HARTMAN'S NURSING ASSISTANT
CARE CHAPTER 5, 6, & 7 EXAM
QUESTIONS AND ANSWERS
Confusion -Answer-The inability to think clearly or make decisions
Delirium -Answer-Severe confusion which occurs suddenly - usually temporary-
Drugs and alcohol usually involved but could also be due to disease, illness, fluid
imbalance, poor nutrition
Causes of Confusion -Answer-UTI, Low Blood Sugar, Dehydration, Fever, Lack of
Oxygen, Infections, Brain Tumor
Guidelines of Care for Residents experiencing Confusion -Answer-Do NOT leave
resident alone, provide a quiet environment, introduce self each time you see the
resident and use their name, Keep a routine and talk to residents about plan for the
day, use calendars - remind them of date, time, place
Signs of Delirium -Answer-Agitation, Irritability, Anger, Depression, Diorientation,
Trouble focusing, Aphasia, Changes in Perspective & Sensations, Changes in
Consciousness, STM loss
Goal of Treatment for Delirium -Answer-Control or Reverse the cause
Cognition -Answer-The ability to think logically and clearly & make decisions
Cognitive Impairment -Answer-Inability to think logically & clearly (Not rational)
Dementia -Answer-Symptom not a diagnosis. Loss of thinking, reasoning,
remembering, & communicating. No recovery. Difficulty to perform ADL's.
Cause Dementia -Answer-Alzheimer's, Multi-Infarc/Vascular Dementia (series of
CVAs causes damage to the brain, Lewy Body Dementia, Parkinson's, Huntington's.
Lewy Body Dementia -Answer-Most common type of dementia. It involves
fluctuations between alertness and attention, meaning that one moment resident
may seem completely fine and the next he is staring into space and drowsy. It also
involves frequent hallucinations and gradual loss of motor skills.
Huntington's Disease -Answer-Caused by a faulty gene on chromosome 4. The
faulty gene leads to a damage of the nerve cells in areas of the brain, including the
the basal ganglia and cerebral cortex.
This leads to gradual physical, mental and emotional changes. It is a dominant
hereditary disease.
, The hallmark symptom is uncontrolled movement of the arms, legs, head, face and
upper body. Also causes a decline in thinking and reasoning skills, including
memory, concentration, judgment and ability to plan and organize.
Other symptoms include alterations in mood, especially depression, anxiety, and
uncharacteristic anger and irritability, obsessive-compulsive behavior, leading a
person to repeat the same question or activity over and over.
Alzheimer's Disease -Answer-Most common cause of dementia in the "elderly".
Women are more prone to the disease (possibly hormone imbalances). Causes
"tangled nerve fibers (tangles)" and protein deposits to form in the brain. No known
cause or cure. Only sure way to "diagnose is by autopsy".
Skills a person has used over a lifetime (playing instruments) are usually kept longer.
Alzheimer's Care Guidelines -Answer-Encourage independence to keep mind and
body active as possible. Problem solving, socializing , reading, working/projects all
help slow the disease.
CNA's attitude when dealing with Alzheimer's should be: -Answer-Empathetic,
DON"T take things personally, "Let's..." Team Effort Approach
Strategies for better communication with Alzheimer's patients -Answer-Approach
from front (so as not to startle)
Determine patient's "space bubble" comfort zone
Reduce distractions
Always identify yourself and address resident by name
Lower tone of voice
Use same words and phrases & repeat yourself
Use signs, pictures & gestures
Break complex tasks into smaller, simpler ones
Give simple step by step instructions (treat as an adult but use toddler logic...limited
choice etc.)
Strategies for helping frightened or agitated Alzheimer's patients -Answer-Get rid of
noise & distractions
Keep them calm
Always describe what you are going to do
Toddler logic while treating patient as an adult (Don't say don't, limited choice,
distractions work well)
Watch for non-verbal cues
Touch & Smiles reassure them
Place pictures on cabinets/bathroom doors/resident's door
"Let's..." get dressed now, bathe, walk etc. "Team effort"
Strategies for helping depressed or lonely Alzheimer's patients -Answer-Take one on
one time to listen
Involve resident in activities
Report signs of depression to the nurse
When Alzheimer's resident wants to go home -Answer-"Tell me about your home"
CARE CHAPTER 5, 6, & 7 EXAM
QUESTIONS AND ANSWERS
Confusion -Answer-The inability to think clearly or make decisions
Delirium -Answer-Severe confusion which occurs suddenly - usually temporary-
Drugs and alcohol usually involved but could also be due to disease, illness, fluid
imbalance, poor nutrition
Causes of Confusion -Answer-UTI, Low Blood Sugar, Dehydration, Fever, Lack of
Oxygen, Infections, Brain Tumor
Guidelines of Care for Residents experiencing Confusion -Answer-Do NOT leave
resident alone, provide a quiet environment, introduce self each time you see the
resident and use their name, Keep a routine and talk to residents about plan for the
day, use calendars - remind them of date, time, place
Signs of Delirium -Answer-Agitation, Irritability, Anger, Depression, Diorientation,
Trouble focusing, Aphasia, Changes in Perspective & Sensations, Changes in
Consciousness, STM loss
Goal of Treatment for Delirium -Answer-Control or Reverse the cause
Cognition -Answer-The ability to think logically and clearly & make decisions
Cognitive Impairment -Answer-Inability to think logically & clearly (Not rational)
Dementia -Answer-Symptom not a diagnosis. Loss of thinking, reasoning,
remembering, & communicating. No recovery. Difficulty to perform ADL's.
Cause Dementia -Answer-Alzheimer's, Multi-Infarc/Vascular Dementia (series of
CVAs causes damage to the brain, Lewy Body Dementia, Parkinson's, Huntington's.
Lewy Body Dementia -Answer-Most common type of dementia. It involves
fluctuations between alertness and attention, meaning that one moment resident
may seem completely fine and the next he is staring into space and drowsy. It also
involves frequent hallucinations and gradual loss of motor skills.
Huntington's Disease -Answer-Caused by a faulty gene on chromosome 4. The
faulty gene leads to a damage of the nerve cells in areas of the brain, including the
the basal ganglia and cerebral cortex.
This leads to gradual physical, mental and emotional changes. It is a dominant
hereditary disease.
, The hallmark symptom is uncontrolled movement of the arms, legs, head, face and
upper body. Also causes a decline in thinking and reasoning skills, including
memory, concentration, judgment and ability to plan and organize.
Other symptoms include alterations in mood, especially depression, anxiety, and
uncharacteristic anger and irritability, obsessive-compulsive behavior, leading a
person to repeat the same question or activity over and over.
Alzheimer's Disease -Answer-Most common cause of dementia in the "elderly".
Women are more prone to the disease (possibly hormone imbalances). Causes
"tangled nerve fibers (tangles)" and protein deposits to form in the brain. No known
cause or cure. Only sure way to "diagnose is by autopsy".
Skills a person has used over a lifetime (playing instruments) are usually kept longer.
Alzheimer's Care Guidelines -Answer-Encourage independence to keep mind and
body active as possible. Problem solving, socializing , reading, working/projects all
help slow the disease.
CNA's attitude when dealing with Alzheimer's should be: -Answer-Empathetic,
DON"T take things personally, "Let's..." Team Effort Approach
Strategies for better communication with Alzheimer's patients -Answer-Approach
from front (so as not to startle)
Determine patient's "space bubble" comfort zone
Reduce distractions
Always identify yourself and address resident by name
Lower tone of voice
Use same words and phrases & repeat yourself
Use signs, pictures & gestures
Break complex tasks into smaller, simpler ones
Give simple step by step instructions (treat as an adult but use toddler logic...limited
choice etc.)
Strategies for helping frightened or agitated Alzheimer's patients -Answer-Get rid of
noise & distractions
Keep them calm
Always describe what you are going to do
Toddler logic while treating patient as an adult (Don't say don't, limited choice,
distractions work well)
Watch for non-verbal cues
Touch & Smiles reassure them
Place pictures on cabinets/bathroom doors/resident's door
"Let's..." get dressed now, bathe, walk etc. "Team effort"
Strategies for helping depressed or lonely Alzheimer's patients -Answer-Take one on
one time to listen
Involve resident in activities
Report signs of depression to the nurse
When Alzheimer's resident wants to go home -Answer-"Tell me about your home"
