Pre Simulation Quiz Mental Health Case:
George Palo
An older adult diagnosed with dementia has presented with behaviors that suggest a
disturbance in executive functioning. Which assessment finding supports this finding?
Your Response: Needs to be reminded to use toothpaste when brushing teeth
Rationale: A disturbance in executive functioning, which is the ability to think abstractly
and to plan, initiate, sequence, monitor, and stop complex behavior, would include the
need to be reminded to use toothpaste when brushing one's teeth. Having fallen three
times in the last month is likely a result of apraxia, or impaired ability to execute motor
activities despite intact motor functioning. Referring to a cup as "that blue thing" is an
example of agnosia, which is failure to recognize or identify objects despite intact
sensory function. Speaking in only short phrases of no more than three or four words is
an example of aphasia, or alterations in language ability.
What is the fundamental characteristic of anhedonia?
Your Response: Lack of pleasure and enjoyment
Rationale: Patients experiencing depression may describe themselves as hopeless,
helpless, down, or anxious and often experience anhedonia, defined as the loss of any
sense of pleasure from activities they formerly enjoyed. Although the other options
identify possible characteristics of depression, none is associated with anhedonia.
What is the therapeutic value of a cholinesterase inhibitor for a patient diagnosed with
Alzheimer disease?
Your Response: Temporarily slows the progress of the dementia
Rationale: Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl,
Razadyne, Nivalin) are cholinesterase inhibitors that have shown modest therapeutic
effects and that temporarily slow the progress of dementia-related cognitive decline.
They have no effect, however, on the overall course of the disease or on life expectancy.
What is the primary risk factor for the development of cognitive disorders such as
Alzheimer disease?
Your Response: Age
George Palo
An older adult diagnosed with dementia has presented with behaviors that suggest a
disturbance in executive functioning. Which assessment finding supports this finding?
Your Response: Needs to be reminded to use toothpaste when brushing teeth
Rationale: A disturbance in executive functioning, which is the ability to think abstractly
and to plan, initiate, sequence, monitor, and stop complex behavior, would include the
need to be reminded to use toothpaste when brushing one's teeth. Having fallen three
times in the last month is likely a result of apraxia, or impaired ability to execute motor
activities despite intact motor functioning. Referring to a cup as "that blue thing" is an
example of agnosia, which is failure to recognize or identify objects despite intact
sensory function. Speaking in only short phrases of no more than three or four words is
an example of aphasia, or alterations in language ability.
What is the fundamental characteristic of anhedonia?
Your Response: Lack of pleasure and enjoyment
Rationale: Patients experiencing depression may describe themselves as hopeless,
helpless, down, or anxious and often experience anhedonia, defined as the loss of any
sense of pleasure from activities they formerly enjoyed. Although the other options
identify possible characteristics of depression, none is associated with anhedonia.
What is the therapeutic value of a cholinesterase inhibitor for a patient diagnosed with
Alzheimer disease?
Your Response: Temporarily slows the progress of the dementia
Rationale: Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Reminyl,
Razadyne, Nivalin) are cholinesterase inhibitors that have shown modest therapeutic
effects and that temporarily slow the progress of dementia-related cognitive decline.
They have no effect, however, on the overall course of the disease or on life expectancy.
What is the primary risk factor for the development of cognitive disorders such as
Alzheimer disease?
Your Response: Age
