Neurocognitive Disorder due to Alzheimer's
Disease Case Study
Meet the Client: Mr. WilsonMr. Wilson is a 78-year-old widower, seen today by an
Advanced Practice Registered Nurse (APRN), the healthcare provider (HCP) at the
community ambulatory care clinic. He is accompanied by his daughter, who is
concerned about his increasing forgetfulness, anxiety, and wandering in the
house at night. He has a history of coronary artery disease, hypertension, and
NIDDM. He was diagnosed with Mild Neurocognitive disorder due to Alzheimer's
disease one year ago.Mr. Wilson's daughter moved into his home 6 months ago
to help care for him. She works full time as an engineer for the city. Mr. Wilson
has managed his ADLs and medication administration until this past month. His
daughter purchased a pill organizer to help him remember to take his medication,
and she leaves him prepared lunches when she goes to work, which he forgets to
eat.The nurse administers the Mini-Cog assessment tool. Mr. Wilson has poor
short term memory, is easily distracted, and is orientated to person and place
only. Mr. Wilson's vital signs are: He is given a glucose supplement and fluids in
the office.
Which is the best response by the nurse to Mr. Caudill's statement?
A. "Mr. Caudill, there is nothing to worry about."
B. "Anxiety is common when people have problems remembering things. You will
be fine."
C. "You look worried. How can I make you feel more comfortable?"
D. "You have Alzheimer's disease and have become more forgetful lately."
C. "You look worried. How can I make you feel more comfortable?"
This response acknowledges the clients feelings and the word "worried" is generally
neutral.
Mr. Wilson responds, "I am okay. What do you want to know?" The nurse settles
him in a chair and begins the assessment.
Which of the following are risk factors for Alzheimer's disease? (Select all that
apply.)
A. Advancing age.
B. Increased serum calcium.
C. Use of aluminum products.
D. Father and uncle had Alzheimer's disease.
E. Previous head trauma.
A. Advancing age.
D. Father and uncle had Alzheimer's disease.
E. Previous head trauma.
The risk for developing Alzheimer's disease increases as age advances. A family history
is a known risk factor for Alzheimer's disease. There is an association between a history
of head trauma and Alzheimer's disease, particularly repeated head trauma.
While Mr. Wilson goes to the bathroom, his daughter asks, "My father just doesn't
act like himself anymore. Why is this happening?"
, What is the best initial response by the nurse?
A. "Changes in behavior and personality often occur as Alzheimer's disease
progresses."
B. "Behavior changes may indicate that he has already progressed to a later
stage of the disease."
C. "Behavior changes are probably the result of his effort to cope with his altered
mental function."
D. "Behavior changes usually indicate that the person is feeling depressed about
the situation."
A. "Changes in behavior and personality often occur as Alzheimer's disease
progresses."
Subtle changes in behavior and personality, which would easily be recognized by a
loved one, occur even in early AD.
The nurse administers a Mental Status Exam to assess Mr. Wilson's cognitive
functioning.
Which question gives the nurse the most information about Mr. Caudill's
judgment?
A. "Are you in good spirits most of the time?"
B. "If you smelled smoke in a movie theater, what would you do?"
C. "Who is the current President of the United States?"
D. "What was the name of your favorite childhood pet?"
B. "If you smelled smoke in a movie theater, what would you do?"
This question elicits the most information about judgment. The client must know what a
fire is and describe how he would react.
During the assessment, Mr. Wilson becomes anxious and says, "Why are you
asking me all these questions? My memory is fine."
What is the best response to Mr. Caudill by the nurse?
A. "Hang in there. I will be done shortly."
B. "Let's take a break. Would you like a cup of water?"
C. "I appreciate your cooperation. Tell me what you think is the problem."
D. "Your daughter is worried about you."
C. "I appreciate your cooperation. Tell me what you think is the problem."
This acknowledges the client's concerns and engages him in his own care as much as
possible. Giving the client some control may decrease his anxiety.
Which of the following memory issues/deficits are related to Mild Neurocognitive
disorder due to Alzheimer's disease? (Select all that apply.)
A. Temporarily misplaces keys and purse.
B. Forgets the purpose or use of an item.
C. Cooks a meal and forgets to serve it.
D. Momentarily forgets an acquaintance's name.
E. Becomes lost on the client's own street.
B. Forgets the purpose or use of an item.
C. Cooks a meal and forgets to serve it.
Disease Case Study
Meet the Client: Mr. WilsonMr. Wilson is a 78-year-old widower, seen today by an
Advanced Practice Registered Nurse (APRN), the healthcare provider (HCP) at the
community ambulatory care clinic. He is accompanied by his daughter, who is
concerned about his increasing forgetfulness, anxiety, and wandering in the
house at night. He has a history of coronary artery disease, hypertension, and
NIDDM. He was diagnosed with Mild Neurocognitive disorder due to Alzheimer's
disease one year ago.Mr. Wilson's daughter moved into his home 6 months ago
to help care for him. She works full time as an engineer for the city. Mr. Wilson
has managed his ADLs and medication administration until this past month. His
daughter purchased a pill organizer to help him remember to take his medication,
and she leaves him prepared lunches when she goes to work, which he forgets to
eat.The nurse administers the Mini-Cog assessment tool. Mr. Wilson has poor
short term memory, is easily distracted, and is orientated to person and place
only. Mr. Wilson's vital signs are: He is given a glucose supplement and fluids in
the office.
Which is the best response by the nurse to Mr. Caudill's statement?
A. "Mr. Caudill, there is nothing to worry about."
B. "Anxiety is common when people have problems remembering things. You will
be fine."
C. "You look worried. How can I make you feel more comfortable?"
D. "You have Alzheimer's disease and have become more forgetful lately."
C. "You look worried. How can I make you feel more comfortable?"
This response acknowledges the clients feelings and the word "worried" is generally
neutral.
Mr. Wilson responds, "I am okay. What do you want to know?" The nurse settles
him in a chair and begins the assessment.
Which of the following are risk factors for Alzheimer's disease? (Select all that
apply.)
A. Advancing age.
B. Increased serum calcium.
C. Use of aluminum products.
D. Father and uncle had Alzheimer's disease.
E. Previous head trauma.
A. Advancing age.
D. Father and uncle had Alzheimer's disease.
E. Previous head trauma.
The risk for developing Alzheimer's disease increases as age advances. A family history
is a known risk factor for Alzheimer's disease. There is an association between a history
of head trauma and Alzheimer's disease, particularly repeated head trauma.
While Mr. Wilson goes to the bathroom, his daughter asks, "My father just doesn't
act like himself anymore. Why is this happening?"
, What is the best initial response by the nurse?
A. "Changes in behavior and personality often occur as Alzheimer's disease
progresses."
B. "Behavior changes may indicate that he has already progressed to a later
stage of the disease."
C. "Behavior changes are probably the result of his effort to cope with his altered
mental function."
D. "Behavior changes usually indicate that the person is feeling depressed about
the situation."
A. "Changes in behavior and personality often occur as Alzheimer's disease
progresses."
Subtle changes in behavior and personality, which would easily be recognized by a
loved one, occur even in early AD.
The nurse administers a Mental Status Exam to assess Mr. Wilson's cognitive
functioning.
Which question gives the nurse the most information about Mr. Caudill's
judgment?
A. "Are you in good spirits most of the time?"
B. "If you smelled smoke in a movie theater, what would you do?"
C. "Who is the current President of the United States?"
D. "What was the name of your favorite childhood pet?"
B. "If you smelled smoke in a movie theater, what would you do?"
This question elicits the most information about judgment. The client must know what a
fire is and describe how he would react.
During the assessment, Mr. Wilson becomes anxious and says, "Why are you
asking me all these questions? My memory is fine."
What is the best response to Mr. Caudill by the nurse?
A. "Hang in there. I will be done shortly."
B. "Let's take a break. Would you like a cup of water?"
C. "I appreciate your cooperation. Tell me what you think is the problem."
D. "Your daughter is worried about you."
C. "I appreciate your cooperation. Tell me what you think is the problem."
This acknowledges the client's concerns and engages him in his own care as much as
possible. Giving the client some control may decrease his anxiety.
Which of the following memory issues/deficits are related to Mild Neurocognitive
disorder due to Alzheimer's disease? (Select all that apply.)
A. Temporarily misplaces keys and purse.
B. Forgets the purpose or use of an item.
C. Cooks a meal and forgets to serve it.
D. Momentarily forgets an acquaintance's name.
E. Becomes lost on the client's own street.
B. Forgets the purpose or use of an item.
C. Cooks a meal and forgets to serve it.
