Chapter 47: Care of Patients with Cognitive Disorders |DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. Which percentage of the population that is 85 years of age and older has some stage of Alzheimer disease (AD)? a. 10% b. 20% c. 35% d. 50% ANS: D AD is the most common degenerative disease of the brain. Approximately 5.3 million Americans have AD (Alzheimer Association, 2010), and there is no known cause or cure. AD typically affects people over 65 years of age, but can also strike younger people. The 85- year-old and over age group is currently the fastest-growing age group in the United States. It is estimated that 50% of this age group have AD. PTS:1 DIF: Cognitive Level: Knowledge REF: 1094 OBJ:1 (theory) TOP: AD: Incidence KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance 2. An 85-year-old man is admitted to the hospital with gastroenteritis and dehydration. He receives a dose of meclizine hydrochloride, an anticholinergic, for vomiting. He begins to hallucinate and talk to his wife, who has been dead for 10 years. Which explanation best describes this behavior? a. Dementia related to advanced age b. Delirium related to dehydration c. Dementia related to early Alzheimer’s disease (AD) d. Delirium related to side effect of anticholinergic ANS: D Anticholinergic drugs can cause sudden confusion in older adults. There is nothing in the history that suggests that the behavior would be related to AD or any other dementia as dementias progress slowly. Dehydration would increase the effect of the anticholinergic. PTS:1 DIF: Cognitive Level: Analysis REF: 1093 OBJ:2 (theory) TOP: Delirium: Etiology KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance 3. The nurse is aware that the older adult is at risk for drug-induced delirium. Which age related change contributes to this risk? a. Slower bowel motility b. Reduced fluid intake c. Overall reduced metabolism d. Sedentary lifestyle ANS: C Slower renal and liver clearance of drugs allows the drugs to accumulate in the system of the older adult. PTS: 1 DIF: Cognitive Level: Comprehension REF: 1093, Older Adult Care Points OBJ: 2 (theory) TOP: Drug-Induced Delirium: Older Adult KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. Memory lapses seen in early stages of Alzheimer disease (AD) are related to the pathophysiology of which condition? a. Frontal lobe atrophy b. Overproduction of neurotransmitters c. Pituitary disorders d. Inadequate clearance of metabolic toxins