HESI MENTAL HEALTH
CHAPTER 18 NEUROCOGNITIVE
DISORDERS TEST BANK
QUESTIONS AND ANSWERS
(WITH REF) A GRADE | STUDY
WITH THE BEST!!!
Chapter 18: Neurocognitive Disorders Test Bank
MULTIPLE CHOICE
1. An older adult patient takes digoxin and hydrochlorothiazide daily, as well
as lorazepam (Ativan) as needed for anxiety. Over 2 days, the patient developed
confusion, slurred speech, an unsteady gait, and fluctuating levels of orientation. These
findings are most characteristic of:
a. delirium
b. dementia
c. amnestic syndrome
d. Alzheimer’s disease
ANS: A
Delirium is characterized by an abrupt onset of fluctuating levels of awareness,
clouded consciousness, perceptual disturbances, and disturbed memory and
orientation. The onset of dementia or Alzheimer’s disease, a type of dementia, is
more insidious. Amnestic syndrome involves memory impairment without other
cognitive problems.
DIF: Cognitive Level: Application REF: Pages: 332-334
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A patient with fluctuating levels of awareness, confusion, and disturbed
orientation shouts, “Bugs are crawling on my legs! Get them off!” Which problem is the
patient experiencing?
a. Aphasia
b. Dystonia
c. Tactile hallucinations
d. Mnemonic disturbance
, ANS: C
The patient feels bugs crawling on both legs, although no sensory stimulus is
actually present. This description coincides with the definition of a hallucination, a
false sensory perception. Tactile hallucinations may be part of the symptom
constellation of delirium. Aphasia refers to a speech disorder. Dystonia refers to
excessive muscle tonus.
Mnemonic disturbance is associated with dementia rather than delirium.
DIF: Cognitive Level: Comprehension REF: Pages: 334-335
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
3. A patient with fluctuating levels of consciousness, disturbed orientation,
and perceptual alteration begs, “Someone get the bugs off me.” What is the nurse’s best
response?
a. “There are no bugs on your legs. Your
imagination is playing tricks on you.”
b. “Try to relax. The crawling sensation will
go away sooner if you can relax.”
c. “Don’t worry, I will have someone stay
here and brush off the bugs for you.”
d. “I don’t see any bugs, but I know you are
frightened so I will stay with you.”
ANS: D
When hallucinations are present, the nurse should acknowledge the patient’s
feelings and state the nurse’s perception of reality, but not argue. Staying with the
patient increases feelings of security, reduces anxiety, offers the opportunity for
reinforcing reality, and provides a measure of physical safety. Denying the patient’s
perception without offering help does not emotionally support the patient. Telling
the patient to relax makes the patient responsible for self-soothing. Telling the
patient that someone will brush the bugs away supports the perceptual distortions.
DIF: Cognitive Level: Application REF: Page: 339|Pages: 345-348
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. What is the priority nursing diagnosis for a patient with fluctuating levels
of consciousness, disturbed orientation, and visual and tactile hallucinations?
a. Bathing/hygiene self-care deficit, related
to altered cerebral function, as evidenced
by confusion and inability to perform
personal hygiene tasks
b. Risk for injury, related to altered cerebral
function, misperception of the
environment, and unsteady gait
CHAPTER 18 NEUROCOGNITIVE
DISORDERS TEST BANK
QUESTIONS AND ANSWERS
(WITH REF) A GRADE | STUDY
WITH THE BEST!!!
Chapter 18: Neurocognitive Disorders Test Bank
MULTIPLE CHOICE
1. An older adult patient takes digoxin and hydrochlorothiazide daily, as well
as lorazepam (Ativan) as needed for anxiety. Over 2 days, the patient developed
confusion, slurred speech, an unsteady gait, and fluctuating levels of orientation. These
findings are most characteristic of:
a. delirium
b. dementia
c. amnestic syndrome
d. Alzheimer’s disease
ANS: A
Delirium is characterized by an abrupt onset of fluctuating levels of awareness,
clouded consciousness, perceptual disturbances, and disturbed memory and
orientation. The onset of dementia or Alzheimer’s disease, a type of dementia, is
more insidious. Amnestic syndrome involves memory impairment without other
cognitive problems.
DIF: Cognitive Level: Application REF: Pages: 332-334
TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity
2. A patient with fluctuating levels of awareness, confusion, and disturbed
orientation shouts, “Bugs are crawling on my legs! Get them off!” Which problem is the
patient experiencing?
a. Aphasia
b. Dystonia
c. Tactile hallucinations
d. Mnemonic disturbance
, ANS: C
The patient feels bugs crawling on both legs, although no sensory stimulus is
actually present. This description coincides with the definition of a hallucination, a
false sensory perception. Tactile hallucinations may be part of the symptom
constellation of delirium. Aphasia refers to a speech disorder. Dystonia refers to
excessive muscle tonus.
Mnemonic disturbance is associated with dementia rather than delirium.
DIF: Cognitive Level: Comprehension REF: Pages: 334-335
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity
3. A patient with fluctuating levels of consciousness, disturbed orientation,
and perceptual alteration begs, “Someone get the bugs off me.” What is the nurse’s best
response?
a. “There are no bugs on your legs. Your
imagination is playing tricks on you.”
b. “Try to relax. The crawling sensation will
go away sooner if you can relax.”
c. “Don’t worry, I will have someone stay
here and brush off the bugs for you.”
d. “I don’t see any bugs, but I know you are
frightened so I will stay with you.”
ANS: D
When hallucinations are present, the nurse should acknowledge the patient’s
feelings and state the nurse’s perception of reality, but not argue. Staying with the
patient increases feelings of security, reduces anxiety, offers the opportunity for
reinforcing reality, and provides a measure of physical safety. Denying the patient’s
perception without offering help does not emotionally support the patient. Telling
the patient to relax makes the patient responsible for self-soothing. Telling the
patient that someone will brush the bugs away supports the perceptual distortions.
DIF: Cognitive Level: Application REF: Page: 339|Pages: 345-348
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity
4. What is the priority nursing diagnosis for a patient with fluctuating levels
of consciousness, disturbed orientation, and visual and tactile hallucinations?
a. Bathing/hygiene self-care deficit, related
to altered cerebral function, as evidenced
by confusion and inability to perform
personal hygiene tasks
b. Risk for injury, related to altered cerebral
function, misperception of the
environment, and unsteady gait
