpful with a combative demented patient. Arguing serves no purpose other than to make the resident more upset.

DIF: Cognitive Level: Application REF: 189 OBJ: 7

TOP: Combative Patient KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

12. The nurse explains to a family that current Omnibus Budget Reconciliation Act (OBRA) guidelines allow the use of antipsychotic medication as a chemical restraint to control:

a.

disruptive verbal behavior.

b.

constant yelling and screaming.

c.

hallucinations.

d.

disorientation.

ANS: B

The current OBRA prohibits the use of antipsychotic drugs to control nonaggressive behavior. However, antipsychotic drugs may be prescribed for the control of constant screaming and yelling.

DIF: Cognitive Level: Application REF: 190 OBJ: 7

TOP: Use of Antipsychotic Drugs KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Pharmacological Therapies

13. When the patient with a cognitive disorder acts out because of excessive stimulation, the nurses most effective intervention would be to:

a.

medicate with a psychoactive drug such as lorazepam or diazepam.

b.

send the patient to his or her room for time out.

c.

remind the patient that acting out behavior will not be tolerated.

d.

distract the patient with a quiet activity.

ANS: D

Distraction with a quiet activity and with interpersonal contact frequently interrupts acting out.

DIF: Cognitive Level: Application REF: 191 OBJ: 7

TOP: Acting Out Behavior KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

14. When the home health nurse is helping a family accept the diagnosis and prepare for the patient with a cognitive disorder, the nurse should:

a.

leave them literature about the disorder.

b.

instruct them about the physiological changes that cause the disorder.

c.

allow them time for expression of their feelings and grief.

d.

discuss options for placement in a long-term care facility.

ANS: C

Allowing time for expression of their feelings will help the family cope and begin planning how best to care for their loved one.

DIF: Cognitive Level: Application REF: 191 OBJ: 3

TOP: Impact of Cognitive Disorder on Family

KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

15. To help a male patient with expressive aphasia communicate, the nurses most effective intervention would be to:

a.

provide flash cards with text and pictures.

b.

be patient and ask him to repeat himself.

c.

encourage him to practice slow speech.

d.

arrange with him to blink the eyes once for yes and twice for no.

ANS: A

Flash cards or pen and paper help the patient with expressive aphasia communicate. Blinking only allows the patient to answer, not communicate needs.

DIF: Cognitive Level: Comprehension REF: 194 OBJ: 7

TOP: Expressive Aphasia KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

16. The nurse in an extended care facility finds an 86-year-old female resident in tears and her hearing aids on the floor. The resident says, Ill just be deaf! I cant stand those things in my ears! All I can hear is static, hums, and whistles! The nurses most helpful response is:

a.

Everybody says that. Im going to put these back in the box in your bedside table.

b.

Those are very expensive pieces of equipment. Because you paid for them, it seems to me to just be good sense to use them.

c.

Lets put them back in. Youll get used to them in a few days.

d.

Its frustrating to have something not work. Let me help you replace them and after 10 minutes, Ill help you take them out.

ANS: D

Many people who have new hearing aids report that the sounds are tinny and noisy. When first fitted, the person may be able to tolerate the hearing aids for only a few minutes a day.

DIF: Cognitive Level: Comprehension REF: 184 OBJ: 7

TOP: Hearing Aid Adjustment KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

17. The nurse reading the history of a newly admitted 88-year-old man with dementia sees that this resident is prone to catastrophic reactions. The nurse understands that this person will:

a.

demonstrate excessive emotional reactions.

b.

become combative with little stimulus.

c.

suddenly display self-destructive behaviors.

d.

openly expose himself or make sexual advances.

ANS: A

Catastrophic reactions are reactions that are excessively emotional.

DIF: Cognitive Level: Comprehension REF: 188 OBJ: 3

TOP: Catastrophic Reactions KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

18. An 84-year-old female resident with dementia in an extended care facility rapidly paces the halls and the common areas from right after breakfast to bedtime. The nurse should include in the plan of care to:

a.

restrain the resident from pacing.

b.

apply a bracelet that sounds an alarm if the resident leaves the building.

c.

encourage rest by asking her to sit and have a glass of juice or a snack.

d.

pace with her and engage her in conversations.

ANS: C

Encourage rest periods during the day by offering a snack or juice. Pacers should not be restrained from pacing. An alarm bracelet is not necessary if no attempt to leave the building is made. Pacing with her does not result in rest periods.

DIF: Cognitive Level: Application REF: 189 OBJ: 7

TOP: Pacing KEY: Nursing Process Step: Planning

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

MULTIPLE RESPONSE

1. The nurse lists indicators of hearing loss, which include __________. (Select all that apply.)

a.

understanding the female voice better than the male voice

b.

reluctance to have telephone conversations

c.

becoming irritable with background noise

d.

turning the TV up to the loudest volume

e.

responding with off-the-wall answers to a question

ANS: B, C, D, E

Because of the higher register of the female voice and that of children, the person with a hearing impairment does not understand them well. All other options are valid indicators of hearing loss.

DIF: Cognitive Level: Comprehension REF: 182 OBJ: 4

TOP: Sensory Deficit KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

2. The nurse is aware that memory loss in the older adult __________. (Select all that apply.)

a.

increases with age

b.

decreases in a person with more education

c.

increases with the use of antihistamines

d.

decreases with the use of vitamin A

e.

decreases in persons who have many varied memories

ANS: A, B, E

The use of vitamin A has no memory enhancement capability. Antihistamines do not have a history of being a cause of memory loss.

DIF: Cognitive Level: Comprehension REF: 182 OBJ: 2

TOP: Memory Loss KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

3. The nurse instructs a hearing-impaired patient on some methods to improve communication, which include __________. (Select all that apply.)

a.

informing others of the hearing deficit

b.

focusing on the speaker

c.

facing the speaker

d.

requesting the speaker to shout if necessary

e.

asking the speaker to repeat what is not clear

ANS: A, B, C, E

Shouting does not help a hearing-impaired patient to understand. All other options improve communication for a hearing-impaired person.

DIF: Cognitive Level: Comprehension REF: 185 OBJ: 7

TOP: Hearing Impairment KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

4. The nurse explains that confusion is divided into three different types, which are __________. (Select the three that apply.)

a.

acute confusion

b.

mixed confusion

c.

idiopathic confusion

d.

generic confusion

e.

dementia

ANS: A, C, E

The three types of confusion are acute confusion or delirium, idiopathic confusion, and dementia.

DIF: Cognitive Level: Comprehension REF: 186 OBJ: 3

TOP: Types of Confusion KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

5. The nurse can help a demented person maintain orientation by __________. (Select all that apply.)

a.

consistently calling the patient by name, usually the first name

b.

referring the patient to a calendar to note special events

c.

reminding the patient about the time of day by pointing to the clock

d.

calmly taking the patient to an appointment without explanation

e.

reminding the patient of her or his whereabouts frequently

ANS: A, B, C, E

Demented persons need a simple explanation of all procedures involved in their care. All other options are helpful in maintaining orientation for a demented patient.

DIF: Cognitive Level: Application REF: 189 OBJ: 7

TOP: Orientation Methods KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

6. The nurse should include which factor(s) in a pain assessment? (Select all that apply.)

a.

What provokes it

b.

Location

c.

Radiation

d.

Severity

e.

Frequency

ANS: A, B, C, D, E

All options are significant parts of a pain assessment.

DIF: Cognitive Level: Knowledge REF: 197 OBJ: 8

TOP: Pain Assessment KEY: Nursing Process Step: Assessment

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

7. The nurse designing a teaching plan for a family caring for an older adult who is experiencing pain would stress __________. (Select all that apply.)

a.

giving medication before the pain becomes severe

b.

distracting the patient instead of medicating

c.

that pain reported by the older adult may be exaggerated

d.

delaying administration to reduce the risk of addiction

e.

observing the effectiveness of the medication

ANS: A, E

Giving medication before pain is severe alleviates pain better and results in the patient requiring less medication. Assessment of the drugs effectiveness is important to relay to the physician in the event the drug needs to be changed or the dose increased.

DIF: Cognitive Level: Application REF: 198 OBJ: 8

TOP: Pain Control KEY: Nursing Process Step: Implementation

MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

COMPLETION

1. The nurse explains that the term that describes the ability to make judgments quickly on the basis of unfamiliar stimuli is __________ __________.

ANS: fluid intelligence

DIF: Cognitive Level: Knowledge REF: 181 OBJ: 1

TOP: Fluid Intelligence KEY: Nursing Process Step: Implementation

MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

2. The center for speech located in the brain is the __________ area.

ANS: Broca

DIF: Cognitive Level: Knowledge REF: 193 OBJ: 1

TOP: Broca Area KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

3. The person who is unable to identify time, place, or person to the point that he or she is unable to make appropriate decisions is described as __________.

ANS: confused

DIF: Cognitive Level: Knowledge REF: 185 OBJ: 3

TOP: Confusion KEY: Nursing Process Step: N/A MSC: NCLEX: N/A

Copyright 2012 by Mosby, Inc., an affiliate of Elsevier Inc.

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