GUARANTEED
1. An Alzheimer patient is actively resistive to basic hygiene. However, in order to meet basic
standards for hygiene, how frequently should the patient be bathed?
o Daily
o Two to three times weekly
o Biweekly
o Weekly - ANSWER While adults don't usually need daily baths, they should bathe
two to three times weekly. Grab bars, shower or tub seats, tub mats, handheld showers, and
proper heating (to avoid chilling the patient) can facilitate more frequent bathing. Mild soap
and bath oil may reduce the drying of skin. Patients who are fearful of tubs and showers,
common with dementia, may receive a sponge bath or Comfort Bath with premoistened,
warmed washcloths. Thick-handled toothbrushes or electric toothbrushes may facilitate
mouth care.
2. At which time of day are patients with cognitive impairment usually MOST sensitive to
sensory overload?
o Noon
o Early morning
o Late evening
o Afternoon - ANSWER Many people are more sensitive to sensory overload in the
afternoon when cortisol levels are highest. Sensory overload most often affects those with
cognitive impairment or those in stressful situations. Excess noise and activity can cause
distress, agitation, confusion, and delirium. Sensory deprivation occurs when there is too
little environmental stimulation because of reduction in sensory input because of hearing or
vision deficits, inability to recognize sensory input because of cognitive impairment, or a
boring environment. Sensory deprivation can contribute to confusion, disorientation, and
depression.
1
, 3. Which of the following is characteristic of nociceptive pain?
o Association with chronic conditions such as diabetes or cancer
o Diffuse or cramping pain
o Burning, stabbing, or shooting pains
o Acute aching or throbbing pain localized to the site of injury - ANSWER Nociceptive
pain usually correlates with the extent and type of injury: the greater the injury, the greater
the pain. It may be procedural pain (related to wound manipulation and dressing changes)
or surgical pain (related to the cutting of tissue). It may also be continuous or cyclic,
depending upon the type of injury. This type of pain, often described as aching or throbbing,
is usually localized to the area of injury and resolves over time as healing takes place, and it
usually responds to analgesia.
4. According to the three-step World Health Organization (WHO) "analgesic ladder," a
patient complaining of moderate to severe pain unresponsive to NSAIDs may require which
of the following medications?
o Acetaminophen
o Demerol
o Codeine
o Morphine - ANSWER Codeine. Systemic medications may be given orally or by
injection into muscles, subcutaneous tissue, or veins to control pain. World Health
Organization (WHO) pain classifications include the following:
• Step 1: Mild to moderate pain is treated with aspirin, acetaminophen, and NSAIDs.
• Step 2: Moderate to severe pain unrelieved by Step 1 medications may need opioids, such
as codeine, tramadol, or Percocet.
• Step 3: Severe pain without relief from Step 1 or Step 2 medications may need stronger
opioids, such as morphine, Dilaudid, or MS-Contin.
5. Which type of precautions is indicated for a patient with a surgical-site infection and
purulent discharge?
o Contact
o Contact and droplet
2
1. An Alzheimer patient is actively resistive to basic hygiene. However, in order to meet basic
standards for hygiene, how frequently should the patient be bathed?
o Daily
o Two to three times weekly
o Biweekly
o Weekly - ANSWER While adults don't usually need daily baths, they should bathe
two to three times weekly. Grab bars, shower or tub seats, tub mats, handheld showers, and
proper heating (to avoid chilling the patient) can facilitate more frequent bathing. Mild soap
and bath oil may reduce the drying of skin. Patients who are fearful of tubs and showers,
common with dementia, may receive a sponge bath or Comfort Bath with premoistened,
warmed washcloths. Thick-handled toothbrushes or electric toothbrushes may facilitate
mouth care.
2. At which time of day are patients with cognitive impairment usually MOST sensitive to
sensory overload?
o Noon
o Early morning
o Late evening
o Afternoon - ANSWER Many people are more sensitive to sensory overload in the
afternoon when cortisol levels are highest. Sensory overload most often affects those with
cognitive impairment or those in stressful situations. Excess noise and activity can cause
distress, agitation, confusion, and delirium. Sensory deprivation occurs when there is too
little environmental stimulation because of reduction in sensory input because of hearing or
vision deficits, inability to recognize sensory input because of cognitive impairment, or a
boring environment. Sensory deprivation can contribute to confusion, disorientation, and
depression.
1
, 3. Which of the following is characteristic of nociceptive pain?
o Association with chronic conditions such as diabetes or cancer
o Diffuse or cramping pain
o Burning, stabbing, or shooting pains
o Acute aching or throbbing pain localized to the site of injury - ANSWER Nociceptive
pain usually correlates with the extent and type of injury: the greater the injury, the greater
the pain. It may be procedural pain (related to wound manipulation and dressing changes)
or surgical pain (related to the cutting of tissue). It may also be continuous or cyclic,
depending upon the type of injury. This type of pain, often described as aching or throbbing,
is usually localized to the area of injury and resolves over time as healing takes place, and it
usually responds to analgesia.
4. According to the three-step World Health Organization (WHO) "analgesic ladder," a
patient complaining of moderate to severe pain unresponsive to NSAIDs may require which
of the following medications?
o Acetaminophen
o Demerol
o Codeine
o Morphine - ANSWER Codeine. Systemic medications may be given orally or by
injection into muscles, subcutaneous tissue, or veins to control pain. World Health
Organization (WHO) pain classifications include the following:
• Step 1: Mild to moderate pain is treated with aspirin, acetaminophen, and NSAIDs.
• Step 2: Moderate to severe pain unrelieved by Step 1 medications may need opioids, such
as codeine, tramadol, or Percocet.
• Step 3: Severe pain without relief from Step 1 or Step 2 medications may need stronger
opioids, such as morphine, Dilaudid, or MS-Contin.
5. Which type of precautions is indicated for a patient with a surgical-site infection and
purulent discharge?
o Contact
o Contact and droplet
2
