ALZHEIMER’S, DELIRIUM, AND
DEMENTIA NCLEX PRACTICE QUIZ: 65
QUESTIONS
1. . Question
Nurse Isabelle enters the room of a client with a cognitive
impairment disorder and asks what day of the week it is; what
the date, month, and year are; and where the client is. The nurse
is attempting to assess:
o A. Confabulation.
o B. Delirium.
o C. Orientation.
o D. Perseveration.
Correct Answer: C. Orientation.
The initial, most basic assessment of a client with cognitive
impairment involves determining his level of orientation
(awareness of time, place, and person). The tools for reality
orientation aim to reinforce the naming of objects and people as
well as a timeline of events, past or present. Multiple studies
have demonstrated that the use of reality orientation has
improved cognitive functioning for people living with dementia
when compared to control groups who did not receive it. As a
rule, reality orientation must be mixed with compassion and used
appropriately to benefit someone living with the confusion of
dementia. Applying it without evaluating if it might cause
emotional distress to the individual since there are some times
when it would not be appropriate.
Option A: Confabulation is a type of memory error in
which gaps in a person’s memory are unconsciously
filled with fabricated, misinterpreted, or distorted
information. When someone confabulates, they are
confusing things they have imagined with real
memories. A person who is confabulating is not lying.
They are not making a conscious or intentional
, attempt to deceive. Rather, they are confident in the
truth of their memories even when confronted with
contradictory evidence.
Option B: Delirium is a type of cognitive impairment;
however, other symptoms are necessary to establish
this diagnosis. Delirium, also known as the acute
confusional state, is a clinical syndrome that usually
develops in the elderly. It is characterized by an
alteration of consciousness and cognition with reduced
ability to focus, sustain, or shift attention. It develops
over a short period and fluctuates during the day. The
clinical presentation can vary, but usually, it flourishes
with psychomotor behavioral disturbances such as
hyperactivity or hypoactivity with increased
sympathetic activity and impairment in sleep duration
and architecture.
Option D: The nurse may also assess for
perseveration in a client with cognitive impairment but
the questions in this situation would not elicit the
symptom response. Perseveration according to
psychology, psychiatry, and speech-language
pathology, is the repetition of a particular response
(such as a word, phrase, or gesture) regardless of the
absence or cessation of a stimulus. It is usually caused
by a brain injury or other organic disorder.
2. 2. Question
A student nurse was asked which of the following best describes
dementia. Which of the following best describes the condition?
A. Memory loss occurring as part of the natural
consequence of aging.
B. Difficulty coping with physical and psychological
change.
C. Severe cognitive impairment that occurs rapidly.
D. Loss of cognitive abilities, impairing ability to
perform activities of daily living.
, Correct Answer: D. Loss of cognitive abilities, impairing
ability to perform activities of daily living.
The impaired ability to perform self-care is an important measure
of a client’s dementia progression and loss of cognitive abilities.
Difficulty or impaired ability to perform normal activities of daily
living, such as maintaining hygiene and grooming, toileting,
making meals, and maintaining a household, are significant
indications of dementia. Slowing of processes necessary for
information retrieval is a normal consequence of aging. However,
the global statement that memory loss occurs as part of natural
aging is not true.
Option A: Dementia is not normal; it is a disease.
Dementia is a disorder that is characterized by
cognitive decline involving memory and at least 1 of
the other domains, including personality, praxis,
abstract thinking, language, executive functioning,
complex attention, social and visuospatial skills.
Option B: Difficulty coping with changes can be
experienced by any client, not just one with dementia.
In addition to the noted decline, the severity must be
significant enough to interfere with daily functionality.
It is often a progressive disorder, and individuals often
do not have insight into their deficits. Currently, no
cure exists for any of the causes of dementia.
Option C: The rapid occurrence of cognitive
impairment refers to delirium. History must be
obtained from the patient and their family members.
Patients may present with symptoms of change in
behavior, getting lost in familiar neighborhoods,
memory loss, mood changes, aggression, social
withdrawal, self-neglect, cognitive difficulty,
personality changes, difficulty performing tasks,
forgetfulness, difficulty in communication, vulnerability
to infections, loss of independence, etc., A detailed
history should include past medical, family, drug, and
alcohol history
3. 3. Question
Which of the following will Nurse Dory use when communicating
with a client who has cognitive impairment?
, A. Complete explanations with multiple details.
B. Pictures or gestures instead of words.
C. Stimulating words and phrases to capture the client's
attention.
D. Short words and simple sentences.
Correct Answer: D. Short words and simple sentences.
Short words and simple sentences minimize client confusion and
enhance communication. Assess the patient’s ability to speak,
language deficit, cognitive or sensory impairment, presence of
aphasia, dysarthria, aphonia, dyslalia, or apraxia. Presence of
psychosis, and/or other neurologic disorders affecting speech.
This identifies problem areas and speech patterns to help
establish a plan of care.
Option A: Use simple, direct questions requiring one-
word answers. Repeat and reword questions if
misunderstanding occurs. This promotes self-
confidence of the patient who is able to achieve some
degree of speech or communication. Encourage the
patient to breathe prior to speaking, pause between
words, and use the tongue, lips, and jaw to speak.
Encourage the patient to control the length and rate of
phrases, over articulate words, and separate syllables,
emphasizing consonants.
Option B: Although pictures and gestures may be
helpful, they would not substitute for verbal
communication. When communicating with the
patient, face the patient and maintain eye contact,
speaking slowly and enunciating clearly in a moderate
or low-pitched tone. Clarity, brevity, and time provided
for responses promote the opportunity for successful
speech by allowing patient time to receive and
process the information.
Option C: Complete explanations with multiple details
and stimulating words and phrases would increase
confusion in a client with short attention span and
difficulty with comprehension. Remove competing
stimuli, and provide a calm, unhurried atmosphere for
communication. This reduces unnecessary noise and
DEMENTIA NCLEX PRACTICE QUIZ: 65
QUESTIONS
1. . Question
Nurse Isabelle enters the room of a client with a cognitive
impairment disorder and asks what day of the week it is; what
the date, month, and year are; and where the client is. The nurse
is attempting to assess:
o A. Confabulation.
o B. Delirium.
o C. Orientation.
o D. Perseveration.
Correct Answer: C. Orientation.
The initial, most basic assessment of a client with cognitive
impairment involves determining his level of orientation
(awareness of time, place, and person). The tools for reality
orientation aim to reinforce the naming of objects and people as
well as a timeline of events, past or present. Multiple studies
have demonstrated that the use of reality orientation has
improved cognitive functioning for people living with dementia
when compared to control groups who did not receive it. As a
rule, reality orientation must be mixed with compassion and used
appropriately to benefit someone living with the confusion of
dementia. Applying it without evaluating if it might cause
emotional distress to the individual since there are some times
when it would not be appropriate.
Option A: Confabulation is a type of memory error in
which gaps in a person’s memory are unconsciously
filled with fabricated, misinterpreted, or distorted
information. When someone confabulates, they are
confusing things they have imagined with real
memories. A person who is confabulating is not lying.
They are not making a conscious or intentional
, attempt to deceive. Rather, they are confident in the
truth of their memories even when confronted with
contradictory evidence.
Option B: Delirium is a type of cognitive impairment;
however, other symptoms are necessary to establish
this diagnosis. Delirium, also known as the acute
confusional state, is a clinical syndrome that usually
develops in the elderly. It is characterized by an
alteration of consciousness and cognition with reduced
ability to focus, sustain, or shift attention. It develops
over a short period and fluctuates during the day. The
clinical presentation can vary, but usually, it flourishes
with psychomotor behavioral disturbances such as
hyperactivity or hypoactivity with increased
sympathetic activity and impairment in sleep duration
and architecture.
Option D: The nurse may also assess for
perseveration in a client with cognitive impairment but
the questions in this situation would not elicit the
symptom response. Perseveration according to
psychology, psychiatry, and speech-language
pathology, is the repetition of a particular response
(such as a word, phrase, or gesture) regardless of the
absence or cessation of a stimulus. It is usually caused
by a brain injury or other organic disorder.
2. 2. Question
A student nurse was asked which of the following best describes
dementia. Which of the following best describes the condition?
A. Memory loss occurring as part of the natural
consequence of aging.
B. Difficulty coping with physical and psychological
change.
C. Severe cognitive impairment that occurs rapidly.
D. Loss of cognitive abilities, impairing ability to
perform activities of daily living.
, Correct Answer: D. Loss of cognitive abilities, impairing
ability to perform activities of daily living.
The impaired ability to perform self-care is an important measure
of a client’s dementia progression and loss of cognitive abilities.
Difficulty or impaired ability to perform normal activities of daily
living, such as maintaining hygiene and grooming, toileting,
making meals, and maintaining a household, are significant
indications of dementia. Slowing of processes necessary for
information retrieval is a normal consequence of aging. However,
the global statement that memory loss occurs as part of natural
aging is not true.
Option A: Dementia is not normal; it is a disease.
Dementia is a disorder that is characterized by
cognitive decline involving memory and at least 1 of
the other domains, including personality, praxis,
abstract thinking, language, executive functioning,
complex attention, social and visuospatial skills.
Option B: Difficulty coping with changes can be
experienced by any client, not just one with dementia.
In addition to the noted decline, the severity must be
significant enough to interfere with daily functionality.
It is often a progressive disorder, and individuals often
do not have insight into their deficits. Currently, no
cure exists for any of the causes of dementia.
Option C: The rapid occurrence of cognitive
impairment refers to delirium. History must be
obtained from the patient and their family members.
Patients may present with symptoms of change in
behavior, getting lost in familiar neighborhoods,
memory loss, mood changes, aggression, social
withdrawal, self-neglect, cognitive difficulty,
personality changes, difficulty performing tasks,
forgetfulness, difficulty in communication, vulnerability
to infections, loss of independence, etc., A detailed
history should include past medical, family, drug, and
alcohol history
3. 3. Question
Which of the following will Nurse Dory use when communicating
with a client who has cognitive impairment?
, A. Complete explanations with multiple details.
B. Pictures or gestures instead of words.
C. Stimulating words and phrases to capture the client's
attention.
D. Short words and simple sentences.
Correct Answer: D. Short words and simple sentences.
Short words and simple sentences minimize client confusion and
enhance communication. Assess the patient’s ability to speak,
language deficit, cognitive or sensory impairment, presence of
aphasia, dysarthria, aphonia, dyslalia, or apraxia. Presence of
psychosis, and/or other neurologic disorders affecting speech.
This identifies problem areas and speech patterns to help
establish a plan of care.
Option A: Use simple, direct questions requiring one-
word answers. Repeat and reword questions if
misunderstanding occurs. This promotes self-
confidence of the patient who is able to achieve some
degree of speech or communication. Encourage the
patient to breathe prior to speaking, pause between
words, and use the tongue, lips, and jaw to speak.
Encourage the patient to control the length and rate of
phrases, over articulate words, and separate syllables,
emphasizing consonants.
Option B: Although pictures and gestures may be
helpful, they would not substitute for verbal
communication. When communicating with the
patient, face the patient and maintain eye contact,
speaking slowly and enunciating clearly in a moderate
or low-pitched tone. Clarity, brevity, and time provided
for responses promote the opportunity for successful
speech by allowing patient time to receive and
process the information.
Option C: Complete explanations with multiple details
and stimulating words and phrases would increase
confusion in a client with short attention span and
difficulty with comprehension. Remove competing
stimuli, and provide a calm, unhurried atmosphere for
communication. This reduces unnecessary noise and
