Chapter 27 Cognitive Disorders

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Chapter 27  Cognitive Disorders

 

 

Complete Chapter Questions And Answers
 

Sample Questions

 

 

A client with Alzheimer’s disease in the intensive treatment unit repeatedly tries to go into other patients’ rooms to nap during the day. The most appropriate nursing intervention for this patient is what?
A)
Allowing her to nap in an empty room
B)
Explaining to her why this cannot be tolerated
C)
Escorting the patient to her room for napping
D)
Suggesting that daytime napping be decreased
Ans:
C

Feedback:

Allowing the client to nap in an empty room would disrupt unit activity because of frequent bed changes and does not serve any therapeutic purpose. Explaining to the client why this behavior cannot be tolerated would be ineffective, because the client has memory impairment and would not remember not to go into the rooms of others. Escorting the client to her room for napping allows the client her own space and reinforces the reality of her personal room. Unless daytime napping interferes with nighttime sleep, there is no reason to eliminate short napping periods.

2.
A client has experienced a gradual flattening of affect, confusion, and withdrawal and has been diagnosed with Alzheimer’s disease. The nurse assesses which of the following additional characteristics of this disorder?
A)
Personality change, wandering, and inability to perform purposeful movements
B)
Delusions, hallucinations, and confusion about date and time
C)
Tremors, unsteady gait, and transient paresthesias
D)
Transient blindness, slurred speech, and weakness
Ans:
A

Feedback:

Alzheimer’s disease is not typically characterized by delusions, transient paresthesias, blindness, or slurred speech. Instead, general changes in personality, wandering, and the inability to perform purposeful, goal-directed movements are impaired.

3.
Heindel and Salloway (1999) identified four distinct, yet mutually interacting, memory systems as being affected in dementia. Which of the following is not one of them?
A)
Working memory
B)
Episodic memory
C)
Semantic memory
D)
Short-term memory
Ans:
D

Feedback:

Heindel and Salloway (1999) have found that memory is not a single homogenous entity. Rather, it is composed of four distinct, yet mutually interacting, memory systems: working memory, episodic memory, semantic memory, and procedural memory. Short-term memory refers to the length of time during which material is remembered, not to a distinct type of memory system.

4.
A client was admitted to the ICU after a motor vehicle accident. She sustained a right parietal injury, resulting in an acute confusional state or delirium. She complains that there are “bugs crawling around” on her arms. The nurse understands what?
A)
Such hallucinations suggest preexisting schizophrenia.
B)
Transient tactile hallucinations are sometimes seen in delirium.
C)
Such symptoms indicate increasing brain damage and poor prognosis.
D)
The client is more prone to such episodes early in the morning.
Ans:
B

Feedback:

With delirium, as is the case with the client, transient tactile hallucinations are seen in many cases. This type of tactile hallucination would not indicate schizophrenia or brain damage, nor would the client be any more prone to them at any time of the day.

5.
The nurse is working with the family of a client who is newly diagnosed with Alzheimer’s type dementia. Which of the following suggestions would be effective for assisting the family in daily orienting of their family member when the client returns home?
A)
Provide a flexible schedule and change the activities each day.
B)
Use daily newspapers, calendars, and a set routine.
C)
Read to the client for long periods at a time.
D)
Use a daily current events quiz, making sure that the client participates.
Ans:
B

Feedback:

Using daily newspapers, calendars, and a set, unchanging routine would be a more effective way to provide daily orientation for the family member. Changing daily activities would make it more difficult to maintain orientation. Reading to the client for long periods of time would not maintain client involvement and appropriate stimulation. Using daily quizzes would place stressful demands on the client and not provide functionally appropriate tasks.

 

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