MDC 4 NUR2755 FINAL EXAMINATION: NEUROLOGICAL AND
CRITICAL CARE DISORDERS COMPLETE QUESTIONS WITH
100% CORRECT ANSWERS
1. A nurse is assessing a client in the mild stage of Alzheimer's disease.
Which finding should the nurse expect?
A. Inability to perform ADLs and bedridden status
B. Psychotic behaviors including delusions and hallucinations
C. Forgetting names and misplacing household items
D. Agnosia and difficulty eating
Correct Answer: C
Rationale: The mild stage of Alzheimer's disease is characterized by
short-term memory loss, forgetting names, misplacing items, and subtle
personality changes. Options A and D occur in the late stage. Option B
occurs in the moderate stage.
2. A client with moderate Alzheimer's disease begins to wander
throughout the unit and becomes agitated. Which nursing action is
most appropriate?
A. Apply soft wrist restraints to prevent injury
B. Redirect the client calmly to a safe, familiar area
,C. Administer a PRN dose of memantine immediately
D. Place the client in seclusion until the agitation subsides
Correct Answer: B
Rationale: Redirection to a safe, familiar environment is a
nonpharmacological intervention that reduces agitation and wandering
in moderate Alzheimer's disease. Restraints and seclusion are restrictive
and should be avoided. Memantine is used for moderate to late stages
but is not an immediate PRN for agitation.
3. A client in the late stage of Alzheimer's disease is totally
incapacitated and bedridden. The nurse understands that which
manifestation is expected in this stage?
A. Short-term memory loss only
B. Difficulty driving and getting lost
C. Episodes of wandering and trouble sleeping
D. Total dependence in activities of daily living
Correct Answer: D
Rationale: The late stage of Alzheimer's disease is characterized by total
incapacitation, bedridden status, total dependence in ADLs, agnosia,
hallucinations, incontinence, and difficulty eating. Short-term memory
loss occurs in the mild stage. Difficulty driving, wandering, and trouble
sleeping occur in the moderate stage.
4. The nurse is teaching a family about apraxia in a client with
Alzheimer's disease. Which statement by the family indicates
understanding?
,A. My father will have trouble understanding what we say to him
B. My father will lose the ability to recognize our faces
C. My father will have difficulty planning movements to perform tasks
D. My father will forget the names of common objects like a fork
Correct Answer: C
Rationale: Apraxia is difficulty with motor planning to perform tasks or
movements. Aphasia is the inability to speak or understand language.
Agnosia is loss of sensory comprehension including facial recognition.
Anomia is the inability to recall the names of everyday objects.
5. A client with Alzheimer's disease has difficulty recalling the names
of everyday objects. The nurse documents this finding as which of the
following?
A. Apraxia
B. Aphasia
C. Agnosia
D. Anomia
Correct Answer: D
Rationale: Anomia is the specific inability to recall the names of
everyday objects. Apraxia is difficulty with motor planning. Aphasia is
inability to speak or understand language. Agnosia is loss of sensory
comprehension including facial recognition.
6. The nurse is discussing the diagnosis of Alzheimer's disease with a
family member. Which statement about diagnostic testing is accurate?
, A. A blood test can confirm the diagnosis of Alzheimer's disease with
95% accuracy
B. Lumbar puncture showing elevated tau protein is definitive for
Alzheimer's disease
C. Definitive diagnosis is made by brain tissue examination at autopsy
showing neurofibrillary tangles and neuritic plaques
D. CT scan of the brain showing atrophy is diagnostic for Alzheimer's
disease
Correct Answer: C
Rationale: No laboratory test can confirm the diagnosis of Alzheimer's
disease. Definitive diagnosis is made only by brain tissue examination at
autopsy, which confirms the presence of neurofibrillary tangles and
neuritic plaques. Imaging and CSF studies are supportive but not
definitive.
7. A client with Alzheimer's disease is prescribed donepezil. The nurse
understands that this medication belongs to which class?
A. NMDA receptor antagonist
B. Cholinesterase inhibitor
C. Dopamine agonist
D. Antipsychotic agent
Correct Answer: B
Rationale: Donepezil is a cholinesterase inhibitor that increases
acetylcholine levels in the brain. Memantine is an NMDA receptor
antagonist. Dopamine agonists are used for Parkinson's disease.
Antipsychotics are not first-line for Alzheimer's disease.
CRITICAL CARE DISORDERS COMPLETE QUESTIONS WITH
100% CORRECT ANSWERS
1. A nurse is assessing a client in the mild stage of Alzheimer's disease.
Which finding should the nurse expect?
A. Inability to perform ADLs and bedridden status
B. Psychotic behaviors including delusions and hallucinations
C. Forgetting names and misplacing household items
D. Agnosia and difficulty eating
Correct Answer: C
Rationale: The mild stage of Alzheimer's disease is characterized by
short-term memory loss, forgetting names, misplacing items, and subtle
personality changes. Options A and D occur in the late stage. Option B
occurs in the moderate stage.
2. A client with moderate Alzheimer's disease begins to wander
throughout the unit and becomes agitated. Which nursing action is
most appropriate?
A. Apply soft wrist restraints to prevent injury
B. Redirect the client calmly to a safe, familiar area
,C. Administer a PRN dose of memantine immediately
D. Place the client in seclusion until the agitation subsides
Correct Answer: B
Rationale: Redirection to a safe, familiar environment is a
nonpharmacological intervention that reduces agitation and wandering
in moderate Alzheimer's disease. Restraints and seclusion are restrictive
and should be avoided. Memantine is used for moderate to late stages
but is not an immediate PRN for agitation.
3. A client in the late stage of Alzheimer's disease is totally
incapacitated and bedridden. The nurse understands that which
manifestation is expected in this stage?
A. Short-term memory loss only
B. Difficulty driving and getting lost
C. Episodes of wandering and trouble sleeping
D. Total dependence in activities of daily living
Correct Answer: D
Rationale: The late stage of Alzheimer's disease is characterized by total
incapacitation, bedridden status, total dependence in ADLs, agnosia,
hallucinations, incontinence, and difficulty eating. Short-term memory
loss occurs in the mild stage. Difficulty driving, wandering, and trouble
sleeping occur in the moderate stage.
4. The nurse is teaching a family about apraxia in a client with
Alzheimer's disease. Which statement by the family indicates
understanding?
,A. My father will have trouble understanding what we say to him
B. My father will lose the ability to recognize our faces
C. My father will have difficulty planning movements to perform tasks
D. My father will forget the names of common objects like a fork
Correct Answer: C
Rationale: Apraxia is difficulty with motor planning to perform tasks or
movements. Aphasia is the inability to speak or understand language.
Agnosia is loss of sensory comprehension including facial recognition.
Anomia is the inability to recall the names of everyday objects.
5. A client with Alzheimer's disease has difficulty recalling the names
of everyday objects. The nurse documents this finding as which of the
following?
A. Apraxia
B. Aphasia
C. Agnosia
D. Anomia
Correct Answer: D
Rationale: Anomia is the specific inability to recall the names of
everyday objects. Apraxia is difficulty with motor planning. Aphasia is
inability to speak or understand language. Agnosia is loss of sensory
comprehension including facial recognition.
6. The nurse is discussing the diagnosis of Alzheimer's disease with a
family member. Which statement about diagnostic testing is accurate?
, A. A blood test can confirm the diagnosis of Alzheimer's disease with
95% accuracy
B. Lumbar puncture showing elevated tau protein is definitive for
Alzheimer's disease
C. Definitive diagnosis is made by brain tissue examination at autopsy
showing neurofibrillary tangles and neuritic plaques
D. CT scan of the brain showing atrophy is diagnostic for Alzheimer's
disease
Correct Answer: C
Rationale: No laboratory test can confirm the diagnosis of Alzheimer's
disease. Definitive diagnosis is made only by brain tissue examination at
autopsy, which confirms the presence of neurofibrillary tangles and
neuritic plaques. Imaging and CSF studies are supportive but not
definitive.
7. A client with Alzheimer's disease is prescribed donepezil. The nurse
understands that this medication belongs to which class?
A. NMDA receptor antagonist
B. Cholinesterase inhibitor
C. Dopamine agonist
D. Antipsychotic agent
Correct Answer: B
Rationale: Donepezil is a cholinesterase inhibitor that increases
acetylcholine levels in the brain. Memantine is an NMDA receptor
antagonist. Dopamine agonists are used for Parkinson's disease.
Antipsychotics are not first-line for Alzheimer's disease.
