Chapter 37- Delirium, Dementias, and Other Related Disorders My Nursing Test Banks

 

1.

An older adult client is brought to the emergency department after ingesting an unknown substance. The client, who appears to have dementia, has tremors, ataxia of the upper and lower extremities, depression, and confusion. The nurse suspects ingestion of which of the following?

A)

Lead

B)

Aluminum

C)

Manganese

D)

Mercury

2.

An adolescent client is seen in the emergency department with symptoms of dementia, tremors, and ataxia. The client had been sniffing glue with a friend. The nurse suspects the clients symptoms were caused by poisoning with which of the following?

A)

Mercury

B)

Lead.

C)

Toluene

D)

Arsenic

3.

The nurse is assessing a client who has received a tentative diagnosis of delirium. The nurse is explaining to the family about the major cause of the clients condition. Which statement by the nurse would be most appropriate?

A)

Basically, this diagnosis is based on the clients inability to talk normally.

B)

Your report of gradually developing confusion over time was the basis for the diagnosis.

C)

His diagnosis is primarily based on the rapid onset of his change in consciousness.

D)

The clients exposure to an infectious agent led us to determine the diagnosis.

4.

As part of a follow-up home visit to an 80-year-old client who has had surgery, the nurse discusses the clients risk for delirium with his family members. Which of the following would the nurse include as placing the client at increased risk? Select all that apply.

A)

Urinary tract infection

B)

Hypertension

C)

Acute stress

D)

Bone fractures

E)

Dehydration

F)

Electrolyte balance

5.

The nurse is caring for a client diagnosed with delirium who has been brought for treatment by his son. While taking the clients history, which question would be most appropriate for the nurse to ask the clients son?

A)

Has your father taken any medications recently?

B)

Are you aware of your father falling or injuring his head in any way?

C)

Has your father had a recent stroke?

D)

Has your father experienced any major losses recently?

6.

The nurse makes a home visit to a family caring for a client with Alzheimers disease. The clients wife tells the nurse that she hasnt been out of the house for more than 2 weeks because her sister has been unable to help her care for the client. Which nursing diagnosis would the nurse identify as the priority?

A)

Ineffective Family Coping related to care of a client with Alzheimers disease

B)

Risk for Activity Intolerance related to Alzheimers disease

C)

Caregiver Role Strain related to social isolation

D)

Powerlessness related to seclusion and long-term care of client

7.

A daughter brings her mother, who has Alzheimers disease, to the clinic. The client has been taking a cholinesterase inhibitor medication for 1 month. When assessing the client, the nurse would be alert for the possibility of which side effect?

A)

Gastrointestinal distress

B)

Mild headache

C)

Muscle tics

D)

Blurred vision

8.

A son brings his mother to the clinic for an evaluation. The sons mother has moderate Alzheimers disease without delirium. The nurse assesses the client for which of the following as the priority?

A)

Hearing deficits

B)

Mania

C)

Strange verbalizations

D)

Catastrophic reactions

9.

A client is admitted to the hospital with dementia related to Parkinsons disease. The client is being treated for a fractured tibia from a recent fall. The nurse should assess the clients history for use of which type of medication?

A)

Anticholinergics

B)

Dopamine agonists

C)

Anxiolytics

D)

Benzodiazepines

10.

While the nurse is caring for a hospitalized client in the advanced stages of Alzheimers disease, the client begins to have a catastrophic reaction to feeding himself. Which of the following should the nurse do first?

A)

Remain calm and reassuring.

B)

Restrain the client temporarily.

C)

Draw the curtains to darken the room.

D)

Offer to feed the client.

11.

While reviewing the medical record of a client with moderate dementia of the Alzheimer type, the nurse notes that the client has been receiving memantine. The nurse identifies this drug as which type?

A)

Atypical antipsychotic

B)

Cholinesterase inhibitor

C)

NMDA receptor antagonist

D)

Benzodiazepine

12.

A group of nursing students is reviewing information about delirium and dementia. The students demonstrate a need for additional review when they identify which of the following as characteristics of dementia?

A)

Fluctuating changes within a 24-hour period

B)

Possible hallucinations

C)

Normal psychomotor activity

D)

Globally impaired cognition

13.

A client is brought to the emergency department by his wife. The wife states that over the past few hours, the client has become disoriented and confused. He didnt know where he was and didnt seem to recognize me or be able to carry on a coherent conversation. The nurse suspects delirium. When reviewing the clients medication history with the wife, use of which of the following would alert the nurse to a potential cause? Select all that apply.

A)

Propranolol

B)

Acetaminophen

C)

Diphenhydramine

D)

Verapamil

E)

Quinidine

14.

A nurse is assessing a client diagnosed with Alzheimers disease. As part of the assessment, the nurse asks the client to identify common objects. The nurse is assessing for which of the following?

A)

Aphasia

B)

Apraxia

C)

Agnosia

D)

Executive functioning

15.

A nursing instructor is preparing a presentation on the etiology of Alzheimers disease. When discussing the role of neurotransmitters in the course of the disease, which of the following would the instructor most likely emphasize?

A)

Serotonin

B)

Acetylcholine

C)

Dopamine

D)

Norepinephrine

16.

When assessing a client with dementia, the nurse identifies that the client is experiencing hallucinations. Based on the nurses understanding of this disorder, which type of hallucination would the nurse expect as most common?

A)

Auditory

B)

Visual

C)

Gustatory

D)

Olfactory

17.

A nurse is talking with the husband of a female client diagnosed with Alzheimers disease. During the conversation, the husband tells the nurse that she often begins to scream and curse for no apparent reason. The nurse interprets this as which of the following?

A)

Hypersexuality

B)

Disinhibition

C)

Hypervocalization

D)

Apathy

18.

After teaching a group of nursing students about Alzheimers disease and appropriate nursing care, the instructor determines that the teaching was successful when the students identify which of the following as the foundation for providing care to the client and family?

A)

Therapeutic relationship

B)

Medication therapy

C)

Injury prevention

D)

Functional independence

19.

A nurse is providing care to a client with Alzheimers disease who is exhibiting suspiciousness and delusional thinking. Which of the following would be most important for the nurse to do with this client?

A)

Tell the client that he is experiencing delusions.

B)

Confront the client about his distorted thinking.

C)

Correct the clients interpretation of the situation.

D)

Determine the trigger for the distorted thinking.

20.

A client with Alzheimers disease is admitted to the acute care facility for treatment of an infection. Assessment reveals that the client is anxious. When developing the clients plan of care, which of the following would be least appropriate to include?

A)

Frequently provide reality orientation.

B)

Simplify the clients routines.

C)

Limit the number of choices to be made.

D)

Establish predictable routines.

Answer Key

1.

D

2.

C

3.

C

4.

A, C, D, E

5.

A

6.

C

7.

A

8.

D

9.

A

10.

A

11.

C

12.

A

13.

A, C, E

14.

C

15.

B

16.

B

17.

C

18.

A

19.

D

20.

A

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