NR 547 QUESTIONS AND ANSWERS LATEST UPDATE
Tell me about the geriatric depression scale
Used to initially assess depression in older adults
0-4 normal
5-8 mild depression
9-11 moderate depression
12-15 severe depression
Tell me about the Montreal Cognitive Assessment (MoCA)
Evaluates 8 cognitive domains. Used to detect mild cognitive decline and early signs of
dementia
Executive and visuospatial function
Naming
Attention
Language
Abstraction
Delayed recall
Orientation
26-30 normal cognition
18-25 mild cognitive impairment
10-17 moderate cognitive impairment
under 10 severe cognitive impairment
Saint Louis University Mental Status Exam (SLUMS)
evaluates patient orientation, executive function, memory, and attention.
27-30 normal
21-26 mild neurocognitive disorder
0-20 dementia
Laboratory testing for dementia/
,blood chemistry profiles (including glucose, sodium, potassium, chlorine, bicarbonate,
bun, and creatinine)
fasting blood glucose
CBC with differential
TSH
cobalamin level
folate level
ESR
CRP
urinalysis with culture
chest x-ray
Additional testing with dementia/delirium
HIV testing in those considered at risk
syphilis testing
urine toxicology panel (for opiates, benzodiazepines, cannabinoids, and cocaine)
collagen vascular profile (if there is evidence of systemic vascular involvement)
urinalysis for heavy metals for clients who are considered at risk by history (i.e.,
suspicion of poisoning, social exposure to lead)
`Neuroimaging for dementia/delirium
CT to identify if there are any brain tumors or structural issues
MRI to identify atrophy, vascular lesions
neurofibrillary tangles
amyloid plaques
fluorodeoxyglucose (FDG)-positron emission tomography (PET) can provide better
accuracy than MRI
amyloid PET can make an earlier and more accurate diagnosis of Alzheimer dementia
Tell me about N-methyl-D-aspartate (NMDA) for dementia
Memantine is used for clients with moderate to severe dementia associated with AD.
This drug selectively blocks the effects of abnormal glutamate release, an excitatory
neurotransmitter.
Tell me about Cholinesterase inhibitors for dementia
, Donepezil, rivastigmine, or galantamine may be used for clients with mild, moderate, or
severe dementia associated with AD. These drugs act by inhibiting
acetylcholinesterase, thus improving cholinergic function, and increasing the circulation
of acetylcholine.
Tell me about Anti-Amyloid for dementia
Aducanumab has been used with clients with mild dementia in clinical trials. This drug
acts by binding to and reducing amyloid-beta plaque in the brain.
IV drug reduce cognitive and functional decline
Nonpharmacological interventions for dementia
physical activity
consistent surroundings and routines
diet (Mediterranean)
memory aids (calendar)
cognitive stimulation (puzzles, word games)
cognitive behavioral therapy
support groups
alternative therapies (aromatherapy, music, dance, animal)
Risk factors for neurocognitive disorders
Elderly
Alcohol
Hospital stay
Polypharmacy
Male
Change in cognitive/functional status
Decreased oral intake
Drugs
Medical conditions
Surgery
Environmental
Sensory
EEG for neurocognitive disorders
Tell me about the geriatric depression scale
Used to initially assess depression in older adults
0-4 normal
5-8 mild depression
9-11 moderate depression
12-15 severe depression
Tell me about the Montreal Cognitive Assessment (MoCA)
Evaluates 8 cognitive domains. Used to detect mild cognitive decline and early signs of
dementia
Executive and visuospatial function
Naming
Attention
Language
Abstraction
Delayed recall
Orientation
26-30 normal cognition
18-25 mild cognitive impairment
10-17 moderate cognitive impairment
under 10 severe cognitive impairment
Saint Louis University Mental Status Exam (SLUMS)
evaluates patient orientation, executive function, memory, and attention.
27-30 normal
21-26 mild neurocognitive disorder
0-20 dementia
Laboratory testing for dementia/
,blood chemistry profiles (including glucose, sodium, potassium, chlorine, bicarbonate,
bun, and creatinine)
fasting blood glucose
CBC with differential
TSH
cobalamin level
folate level
ESR
CRP
urinalysis with culture
chest x-ray
Additional testing with dementia/delirium
HIV testing in those considered at risk
syphilis testing
urine toxicology panel (for opiates, benzodiazepines, cannabinoids, and cocaine)
collagen vascular profile (if there is evidence of systemic vascular involvement)
urinalysis for heavy metals for clients who are considered at risk by history (i.e.,
suspicion of poisoning, social exposure to lead)
`Neuroimaging for dementia/delirium
CT to identify if there are any brain tumors or structural issues
MRI to identify atrophy, vascular lesions
neurofibrillary tangles
amyloid plaques
fluorodeoxyglucose (FDG)-positron emission tomography (PET) can provide better
accuracy than MRI
amyloid PET can make an earlier and more accurate diagnosis of Alzheimer dementia
Tell me about N-methyl-D-aspartate (NMDA) for dementia
Memantine is used for clients with moderate to severe dementia associated with AD.
This drug selectively blocks the effects of abnormal glutamate release, an excitatory
neurotransmitter.
Tell me about Cholinesterase inhibitors for dementia
, Donepezil, rivastigmine, or galantamine may be used for clients with mild, moderate, or
severe dementia associated with AD. These drugs act by inhibiting
acetylcholinesterase, thus improving cholinergic function, and increasing the circulation
of acetylcholine.
Tell me about Anti-Amyloid for dementia
Aducanumab has been used with clients with mild dementia in clinical trials. This drug
acts by binding to and reducing amyloid-beta plaque in the brain.
IV drug reduce cognitive and functional decline
Nonpharmacological interventions for dementia
physical activity
consistent surroundings and routines
diet (Mediterranean)
memory aids (calendar)
cognitive stimulation (puzzles, word games)
cognitive behavioral therapy
support groups
alternative therapies (aromatherapy, music, dance, animal)
Risk factors for neurocognitive disorders
Elderly
Alcohol
Hospital stay
Polypharmacy
Male
Change in cognitive/functional status
Decreased oral intake
Drugs
Medical conditions
Surgery
Environmental
Sensory
EEG for neurocognitive disorders
