PMHNP ancc Chapter 12 Neurocognitive Exam 2023Questions with Correct Answers(2024

when do cognitive disorders occur - correct answer...any age. the very young and very old often have multiple health needs older adults usually have more than one chronic illness and psy. disorders can be co-morbid etiology of cognitive disorders - correct answer...a condition resulting in changes in multiple domains including memory, interpersonal relationships, and behavior. causes of cognitive disorders - correct answer...injury, medical condition, substance abuse, reaction to a medication, other injected agents or a combination of these Delirium is a - correct answer...syndrome, not a disease Subtypes of delirium - correct answer...hyperactive, agitated hypoactive, lethargic slowed mixed, cycles between hyperactive and hypoactive etiology of delerium - correct answer...general medical condition substance induced physical health problems medication sleep deprived incidence of delirium - correct answer...highest in hospitalized older adults 70-87% older adults in ICU 80% terminally ill nearing death screening for delirium - correct answer...Confusion Assessment Method (CAM) Delirium Index (DI) NEECHAM Confusion Scale Mini-Cog presentation of delrium - correct answer...acute change from baseline, waxs and wanes length of delirium - correct answer...can last 3-6 months physical exam finding for delirium - correct answer...tremors.. poor coordination, urinary incontinence, myoclonus, nystagmus. asterixis (flapping of the wrist), increase muscle tone and reflex diagnositc work-up for delerium - correct answer...serum chemistry, CBC, thyroid function, syphilis, HIV, urinalysis. chest x-ray, UDS EEG Pharmacological Treatment for delerium - correct answer...symptomatic tx. agitation and psychosis -Haldol, atypical antipsychotic, anxiolytic, delerium mnemonic - correct answer...Drugs Electrolyte abnormality Low o2 saturation Infection Reduced sensory Intracranial Urinary or renal retention Myocardial non-Pharmacological Treatment for delerium - correct answer...monitor for safety needs, orientation frequently, care for basic needs -hydration, nutrition. the client should neither by sensory deprived or overstimulated helpful to have familiar things in the room Children are suspectable to delerium - correct answer...due to immature brains often mistaken for uncooperative behavior if a child is not soothed by common methods -suspect delirium most common if febrile states medication is known to affect cognition (anticholinergics) Dementia are catagorized by 3 areas of the brain what are they - correct answer...cortical= involves the crotex & frontal lobe subcortical= (below) thalmus basil ganglia brain stem Bothe if it is a cortical Dementia what s/s - correct answer...Memory, language, vision ,judgement, Apraxia agnosia Name of the cortical dementias - correct answer...Alzheimers Picks Creutzfeldt-Jakob Disorder frontotempora; d/t subdural's Dementia if the Alzheimers type charateristics - correct answer...most common gradual onset and progressive decline without neurofocal deficits amyloid deposits and neurofibrillary tangles 1st sign of Alzheimer's - correct answer...memory loss vascular dementia - correct answer...2nd most common type, primary cause by cardiovascular disease, characterized by step-like declines most common in men with blood pressure and CV risk factors carotid bruits, fundoscopic abnormalities, enlarged cardiac chambers formerly called multi-infarct dementia dementia due to HIV - correct answer...classified as subcortical dementia parenchymal abnoramlities visualized om MRI, less severe form, manifestation of dementia due to HIV - correct answer...progressive cognitive decline, motor abnormalities, and behavioral abnormalities HIV- related dementia - correct answer...poor indicator of prognosis - usually death occurs within 6 months late-stage includes global cognitive impairment, mutism, seizures, hallucination, delusions, apathy, mania medication for HIV-related dementias - correct answer...antiretroviral and protease inhibitors these medications are metabolized by the P450 system and inhibitors at CYP3A4. therefore prescribe psychotropic medication with cautioning to avoid drug-drug infraction Pick's disease (frontotemporal dementia) - correct answer...Neuronal loss, gliosis, and Pick's bodies present More common in men Personality and behavioral changes in the early stage Cognitive changes in later stages Kluver Bucy syndrome-hypersexuality, hyperorality, placidity Klüver-Bucy syndrome - correct answer...resulting from bilateral lesions of the medial temporal lobe (including amygdaloid nucleus). Klüver-Bucy syndrome may present with compulsive eating, hypersexuality, insertion of inappropriate objects in the mouth (hyperorality), visual agnosia, and docility Creutzfeldt-Jakob disease (CJD) - correct answer...=Most common form of spongiform encephalopathy =Usually sporadic, but can rarely arise due to exposure to prion-infected human tissue (human growth hormone or corneal transplant) =initial presentation with fatigue, flulike sx =Presents as rapidly progressive dementia associated with ataxia (cerebellum involved) and startle =myoclonus (involuntary contractions of muscle with minimal stimulation