BSN 346 HESI CASE STUDY: Alzheimer's Disease
(Advanced Stages)
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 and to rule
,Section 1
Cognitive Function
AssessmentThe nurse
administers a mental status
examination to assess the
client's cognitive function.
The client's spouse is
present during the exam.
Judgment.
Evaluation of cognitive function includes assessment
of attention, concentration, judgment, perception,
learning, memory, communication, language, and
speed of processing information.
This exam includes
which component?
RATIONALE FOR INCORRECT:
Appetite.
Decreased appetite may occur with Alzheimer's
Judgment.
disease as the result of altered cognitive function,
Pupillary response.
but assessment of nutritional status is not included in
Babinski's reflex.
a mental status exam.
Pupillary response provides information about cranial
nerve function, rather than cognitive function.
Testing for a Babinski's reflex does not provide
information about cognitive function.
, Level of consciousness.
Level of consciousness is an assessment of the
When the nurse is
client's congition.
conducting the client's
cognitive function,
Remote memory.
which components of the
Remote memory is an assessment of the client's
mental status exam best
congition.
assess the client's
cognition? (Select all
RATIONALE FOR INCORRECT:
that apply.) Level of
Level of eye contact is an assessment of the client's
consciousness.
behavior.
Level of eye contact.
Speech articulation is an assessment of the client's
Remote memory.
speech.
Speech articulation.
Facial expression is an assessment of the client's
Facial expression.
appearance.
Section 2
Diagnostic StudiesThe
client is scheduled for
laboratory work and
neuroimaging tests,
including magnetic
resonance imaging (MRI)
and positron emission
tomography (PET). The
client's spouse asks the
nurse what these tests will
show.
, Which is the best The healthcare provider is looking for changes in
explanation by the nurse? the brain that are consistent with Alzheimer's disease
or for other conditions that can cause the client's
The tests are only used to symptoms. Although there are no diagnostic tests
help rule out other causes that provide a definitive differential diagnosis of
for the client's symptoms, Alzheimer's disease, several imaging tests provide
since there are no tests data that show changes consistent with AD. Other
that can be used to problems that cause dementia may also be found via
diagnose Alzheimer's neuroimaging tests.
disease.
The healthcare provider RATIONALE FOR INCORRECT:
is looking for changes in The tests are only used to help rule out other
the brain that are causes for the client's symptoms, since there are no
consistent with tests that can be used to diagnose Alzheimer's
Alzheimer's disease or for disease.
other conditions that Although there are no diagnostic tests that provide a
can cause the client's definitive differential diagnosis of Alzheimer's disease,
symptoms. several imaging tests provide data that show
The tests will provide changes consistent with Alzheimer's disease.
information about the The tests will provide information about the staging
staging of Alzheimer's of Alzheimer's disease, so the healthcare provider
disease, so the healthcare will know which medications to prescribe for the
provider will know best treatment.
which medications to Diagnostic tests are not typically used to stage
prescribe for the best Alzheimer's disease.
treatment. The imaging test results will be used to analyze
The imaging test results the effectiveness of the treatment protocol used to
will be used to analyze the shrink the diseased brain tissue.
effectiveness of the Treatment does not shrink the diseased brain tissue.
treatment protocol used
to shrink the diseased
brain tissue.
The client's laboratory
tests include a CBC, TSH,
T3, T4, electrolytes, BUN,
and glucose levels. The
results are all normal.
(Advanced Stages)
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 and to rule
,Section 1
Cognitive Function
AssessmentThe nurse
administers a mental status
examination to assess the
client's cognitive function.
The client's spouse is
present during the exam.
Judgment.
Evaluation of cognitive function includes assessment
of attention, concentration, judgment, perception,
learning, memory, communication, language, and
speed of processing information.
This exam includes
which component?
RATIONALE FOR INCORRECT:
Appetite.
Decreased appetite may occur with Alzheimer's
Judgment.
disease as the result of altered cognitive function,
Pupillary response.
but assessment of nutritional status is not included in
Babinski's reflex.
a mental status exam.
Pupillary response provides information about cranial
nerve function, rather than cognitive function.
Testing for a Babinski's reflex does not provide
information about cognitive function.
, Level of consciousness.
Level of consciousness is an assessment of the
When the nurse is
client's congition.
conducting the client's
cognitive function,
Remote memory.
which components of the
Remote memory is an assessment of the client's
mental status exam best
congition.
assess the client's
cognition? (Select all
RATIONALE FOR INCORRECT:
that apply.) Level of
Level of eye contact is an assessment of the client's
consciousness.
behavior.
Level of eye contact.
Speech articulation is an assessment of the client's
Remote memory.
speech.
Speech articulation.
Facial expression is an assessment of the client's
Facial expression.
appearance.
Section 2
Diagnostic StudiesThe
client is scheduled for
laboratory work and
neuroimaging tests,
including magnetic
resonance imaging (MRI)
and positron emission
tomography (PET). The
client's spouse asks the
nurse what these tests will
show.
, Which is the best The healthcare provider is looking for changes in
explanation by the nurse? the brain that are consistent with Alzheimer's disease
or for other conditions that can cause the client's
The tests are only used to symptoms. Although there are no diagnostic tests
help rule out other causes that provide a definitive differential diagnosis of
for the client's symptoms, Alzheimer's disease, several imaging tests provide
since there are no tests data that show changes consistent with AD. Other
that can be used to problems that cause dementia may also be found via
diagnose Alzheimer's neuroimaging tests.
disease.
The healthcare provider RATIONALE FOR INCORRECT:
is looking for changes in The tests are only used to help rule out other
the brain that are causes for the client's symptoms, since there are no
consistent with tests that can be used to diagnose Alzheimer's
Alzheimer's disease or for disease.
other conditions that Although there are no diagnostic tests that provide a
can cause the client's definitive differential diagnosis of Alzheimer's disease,
symptoms. several imaging tests provide data that show
The tests will provide changes consistent with Alzheimer's disease.
information about the The tests will provide information about the staging
staging of Alzheimer's of Alzheimer's disease, so the healthcare provider
disease, so the healthcare will know which medications to prescribe for the
provider will know best treatment.
which medications to Diagnostic tests are not typically used to stage
prescribe for the best Alzheimer's disease.
treatment. The imaging test results will be used to analyze
The imaging test results the effectiveness of the treatment protocol used to
will be used to analyze the shrink the diseased brain tissue.
effectiveness of the Treatment does not shrink the diseased brain tissue.
treatment protocol used
to shrink the diseased
brain tissue.
The client's laboratory
tests include a CBC, TSH,
T3, T4, electrolytes, BUN,
and glucose levels. The
results are all normal.
