AHA 2023 Exam 3 Review

1. What does orientation to person, place, and time assess? When you perform assessment, what exactly are you looking for? - ANSWER-A persons state of alertness and level of consciousness. Orientation to person, place, and time, assesses a persons level of consciousness. Looking for cognitive function. Person disorientation or amnesia may occur with a cerebral trauma, seizures, or amnesia. Place disorientation occurs with psychiatric disorders, delirium, and cognitive impairment. Time disorientation is associated with anxiety delirium, depression, and cognitive impairment. Assessing orientation to person, place, and time helps determine state of consciousness Orientation to person, place, and time are measures of states of consciousness and awareness, not degrees of attention span. Analogies and abstract reasoning are higher functions than orientation. Emotional status can be better evaluated by observing behaviors 2. How many serial numbers should most people be able to repeat? For example: counting backwards. How many should the average person be able to repeat? - ANSWER-Five to eight numbers forward or four to six backward can usually be repeated. Under most conditions, adult patients should be able to repeat a series of _____ numbers. Five to eight Most adults should be able to recall immediately a series of 5 to 8 numbers FORWARD and 4 to 6 numbers BACKWARD 3. How do you assess recent memory if you've had a patient your worried about memory? What technique and how would you assess recent memory? - ANSWER-Give the patient a short time to view four or five test objects, telling them you will ask them about them in a few minutes. Ten minutes later, ask the patient to list the objects BALL, TREE, CAT, TABLE. Recent memory may be tested by showing the patient four items and asking him or her to list the items about 10 minutes later. Showing the patient four or five objects, saying you will ask about them in a few minutes, and then 10 minutes later asking the patient to list the objects is a technique to measure recent memory. The other choices are not tests of recent memory. Asking the patient to listen and then repeat tests immediate recall. 4. What pysch or mental condition is considered progressive and not reversible? - ANSWER-Which condition is considered progressive rather than reversible? Dementia Dementia is considered progressive and irreversible, delirium and coma have the potential for reversal, and depression and anxiety are reversible. An older adult is administered the Set Test and scores a 14. The nurse interprets this score as indicative of dementia. Scores of less than 15 on this mental function test indicate dementia. Which of the following is usually related to structural diseases of the brain? Dementia One of the distinguishing characteristics that distinguishes dementia from the others is that it is usually related to structural diseases of the brain such as abnormal deposits, or recurrent strokes. 5. If patient is delirious do they maintain orientation and attention span? Look up delirium and see what you expect patient to maintain. - ANSWER-A state of impaired cognition, consciousness, mood and behavioral dysfunction of acute onset refers to delirium. Delirium is a state of impaired cognition, consciousness, mood and behavioral dysfunction of acute onset. Stupor describes arousals for short periods of time after a stimulus for arousal (e.g., visual, verbal, or painful). Lethargy relates to sleepiness with ease of arousal; coma is nonarousal and nonawareness. Confusion relates to inappropriate responses to questions with decreased attention span and memory. 6. Who should you give a mini mental exam to? Everyone or certain patients? - ANSWER-The Mini-Mental State Examination should be administered for a patient who gets lost in her or his neighborhood. The MMSE is a tool used to estimate cognitive function quantitatively or document cognitive changes serially. Getting lost in a familiar territory is a sign of possible cognitive impairment. The Mini-Mental State Examination (MMSE) may be used to estimate cognitive changes quantitatively. The MMSE is a standard tool that functions to estimate cognitive function quantitatively While interviewing a 70-year-old female clinic patient, she tells you that she takes ginkgo biloba and St. John's wort. You make a short note to check for results of the Mini-Mental State Examination. Ginkgo biloba and St. John's wort are herbal remedies used to improve mental alertness and elevate mood. As side effects, they can also result in disorientation and confusion that can be monitored with the Mini-Mental State Examination. The Denver and Goodenough-Harris tests are used for childhood development, and the Glasgow Coma Scale is used to rate coma depth. The CAGE Questionnaire is a useful tool for approaching a discussion of the use of alcohol. What is the assessment of cognition - ANSWER-...the execution of complex mental processes (e.g., learning, perceiving, decision making, and memory). The Mini-Cog Assessment Instrument for Dementia - ANSWER-TThe Mini-Cog assessment instrument combines an uncued 3-item recall test with a clockdrawing test (CDT). The Mini-Cog can be administered in about 3 minutes, requires no special equipment, and is relatively uninfluenced by level of education or language variations. Administration The test is administered as follows: 1. Instruct the patient to listen carefully to and remember 3 unrelated words and then to repeat the words. 2. Instruct the patient to draw the face of a clock, either on a blank sheet of paper or on a sheet with the clock circle already drawn on the page. After the patient puts the numbers on