Varcarolis Chapter 23 Neurocognitive Disorders Questions and Answers Psychiatric Nursing Study Guide Page 1 2026-03-20
Varcarolis Chapter 23
Neurocognitive Disorders
Questions and Answers
Psychiatric Nursing Study
Guide
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1. An older adult patient takes multiple medications daily. Over 2 days, the patient developed confusion, slurred
speech, an unsteady gait, and fluctuating levels of orientation. These findings are most characteristic of:
a. delirium.
c. amnestic syndrome.
b. dementia.
d. Alzheimers disease.
a. delirium.
Delirium is characterized by an abrupt onset of fluctuating levels of awareness, clouded consciousness, perceptual
disturbances, and disturbed memory and orientation. The onset of dementia or Alzheimers disease, a type of
dementia, is more insidious. Amnestic syndrome involves memory impairment without other cognitive problems.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 432 TOP: Nursing Process: Assessment
MSC: Client Needs: Physiological Integrity
Page 2 of 37 2 of 37 Varcarolis Ch. 23 Neurocognitive Disorders.pdf
,Varcarolis Ch. 23 Neurocognitive Disorders Page 3 2026-03-20
2. A patient with fluctuating levels of awareness, confusion, and disturbed orientation shouts, Bugs are crawling on my
legs. Get them off! Which problem is the patient experiencing?
a. Aphasia
c. Tactile hallucinations
b. Dystonia
d. Mnemonic disturbance
c. Tactile hallucinations
The patient feels bugs crawling on both legs, even though no sensory stimulus is actually present. This description
meets the definition of a hallucination, a false sensory perception. Tactile hallucinations may be part of the symptom
constellation of delirium. Aphasia refers to a speech disorder. Dystonia refers to excessive muscle tonus. Mnemonic
disturbance is associated with dementia rather than delirium.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 432-434 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
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3. A patient with fluctuating levels of consciousness, disturbed orientation, and perceptual alteration begs, Someone
get these bugs off me. What is the nurses best response?
a. No bugs are on your legs. You are having hallucinations.
b. I will have someone stay here and brush off the bugs for you.
c. Try to relax. The crawling sensation will go away sooner if you can relax.
d. I dont see any bugs, but I can tell you are frightened. I will stay with you.
d. I dont see any bugs, but I can tell you are frightened. I will stay with you.
When hallucinations are present, the nurse should acknowledge the patients feelings and state the nurses perception
of reality, but not argue. Staying with the patient increases feelings of security, reduces anxiety, offers the opportunity
for reinforcing reality, and provides a measure of physical safety. Denying the patients perception without offering
help does not support the patient emotionally. Telling the patient to relax makes the patient responsible for self-
soothing. Telling the patient that someone will brush the bugs away supports the perceptual distortions.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 436 (Box 23-1) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
Page 4 of 37 4 of 37 Varcarolis Ch. 23 Neurocognitive Disorders.pdf
Varcarolis Chapter 23
Neurocognitive Disorders
Questions and Answers
Psychiatric Nursing Study
Guide
Guidehttps://www.stuvia.com/dashboard!@_)#*)(@$)($@*($@)($@*_1 of 37
Page 1 of 37 Varcarolis Chapter 23 Neurocognitive Disorders Questions and Answers Psychiatric Nursing Study Guide.pdf
,Varcarolis Ch. 23 Neurocognitive Disorders Page 2 2026-03-20
1. An older adult patient takes multiple medications daily. Over 2 days, the patient developed confusion, slurred
speech, an unsteady gait, and fluctuating levels of orientation. These findings are most characteristic of:
a. delirium.
c. amnestic syndrome.
b. dementia.
d. Alzheimers disease.
a. delirium.
Delirium is characterized by an abrupt onset of fluctuating levels of awareness, clouded consciousness, perceptual
disturbances, and disturbed memory and orientation. The onset of dementia or Alzheimers disease, a type of
dementia, is more insidious. Amnestic syndrome involves memory impairment without other cognitive problems.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 432 TOP: Nursing Process: Assessment
MSC: Client Needs: Physiological Integrity
Page 2 of 37 2 of 37 Varcarolis Ch. 23 Neurocognitive Disorders.pdf
,Varcarolis Ch. 23 Neurocognitive Disorders Page 3 2026-03-20
2. A patient with fluctuating levels of awareness, confusion, and disturbed orientation shouts, Bugs are crawling on my
legs. Get them off! Which problem is the patient experiencing?
a. Aphasia
c. Tactile hallucinations
b. Dystonia
d. Mnemonic disturbance
c. Tactile hallucinations
The patient feels bugs crawling on both legs, even though no sensory stimulus is actually present. This description
meets the definition of a hallucination, a false sensory perception. Tactile hallucinations may be part of the symptom
constellation of delirium. Aphasia refers to a speech disorder. Dystonia refers to excessive muscle tonus. Mnemonic
disturbance is associated with dementia rather than delirium.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 432-434 TOP: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity
Page 3 of 37 3 of 37 Varcarolis Ch. 23 Neurocognitive Disorders.pdf
, Varcarolis Ch. 23 Neurocognitive Disorders Page 4 2026-03-20
3. A patient with fluctuating levels of consciousness, disturbed orientation, and perceptual alteration begs, Someone
get these bugs off me. What is the nurses best response?
a. No bugs are on your legs. You are having hallucinations.
b. I will have someone stay here and brush off the bugs for you.
c. Try to relax. The crawling sensation will go away sooner if you can relax.
d. I dont see any bugs, but I can tell you are frightened. I will stay with you.
d. I dont see any bugs, but I can tell you are frightened. I will stay with you.
When hallucinations are present, the nurse should acknowledge the patients feelings and state the nurses perception
of reality, but not argue. Staying with the patient increases feelings of security, reduces anxiety, offers the opportunity
for reinforcing reality, and provides a measure of physical safety. Denying the patients perception without offering
help does not support the patient emotionally. Telling the patient to relax makes the patient responsible for self-
soothing. Telling the patient that someone will brush the bugs away supports the perceptual distortions.
PTS: 1 DIF: Cognitive Level: Apply (Application)
REF: Page 436 (Box 23-1) TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
Page 4 of 37 4 of 37 Varcarolis Ch. 23 Neurocognitive Disorders.pdf
