Alzheimer's Disease (Advanced Stages) HESI
Case Study
Meet the Client
During a routine physical exam, a client states that she has become increasingly
forgetful and worries that old age is catching up with her. The nurse notes that the client
has difficulty finishing some of her sentences because she forgets common words and
that she is wearing only a thin sweater on a very cold day. The client is scheduled for
more in-depth evaluation for possible neurocognitive disorder due to Alzheimer's
disease.
Cognitive Function Assessment
The nurse administers a mental status examination to assess the client's cognitive
function. The client's spouse is present during the exam.
This exam included which component?
a. appetite
b. judgement
c. pupillary response
d. babinski's reflex
b. Judgement
Evaluation of cognitive function includes assessment of attention, concentration,
judgment, perception, learning, memory, communication, language, and speed of
processing information.
When the nurse is conducting the client's cognitive function, which components
of the mental status exam best assesses the client's cognition? (Select all that
apply. One, some, or all options may be correct.)
a. LOC
b. level of eye contact
c. remote memory
d. speech articulation
e. facial expression
a. LOC
Level of consciousness is an assessment of the client's congition.
c. remote memory
Remote memory is an assessment of the client's congition.
Diagnostic Studies
The client is scheduled for lab work and neuroimaging tests, including a magnetic
resonance imaging (MRI) and a positron emission tomography (PET). The client's
spouse asks the nurse what these tests will show.
What is the best explanation by the nurse?
a. The tests are only used to help rule out other causes for the clients symptoms
since there are no tests that can be used to diagnose Alzheimer's disease.
b. The healthcare provider is looking for changes in the brain that are consistent
with Alzheimer's disease or for other conditions that can cause the client's
symptoms.
, c. The tests will provide information about the staging of the Alzheimer's disease,
so the healthcare provider will know which medications to prescribe for the best
treatment.
d. The imaging test results will be used to analyze the effectiveness of the
treatment protocol used to shrink the diseased brain tissue.
b. The healthcare provider is looking for changes in the brain that are consistent with
Alzheimer's disease or for other conditions that can cause the client's symptoms.
Although there are no diagnostic tests that provide a definitive differential diagnosis of
Alzheimer's disease, several imaging tests provide data that show changes consistent
with AD. Other problems that cause dementia may also be found via neuroimaging
tests.
The client's laboratory tests include a CBC, TSH, T3, T4, electrolytes, BUN, and
glucose levels. The results are all normal.
How should the nurse explain the lab information to the client's spouse?
a. The results likely indicate that the disease is in the early stages.
b. It is common for test results to change as the disease progresses.
c. Normal laboratory tests are not typical and may need to be repeated.
d. Normal laboratory test results help rule out other causes for the symptoms.
d. Normal laboratory test results help rule out other causes for the symptoms.
There are many causes of dementia, especially in the older client. Laboratory tests help
rule out treatable causes before a diagnosis of Alzheimer's disease is established.
Which understanding by the nurse regarding Alzheimer's disease is accurate?
a. Changes in behavior and personality often occur in early Alzheimer's disease.
b. Behavior changes may indicate that she has already progressed to a later
stage of the disease.
c. Behavior changes are probably the result of her effort to cope with her altered
mental function.
d. Behavior changes usually indicate that the person is feeling depressed about
the situation.
a. Changes in behavior and personality often occur in early Alzheimer's disease.
Subtle changes in behavior and personality, which would easily be recognized by a
loved one, occur even in early Alzheimer's disease.
Warning Signs & Risk Factors
Early indicators from the mental status exam show that the client has impaired cognitive
functioning. The nurse explains to the client and her spouse that a number of different
problems can result in altered cognition. The nurse discusses early warning signs and
risk factors for Alzheimer's disease with the couple. The client's spouse says that the
client does not like herself anymore.
The client's spouse asks the nurse what are typical behaviors for early stage
Alzheimer's disease. Which nursing explanation best promotes effective
communication?
a. Frequently misplacing the keys to the car
b. Needs assistance choosing clothes appropriate for season
Case Study
Meet the Client
During a routine physical exam, a client states that she has become increasingly
forgetful and worries that old age is catching up with her. The nurse notes that the client
has difficulty finishing some of her sentences because she forgets common words and
that she is wearing only a thin sweater on a very cold day. The client is scheduled for
more in-depth evaluation for possible neurocognitive disorder due to Alzheimer's
disease.
Cognitive Function Assessment
The nurse administers a mental status examination to assess the client's cognitive
function. The client's spouse is present during the exam.
This exam included which component?
a. appetite
b. judgement
c. pupillary response
d. babinski's reflex
b. Judgement
Evaluation of cognitive function includes assessment of attention, concentration,
judgment, perception, learning, memory, communication, language, and speed of
processing information.
When the nurse is conducting the client's cognitive function, which components
of the mental status exam best assesses the client's cognition? (Select all that
apply. One, some, or all options may be correct.)
a. LOC
b. level of eye contact
c. remote memory
d. speech articulation
e. facial expression
a. LOC
Level of consciousness is an assessment of the client's congition.
c. remote memory
Remote memory is an assessment of the client's congition.
Diagnostic Studies
The client is scheduled for lab work and neuroimaging tests, including a magnetic
resonance imaging (MRI) and a positron emission tomography (PET). The client's
spouse asks the nurse what these tests will show.
What is the best explanation by the nurse?
a. The tests are only used to help rule out other causes for the clients symptoms
since there are no tests that can be used to diagnose Alzheimer's disease.
b. The healthcare provider is looking for changes in the brain that are consistent
with Alzheimer's disease or for other conditions that can cause the client's
symptoms.
, c. The tests will provide information about the staging of the Alzheimer's disease,
so the healthcare provider will know which medications to prescribe for the best
treatment.
d. The imaging test results will be used to analyze the effectiveness of the
treatment protocol used to shrink the diseased brain tissue.
b. The healthcare provider is looking for changes in the brain that are consistent with
Alzheimer's disease or for other conditions that can cause the client's symptoms.
Although there are no diagnostic tests that provide a definitive differential diagnosis of
Alzheimer's disease, several imaging tests provide data that show changes consistent
with AD. Other problems that cause dementia may also be found via neuroimaging
tests.
The client's laboratory tests include a CBC, TSH, T3, T4, electrolytes, BUN, and
glucose levels. The results are all normal.
How should the nurse explain the lab information to the client's spouse?
a. The results likely indicate that the disease is in the early stages.
b. It is common for test results to change as the disease progresses.
c. Normal laboratory tests are not typical and may need to be repeated.
d. Normal laboratory test results help rule out other causes for the symptoms.
d. Normal laboratory test results help rule out other causes for the symptoms.
There are many causes of dementia, especially in the older client. Laboratory tests help
rule out treatable causes before a diagnosis of Alzheimer's disease is established.
Which understanding by the nurse regarding Alzheimer's disease is accurate?
a. Changes in behavior and personality often occur in early Alzheimer's disease.
b. Behavior changes may indicate that she has already progressed to a later
stage of the disease.
c. Behavior changes are probably the result of her effort to cope with her altered
mental function.
d. Behavior changes usually indicate that the person is feeling depressed about
the situation.
a. Changes in behavior and personality often occur in early Alzheimer's disease.
Subtle changes in behavior and personality, which would easily be recognized by a
loved one, occur even in early Alzheimer's disease.
Warning Signs & Risk Factors
Early indicators from the mental status exam show that the client has impaired cognitive
functioning. The nurse explains to the client and her spouse that a number of different
problems can result in altered cognition. The nurse discusses early warning signs and
risk factors for Alzheimer's disease with the couple. The client's spouse says that the
client does not like herself anymore.
The client's spouse asks the nurse what are typical behaviors for early stage
Alzheimer's disease. Which nursing explanation best promotes effective
communication?
a. Frequently misplacing the keys to the car
b. Needs assistance choosing clothes appropriate for season
