FA Davis - MH - Ch 22 - Neurocognitive Disorders PDF

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NCLEX style practice questions for mental health related to neurocognitive disorders....

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FA DAVIS – Questions Chapter 22 – Neurocognitive Disorders

The nurse is assessing a client who is diagnosed with Alzheimer’s disease (AD) with moderate cognitive decline. Which question does the nurse ask the client to assess the progressive nature of symptoms of the disease to the next stage? “How is your performance at work?” - mild “Do you have difficulty recalling names or words?” - mild “Are you experiencing any short-term memory loss?” – stage 2 “Are you able to perform your daily activities independently?” - moderate

Which instructions does the nurse provide to the spouse of a client suffering from severe cognitive decline? Select all that apply. “Don’t be surprised if your spouse forgets your name.” “Your spouse may not be able to recognize some family members.” “Your spouse may be more aggressive during late afternoons and evenings.” “It is important to provide institutional care for your spouse.” “Watch out for infections like pneumonia in your spouse caused by decreased immunity.”

Which symptoms does the nurse observe in a 34-year-old client diagnosed with neurocognitive disorder (NCD) due to Huntington’s disease? Select all that apply. Twitching of limbs Hyperactive behavior Emotional impairment Short-term memory loss Appearance of visual hallucinations

What first-line drug treatment would the nurse expect to be prescribed for an elderly client diagnosed with neurocognitive depression? Doxepin - tricyclic Sertraline - ssri Imipramine - tricyclic Nortriptyline - tricyclic

Which diagnostic tool is useful for revealing the metabolic activity of the brain?

Electroencephalogram (EEG) Magnetic resonance imaging (MRI) Positron emission tomography (PET) scanning Computerized tomography (CT) scanning

The nurse is caring for a client with disorientation and confusion. Which nursing interventions are helpful for providing orientation to reality for the client? Select all that apply. Using reminiscence therapy Allowing the client to view old photographs Maintaining consistency of staff and caregivers Allowing the client to have his or her personal items Encouraging family and close friends to be a part of the client’s care

The registered nurse is teaching students about the care plan provided to a client with hallucinations. Which statement made by the student nurse needs correction? “Distract the client from the surroundings.” “Minimize opportunities for the client to see faces in patterns on fabrics or in pictures on the wall.” “Encourage reflection on the client’s life.” “Try to determine from where the visual hallucination is emanating.”

Which stage of Alzheimer’s disease (AD) is characterized by sundowning? Very mild change Mild cognitive decline Severe cognitive decline Moderately severe cognitive decline

Which medications are preferred for a client with neurocognitive disorder (NCD) experiencing anxiety? Select all that apply. Oxazepam Lorazepam Diazepam Amobarbital Chlordiazepoxide

Which exogenous factors are implicated in the development of delirium in a client? Select all that apply. Porphyria Contusions Prolonged labor

Prenatal infections Obstetric complications

Which medication is useful in treating moderately severe cognitive impairment in a client with a neurocognitive disorder (NCD)? Zaleplon Donepezil Trazodone Physostigmine

The nurse is caring for a client who has impaired ability to perform his or her own activities. Which nursing intervention may minimize the client’s confusion? Allowing the client to have personal items Displaying clocks and calendars with large numbers Providing consistency in the assignment of daily caregivers Anticipating the client’s needs that are not verbally communicated

Which conditions are known to precipitate delirium in a client? Select all that apply. Febrile illness Hypothyroidism Pernicious anemia Systemic infections Hepatic encephalopathy

The client’s spouse says, “My partner is depressed in the morning and is fine in the evening.” What does the nurse suspect in the client? Delirium Pseudodementia Dementia paralytica Neurocognitive disorder (NCD)

Which medication does the nurse expect the primary health-care provider to prescribe for a client with neurocognitive disorder (NCD) who is agitated and aggressive?

Olanzapine Amantadine Alprazolam Mirtazapine

Which focal neurological signs are commonly observed in a client with vascular neurocognitive disorder (NCD)? Select all that apply. Tremor Amnesia Small-stepped gait Difficulty with speech Weakness of the limbs

The nurse is caring for a client with self-care deficits. Which outcome will demonstrate the effectiveness of the nursing intervention? The client will The client will The client will The client will caregivers.

interpret the environment accurately. be able to make his or her needs known to caregivers. use the measures provided to maintain reality orientation. participate in the activities of daily life with the assistance of

Which medication prescribed for agitation is known to cause extrapyramidal symptoms? Olanzapine Risperidone Quetiapine Pimavanserin

Which conditions are known to cause secondary neurocognitive disorders (NCDs) in a client? Select all that apply. Concussion Contracture Cerebral trauma Vascular disease HIV disease

Which statement describes the long-term goal for the client with an impaired ability to process verbal communication? To have the client experience fewer episodes of confusion To help the client make his or her needs known to the primary caregiver To help the client understand basic communication To increase the client’s ability to express his or her needs so they are easily anticipated and fulfilled by caregivers

Which nursing intervention is effective in an agitated client who is at risk for trauma? Encouraging reminiscence therapy Discussing the positive aspects of life Maintaining a low level of stimuli in the environment Encouraging family members to be a part of the client’s care

The nurse is providing soft restraints to a client who is at risk for trauma. Which outcome in the client would indicate the effectiveness of the nursing intervention? The The The The

client client client client

will will will will

not experience physical injury. anticipate unmet needs. minimize his or her confusion. communicate effectively with the nurse.

Which factor is most significant in the etiology of multiple strokes in a client with vascular neurocognitive disorder (NCD)? Pellagra Hypertension Hyperparathyroidism Systemic lupus erythematosus

Which action does the nurse implement to prevent the risk of accidental trauma while caring for a client with neurocognitive disorder (NCD)? Keeping all lights off at night Positioning the bed as low as possible Using clocks and calendars with large numbers Arranging the client’s room away from the nursing station to avoid disturbance

The nurse is reviewing laboratory values for a client with delirium. Which deficiency would play a role in the development of delirium? Vitamin A Vitamin B Vitamin D Vitamin K

For which client is it most important to have electronically controlled exit doors in a health-care facility? A A A A

client client client client

with with with with

agitation disorientation wandering behavior delusions and hallucinations

The client’s medical history indicates that his or her delirium is caused by substance withdrawal. Which class of medications does the primary healthcare provider prescribe to the client in this situation? Antipsychotic Antianxiety Antidepressant Cholinesterase inhibitor

A client with neurocognitive disorder (NCD) is diagnosed with risk for trauma. Which nursing interventions require correction while caring for this client? Select all that apply. Observing the client frequently Avoiding night lights in the client’s room Talking to the client about place and time Storing frequently used items out of the client’s reach Keeping bedrails down when the client is in the bed

While caring for a cognitively impaired client, the nurse provides a cane and instructs the client about its use. Which outcome will the nurse expect from this intervention? The client will not experience physical injury.

The client might show wandering behavior. The client will maintain a therapeutic relationship with the nurse. The client might be able to perform the activities of daily living independently.

Which psychomotor symptoms are observed in a client who is in the severe cognitive decline stage of Alzheimer’s disease (AD)? Select all that apply. Aggression Wandering Frustration Obsessiveness Self-absorption

An elderly client with neurocognitive disorder (NCD) is experiencing anxiety and has a medical history of confusion and paradoxical excitement. Which statement describes the possible reason for the occurrence of these symptoms in the client? Use Use Use Use

of of of of

barbiturates dopaminergic agents cholinesterase inhibitors longer-acting benzodiazepines

The nurse is caring for a client with cardiopulmonary disorder who recently had a head injury. On interaction, the nurse finds that the client has a misperception of the environment and likely has delirium. Which medication, along with the head trauma, does the nurse expect to be the cause of this condition in the client? Antibiotic agents Anticoagulant agents Bronchodilator agents Antihypertensive agents While assessing the verbal fluency of a client, the nurse finds that the client names 10 animals in a time span of 60 seconds. Which score does the nurse record in the client’s medical record? Record your answer as a whole number. Enter numeral only. ___5____

After assessing the cognitive capacity of a client with Alzheimer’s disease (AD), the nurse concludes that the client is in the fourth stage of the disease. Which finding supports the nurse’s conclusion? The The The The

client client client client

is is is is

unable unable unable unable

to to to to

understand current news events. recall address and phone numbers. recall names of family members. plan or organize office work.

A client is admitted into the psychiatric unit with the complaint of pressured and incoherent speech. On further interaction, the nurse finds that the client is suffering from delirium. Which nursing intervention is the priority in this situation? Maintain a low level of stimuli. Monitor the behavior of the client. Provide reorientation and assurance to the client. Determine and correct the underlying causes.

An elderly client with neurocognitive disorder (NCD) is found to be anxious. Which medications help reduce the client’s anxiety? Select all that apply. Oxazepam Diazepam Lorazepam Phenobarbital Chlordiazepoxide

The nurse is teaching a group of student nurses about various forms of neurocognitive disorders (NCDs). Which disorders does the nurse refer to as being reversible? Select all that apply. NCD NCD NCD NCD NCD

due due due due due

to to to to to

HIV infection Alzheimer’s disease (AD) folate deficiency side effects of medications central nervous system infections

A client with neurocognitive disorder (NCD) diagnosed with a disturbed thought process is undergoing psychotherapy. Which outcome does the nurse expect in the client on reassessment?

“The “The “The “The

client client client client

communicates required needs effectively.” accomplishes activities of daily living.” experiences fewer episodes of confusion.” responds to touch and emotional expressions.”

The nurse asks a client with neurocognitive disorder (NCD) about today’s date. Which behavior of the client is the nurse assessing? Orientation Verbal fluency Comprehension Learning ability

The blood pressure of a client with a psychiatric illness is found to be 180/100 mm Hg. The brain scan report reveals the presence of cerebral infarcts. Which complication does the nurse suspect in the client based on these findings? Vascular neurocognitive disorder (NCD) Frontotemporal neurocognitive disorder (NCD) Neurocognitive disorder (NCD) due to prion disease Neurocognitive disorder (NCD) due to Huntington’s disease

The nurse is teaching a group of student nurses about the metabolic disorders that precipitate delirium or neurocognitive disorder (NCD) in a client. Which conditions does the nurse include in the teaching plan? Select all that apply. Hypoxia Hypercarbia Hypoglycemia Hypothyroidism Hyperpituitarism

A widowed client is diagnosed with neurocognitive disorder (NCD) due to Alzheimer’s disease (AD). On interaction, the client says, “It’s my birthday today. I am going out with my husband.” Which response by the nurse is most appropriate in this situation? “Did you take your medicine?” “Don’t you remember that your husband died a few months ago?” “Tell me about your husband. What was it like when you were together?”

“Today is not your birthday. How do you usually celebrate your birthday?”

Which medication is used in the treatment of agitation? Donepezil Risperidone Galantamine Rivastigmine

A client who is in stage 4 of Alzheimer’s disease (AD) is undergoing psychotherapy. Which statement made by the client’s caregiver indicates effective treatment? “The “The “The “The

client client client client

is less impulsive and emotionally unstable.” has reduced tremors and stiffness in her hands.” has improved cognition and memory.” is able to understand and accept problems.”

A client with Parkinson’s disease has involuntary muscle movements and rigidity. What is the pathophysiology associated with these symptoms? Diminished Diminished Diminished Diminished

acetylcholine activity dopamine activity glutamate activity norepinephrine activity

Which behavioral sign does the nurse find in a client diagnosed with mild neurocognitive disorder (NCD)? Modest cognitive decline in learning and memory Ability to carry out motor activities Disorientation to surroundings Inability to perform everyday activities independently

A client with neurocognitive decline is diagnosed with neuronal degradation caused by overstimulation of the N-methyl-D-aspartate (NMDA) receptors. Which medication does the nurse expect the primary health-care provider to prescribe? Donepezil Memantine

Galantamine Rivastigmine

Which nursing intervention is beneficial for a client who has disturbed thought processes? Initiating reminiscence therapy Keeping a dim light in the client’s room at night Keeping the bed as low as possible Speaking loudly and clearly while looking directly into the client’s eyes

Which statement describes the possible etiology for neurocognitive decline in a client who had a recent fracture of a femur bone? Release of Lewy bodies Interruption of blood flow Diminished dopamine activity Impaired muscle coordination During the mental status examination for neurocognitive disorder (NCD), the client is only able to say the date and day of the week correctly. Which number would the nurse assign for the orientation score of the client? Record your answer as a whole number. Enter numeral only. __4___

The spouse of a boxer says, “My partner is having difficulty speaking.” On assessment, the nurse also finds that the client has difficulty picking up objects. Which condition does the nurse suspect in the client? Apraxia Aphasia Confabulation Dementia pugilistica

While communicating with a client who has a delayed ability to process verbal communications, the nurse finds that the client is unable to understand the question. How would the nurse respond to this client? “I “I “I “I

will write down the question for you.” will rephrase the question for you.” think you need to concentrate on my words.” will repeat the question for you.”

Which condition does the nurse suspect in the client with neurocognitive disorder (NCD) who has increased difficulty understanding spoken language? Vascular NCD Frontotemporal NCD NCD due to Parkinson’s disease NCD due to traumatic brain injury

Which medications are beneficial to a client with neurocognitive disorder (NCD) experiencing apathy? Select all that apply. Quetiapine Trazodone Bupropion Amantadine Methylphenidate

While caring for a client who is at risk for trauma, the nurse maintains a low level of stimuli in the environment. Which outcome in the client indicates the effectiveness of treatment? The The The The

client client client client

will will will will

maintain reality orientation. accomplish tasks of daily life. interpret the environment correctly. maintain a calm demeanor with minimal agitated behavior.

A client with Alzheimer’s disease may make up events to fill in memory gaps. What is this condition called? Delusion Contusion Hallucination Confabulation

Which intervention would the nurse implement while caring for a client with neurocognitive disorder (NCD) and diagnosed with wandering behavior? Storing frequently used items out of the client’s reach Teaching the client to hold on to a handrail Maintaining a low level of stimuli in the environment

Keeping the client on a structured schedule of recreational activities

Which diagnostic test is performed to evaluate the progression of Alzheimer’s disease (AD) in a client?

Electroencephalogram (EEG) Magnetic resonance imaging (MRI) Computed tomography (CT) scanning Positron emission tomography (PET) scanning

Which characteristics does the nurse observe in a client with dementia pugilistica? Select all that apply. Depression Nonimpulsivity Emotional liability Dysarthria Ataxia

After assessing a client’s behaviors, the nurse concludes that the client is in stage 4 of Alzheimer’s disease (AD). Which behavior of the client supports the nurse’s conclusion? The The The The

client client client client

has difficulty recalling names or words. is unable to recognize family members. is disoriented to his or her surroundings. denies the existence of the problems by covering up memory loss....