NSG 4067: IMPAIRED COGNITIVE FUNCTION- DELIRIUM AND DEMENTIA
1. Which of the following is a priority nursing intervention for the management of delirium?
A) Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte
balance
B) Reducing noise and placing familiar objects in the client's environment
C) Giving the client a clock, a watch, and calendars to provide the client with temporal
orientation
D) Providing psychological support through cognitive and social stimulation
Ans: A
Feedback:
Priority questions address physiologic integrity. The client needs to be stabilized before the other
interventions can be implemented.
2. A nurse is conducting a class at a senior citizens' center on factors that protect against
dementia. Which of the following statements by an older adult in the class indicates a need for
further teaching by the nurse?
A) "No healthy lifestyle is going to ward off dementia."
B) "Eating food high in omega-3 fatty acids will help preserve my thinking processes."
C) "Engaging in social activities will help prevent dementia."
D) "Engaging in an organized exercise program will help prevent symptoms of dementia."
Ans: A
Feedback:
Engaging in regular exercise has a positive effect on preventing cognitive decline. Omega-3 fatty
acids are nutritional interventions that help preserve cognition. There is evidence that engaging
in stimulating and meaningful activities also has a positive effect on preventing cognitive
decline. Adopting a healthy lifestyle may help ward off dementia just as it does other diseases.
3. A nurse teaches a client and care partner about cholinesterase inhibitors. Which of the
following statements should the nurse include in the teaching?
A) "Rivastigmine (Exelon) has a high chance of interacting with other medications."
B) "Nausea, vomiting, diarrhea, and loss of appetite can be prevented or reduced by starting
with a low dose."
C) "Rivastigmine is only for treatment of mild Alzheimer's disease and will be discontinued
as the disease progresses."
D) "You should have a 'drug holiday' monthly to improve the medication's functioning."
Ans: B
, Feedback:
When administering medications to older adults, it is imperative to start with lower doses and
increase the doses slowly. Exelon is less likely to interact with other drugs and may be safer and
better tolerated in people. It will continue and other medications may be added. The effectiveness
of cholinesterase inhibitors is diminished significantly if it is stopped and then restarted.
4. Which of the following are examples of appropriate communication techniques for dealing
effectively with people with dementia?
A) Ask open-ended questions so the person feels he or she can make choices.
B) For people in the later stages of Alzheimer disease, talk as you would to a child.
C) Maintain good eye contact and use a relaxed and smiling approach.
D) When the person forgets something, remind him or her not to forget next time.
Ans: C
Feedback:
To facilitate communication with people who have dementia, the nurse uses a relaxed and
smiling approach. The nurse should avoid infantilization of the older adult and not emphasize the
person's memory or cognitive deficits.
5. A nurse develops a plan to addressing dementia-related behaviors in an older adult with
dementia. Which of the following interventions should be included in this plan? (Select all that
apply.)
A) Maintain a clutter-free environment.
B) Implement regular rest periods.
C) Place pictures of familiar people in very visible places.
D) Lay out clothing in the order in which the items are to be donned.
E) Test the client's memory with each conversation.
Ans: A, B, C, D
Feedback:
Implement regular rest periods to compensate for fatigue and loss of reserve energy. Use simple
pictures and place pictures of familiar individuals in visible areas. Keep the environment free of
clutter and place dangerous substances in an inaccessible area. Avoid persistent testing of
memory
6. An 80-year-old client was referred to a neurologist after several months of worsening
cognitive deficits and has subsequently been diagnosed with Alzheimer disease. Which statement
by the nurse to the client's family demonstrates appropriate use of terminology?
1. Which of the following is a priority nursing intervention for the management of delirium?
A) Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte
balance
B) Reducing noise and placing familiar objects in the client's environment
C) Giving the client a clock, a watch, and calendars to provide the client with temporal
orientation
D) Providing psychological support through cognitive and social stimulation
Ans: A
Feedback:
Priority questions address physiologic integrity. The client needs to be stabilized before the other
interventions can be implemented.
2. A nurse is conducting a class at a senior citizens' center on factors that protect against
dementia. Which of the following statements by an older adult in the class indicates a need for
further teaching by the nurse?
A) "No healthy lifestyle is going to ward off dementia."
B) "Eating food high in omega-3 fatty acids will help preserve my thinking processes."
C) "Engaging in social activities will help prevent dementia."
D) "Engaging in an organized exercise program will help prevent symptoms of dementia."
Ans: A
Feedback:
Engaging in regular exercise has a positive effect on preventing cognitive decline. Omega-3 fatty
acids are nutritional interventions that help preserve cognition. There is evidence that engaging
in stimulating and meaningful activities also has a positive effect on preventing cognitive
decline. Adopting a healthy lifestyle may help ward off dementia just as it does other diseases.
3. A nurse teaches a client and care partner about cholinesterase inhibitors. Which of the
following statements should the nurse include in the teaching?
A) "Rivastigmine (Exelon) has a high chance of interacting with other medications."
B) "Nausea, vomiting, diarrhea, and loss of appetite can be prevented or reduced by starting
with a low dose."
C) "Rivastigmine is only for treatment of mild Alzheimer's disease and will be discontinued
as the disease progresses."
D) "You should have a 'drug holiday' monthly to improve the medication's functioning."
Ans: B
, Feedback:
When administering medications to older adults, it is imperative to start with lower doses and
increase the doses slowly. Exelon is less likely to interact with other drugs and may be safer and
better tolerated in people. It will continue and other medications may be added. The effectiveness
of cholinesterase inhibitors is diminished significantly if it is stopped and then restarted.
4. Which of the following are examples of appropriate communication techniques for dealing
effectively with people with dementia?
A) Ask open-ended questions so the person feels he or she can make choices.
B) For people in the later stages of Alzheimer disease, talk as you would to a child.
C) Maintain good eye contact and use a relaxed and smiling approach.
D) When the person forgets something, remind him or her not to forget next time.
Ans: C
Feedback:
To facilitate communication with people who have dementia, the nurse uses a relaxed and
smiling approach. The nurse should avoid infantilization of the older adult and not emphasize the
person's memory or cognitive deficits.
5. A nurse develops a plan to addressing dementia-related behaviors in an older adult with
dementia. Which of the following interventions should be included in this plan? (Select all that
apply.)
A) Maintain a clutter-free environment.
B) Implement regular rest periods.
C) Place pictures of familiar people in very visible places.
D) Lay out clothing in the order in which the items are to be donned.
E) Test the client's memory with each conversation.
Ans: A, B, C, D
Feedback:
Implement regular rest periods to compensate for fatigue and loss of reserve energy. Use simple
pictures and place pictures of familiar individuals in visible areas. Keep the environment free of
clutter and place dangerous substances in an inaccessible area. Avoid persistent testing of
memory
6. An 80-year-old client was referred to a neurologist after several months of worsening
cognitive deficits and has subsequently been diagnosed with Alzheimer disease. Which statement
by the nurse to the client's family demonstrates appropriate use of terminology?
