Chapter 28: Neurocognitive Disorders
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. What assessment question best focuses on the foundation of the cognitive process?
a. ―What would you do if you are cold.‖
b. ―What are the birthdates of your children?‖
c. ―What is the name of this hospital?‖
d. ―What makes you happy?‖
ANS: B
Cognitive abilities revolve around memory and learning, with memory as foundational for
learning. The other functions are dependent on memory and learning.
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Physiologic Integrity
2. A nurse assesses a newly admitted patient with possible delirium. Which aspect of the history
provides by family members contributes to confirmation of the diagnosis?
a. ―He became confused all of a sudden.‖
b. ―He is always conscious and alert.‖
c. ―He doesn‘t seem to understand jokes anymore.‖
d. ―He is so distrustful of everyone now.‖
ANS: A
Delirium develops rapidly, as opposed to dementia, which has an insidious onset. Other
symptoms of delirium include fluctuating level of consciousness, logical thoughts alternating
with illogical thoughts, presence of visual hallucinations, and day-night sleep reversal. Loss of
ability to abstract is also seen in dementia. Paranoid delusions are common to dementia.
, DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. What is the expected outcome for donepezil therapy prescribed for a client diagnosed with mild-
to-moderate Alzheimer disease (AD)?
a. Better daily function than without treatment
b. Temporary interruption of disease process
c. Remissions of varying lengths of time
d. Marked decrease in memory impairment
ANS: A
The patient taking donepezil may function better, but the underlying disease process would
continue. None of the other suggestions results occur.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
4. The focus of nursing care for a patient diagnosed with dementia is best demonstrated by which
nursing statement?
a. ―The client‘s plan of care is individualized to meet his or her specific needs.‖
b. ―I think that reminiscence therapy will help the client remember past events
better.‖
c. ―If we give the client enough time, they can dress themselves appropriately each
morning.‖
d. ―The client was so proud when they talked about their war experiences.‖
ANS: C
Because memory is impaired, an individual with dementia cannot learn easily, so maintaining
functioning as long as possible is important. The patient‘s abilities are expected to decline over
time. Use of the word ―optimum‖ suggests the changing nature of the level of functioning.
, Individualizing care and promoting esteem and confidence are of lesser importance than
maintaining optimal function.
Steele: Keltner’s Psychiatric Nursing,
MULTIPLE CHOICE
1. What assessment question best focuses on the foundation of the cognitive process?
a. ―What would you do if you are cold.‖
b. ―What are the birthdates of your children?‖
c. ―What is the name of this hospital?‖
d. ―What makes you happy?‖
ANS: B
Cognitive abilities revolve around memory and learning, with memory as foundational for
learning. The other functions are dependent on memory and learning.
DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Physiologic Integrity
2. A nurse assesses a newly admitted patient with possible delirium. Which aspect of the history
provides by family members contributes to confirmation of the diagnosis?
a. ―He became confused all of a sudden.‖
b. ―He is always conscious and alert.‖
c. ―He doesn‘t seem to understand jokes anymore.‖
d. ―He is so distrustful of everyone now.‖
ANS: A
Delirium develops rapidly, as opposed to dementia, which has an insidious onset. Other
symptoms of delirium include fluctuating level of consciousness, logical thoughts alternating
with illogical thoughts, presence of visual hallucinations, and day-night sleep reversal. Loss of
ability to abstract is also seen in dementia. Paranoid delusions are common to dementia.
, DIF: Cognitive level: Analyzing TOP: Nursing process: Assessment
MSC: Client Needs: Psychosocial Integrity
3. What is the expected outcome for donepezil therapy prescribed for a client diagnosed with mild-
to-moderate Alzheimer disease (AD)?
a. Better daily function than without treatment
b. Temporary interruption of disease process
c. Remissions of varying lengths of time
d. Marked decrease in memory impairment
ANS: A
The patient taking donepezil may function better, but the underlying disease process would
continue. None of the other suggestions results occur.
DIF: Cognitive level: Analyzing TOP: Nursing process: Planning
MSC: Client Needs: Physiologic Integrity
4. The focus of nursing care for a patient diagnosed with dementia is best demonstrated by which
nursing statement?
a. ―The client‘s plan of care is individualized to meet his or her specific needs.‖
b. ―I think that reminiscence therapy will help the client remember past events
better.‖
c. ―If we give the client enough time, they can dress themselves appropriately each
morning.‖
d. ―The client was so proud when they talked about their war experiences.‖
ANS: C
Because memory is impaired, an individual with dementia cannot learn easily, so maintaining
functioning as long as possible is important. The patient‘s abilities are expected to decline over
time. Use of the word ―optimum‖ suggests the changing nature of the level of functioning.
, Individualizing care and promoting esteem and confidence are of lesser importance than
maintaining optimal function.
