1
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NR341 Complex Adult Health Exam 1
Textbook Questions with Rationales
Questions and Answers (100% Correct
Answers) Already Graded A+
A nurse is caring for a group of older adult clients. Which of the
following manifestations indicates one of the clients is
experiencing delirium?
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A. A client wants to know the current time while there is a clock on
the wall.
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B. A client attempts to climb out of bed and repeatedly states she
must get home.
C. A client requests extra blankets when the thermostat in the
room indicates 25.6 Degrees C (78 F).
D. A client refuses to get out of bed and has no motivation to
attend to daily hygiene. [ANS:] B.
(Delirium is characterized by a change in cognition that occurs
over a short period of time. It results from a secondary
physiological condition (e.g., infection, surgery, prolonged
hospitalization, hypoxia, fever, medications) and is a transient
disorder. Although delirium can occur with any age, it is more
common in older adults. It frequently progresses in the evening
hours and is sometimes called "sundown syndrome." Delirium is
, 2
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characterized by alterations in memory, agitation, restlessness,
illusions, or hallucinations. A client who becomes acutely confused
and agitated may be showing manifestations of delirium.)
A community health nurse is providing teaching to the family of a
client who has primary dementia. Which of the following
manifestations should the nurse tell the family to expect?
A. Decreased auditory and visual acuity.
B. Decreased display of emotion.
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C. Personality traits that are opposite of original traits.
D. Forgetfulness gradually progressing to disorientation. [ANS:] D.
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(Dementia usually appears first as forgetfulness. Other
manifestations may be apparent only upon neurologic
examination or cognitive testing. Loss of functioning progresses
slowly from impaired language skills and difficulty with ordinary
daily activities to severe memory loss and complete disorientation
with withdrawal from social interaction.)
A nurse is caring for a client who has dementia. When performing
a Mental Status Examination (MSE) the nurse should include which
of the following data? (Select all that apply.)
A. Ability to perform calculations
B. Level of consciousness
, 3
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C. Recall ability
D. Long-term memory
E. Level of orientation [ANS:] A, C, E.
(Evaluating the client's ability to perform calculations is an
© 2025 Assignment Expert
included component of an MSE. Determining the client's level of
consciousness is not a component of an MSE. Identifying the
client's ability to recall a list of objects or words is an included
component of an MSE. Evaluating long-term memory is not a
Guru01 - Stuvia
component of an MSE. Determining the client's level of orientation
is an included component of an MSE.)
A nurse is caring for a client who has dementia due to Alzheimer's
disease and was admitted to a long-term care facility following
the death of her partner of 40 years. The client states, " I want to
go home; my husband is waiting for me to cook dinner. "Which of
the following responses by the nurse is appropriate?
A. " this is where you live now."
B. " this is a safer place for you to live."
C. "Tell me what you like to cook for dinner."
D. "Your family said there is no one to care for you at home."
[ANS:] C.
, 4
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(Alzheimer's disease is a progressive cognitive disorder. Dementia
due to Alzheimer's disease means that the client is experiencing
the later stages of the illness with moderately severe to severe
cognitive decline. By asking the client to talk about what she likes
to cook for dinner, the nurse is demonstrating validation therapy
by asking the client to talk about the areas that concerned her.
The nurse could continue the conversation by discussing how
much the client misses her home and partner. Validation therapy
helps clients who have cognitive disorders discuss their feelings
© 2025 Assignment Expert
about past events and people.)
A nurse on a long-term care unit is creating a plan of care for a
client who has Alzheimer's disease. Which of the following
Guru01 - Stuvia
interventions should the nurse include in the plan?
A. rotate assignment of daily caregivers.
B. provide an activity schedule that changes from day to day.
C. limit time for the client to perform activities.
D. talk the client through tasks one step at a time. [ANS:] D
(The nurse should plan to talk the client through tasks one step at
a time to minimize confusion and promote independence, which
will decrease the client's anxiety level.)
For Expert help and assignment solutions, +254707240657
NR341 Complex Adult Health Exam 1
Textbook Questions with Rationales
Questions and Answers (100% Correct
Answers) Already Graded A+
A nurse is caring for a group of older adult clients. Which of the
following manifestations indicates one of the clients is
experiencing delirium?
© 2025 Assignment Expert
A. A client wants to know the current time while there is a clock on
the wall.
Guru01 - Stuvia
B. A client attempts to climb out of bed and repeatedly states she
must get home.
C. A client requests extra blankets when the thermostat in the
room indicates 25.6 Degrees C (78 F).
D. A client refuses to get out of bed and has no motivation to
attend to daily hygiene. [ANS:] B.
(Delirium is characterized by a change in cognition that occurs
over a short period of time. It results from a secondary
physiological condition (e.g., infection, surgery, prolonged
hospitalization, hypoxia, fever, medications) and is a transient
disorder. Although delirium can occur with any age, it is more
common in older adults. It frequently progresses in the evening
hours and is sometimes called "sundown syndrome." Delirium is
, 2
For Expert help and assignment solutions, +254707240657
characterized by alterations in memory, agitation, restlessness,
illusions, or hallucinations. A client who becomes acutely confused
and agitated may be showing manifestations of delirium.)
A community health nurse is providing teaching to the family of a
client who has primary dementia. Which of the following
manifestations should the nurse tell the family to expect?
A. Decreased auditory and visual acuity.
B. Decreased display of emotion.
© 2025 Assignment Expert
C. Personality traits that are opposite of original traits.
D. Forgetfulness gradually progressing to disorientation. [ANS:] D.
Guru01 - Stuvia
(Dementia usually appears first as forgetfulness. Other
manifestations may be apparent only upon neurologic
examination or cognitive testing. Loss of functioning progresses
slowly from impaired language skills and difficulty with ordinary
daily activities to severe memory loss and complete disorientation
with withdrawal from social interaction.)
A nurse is caring for a client who has dementia. When performing
a Mental Status Examination (MSE) the nurse should include which
of the following data? (Select all that apply.)
A. Ability to perform calculations
B. Level of consciousness
, 3
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C. Recall ability
D. Long-term memory
E. Level of orientation [ANS:] A, C, E.
(Evaluating the client's ability to perform calculations is an
© 2025 Assignment Expert
included component of an MSE. Determining the client's level of
consciousness is not a component of an MSE. Identifying the
client's ability to recall a list of objects or words is an included
component of an MSE. Evaluating long-term memory is not a
Guru01 - Stuvia
component of an MSE. Determining the client's level of orientation
is an included component of an MSE.)
A nurse is caring for a client who has dementia due to Alzheimer's
disease and was admitted to a long-term care facility following
the death of her partner of 40 years. The client states, " I want to
go home; my husband is waiting for me to cook dinner. "Which of
the following responses by the nurse is appropriate?
A. " this is where you live now."
B. " this is a safer place for you to live."
C. "Tell me what you like to cook for dinner."
D. "Your family said there is no one to care for you at home."
[ANS:] C.
, 4
For Expert help and assignment solutions, +254707240657
(Alzheimer's disease is a progressive cognitive disorder. Dementia
due to Alzheimer's disease means that the client is experiencing
the later stages of the illness with moderately severe to severe
cognitive decline. By asking the client to talk about what she likes
to cook for dinner, the nurse is demonstrating validation therapy
by asking the client to talk about the areas that concerned her.
The nurse could continue the conversation by discussing how
much the client misses her home and partner. Validation therapy
helps clients who have cognitive disorders discuss their feelings
© 2025 Assignment Expert
about past events and people.)
A nurse on a long-term care unit is creating a plan of care for a
client who has Alzheimer's disease. Which of the following
Guru01 - Stuvia
interventions should the nurse include in the plan?
A. rotate assignment of daily caregivers.
B. provide an activity schedule that changes from day to day.
C. limit time for the client to perform activities.
D. talk the client through tasks one step at a time. [ANS:] D
(The nurse should plan to talk the client through tasks one step at
a time to minimize confusion and promote independence, which
will decrease the client's anxiety level.)
