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Chapter 13 Dementia and its treatment
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Chapter 13 Dementia and its treatment
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Chapter 13 Dementia and its treatmentMULTIPLE CHOICE
1. A patient diagnosed with moderate dementia consistently appears to be distorting the
truth resulting in his wife asking, What should I do when he lies to me about unimportant
things? Upon what rationale should the nurses response be based?
a. Changing the topic provides diversion.
b. Delusions should be confronted to clarify thinking.
c. Ignoring memory deficit avoids catastrophic reactions.
d. This isnt lying but rather a way to fill in the memory gaps.
ANS: D
Confabulation is not lying but rather a method for filling in the memory gaps.
Ignoring, using confrontation, and changing the topic would not be as useful as gently
reorienting.
2. The nurse is to perform a complete assessment of a patient in her home, using the
Mini-Mental State Examination (MMSE) as one component. When the nurse arrives,
the patient is seated at the table with her husband, the TV is on, and several
grandchildren are visiting. The patient is quiet, but her hands are gripped tightly, and
she is staring at the ceiling. The best action for the nurse to take would be which of
the following?
Ask the husband to make an appointment to bring his wife to the clinic for
a. testing.
b.
Explain to the husband that accurate data will be sought, and ask him to stay
c.
with the grandchildren in another room.
d.
Do not perform the test during the assessment (because it will not be valid)
ANS: D
and rely on observations and reports from the family.
,E plain the importance of the testing process and make an appointment for
x another day when the environment can be better controlled.
Testing the patient in her home under quieter, less distracting circumstances is the best
solution. Asking the husband to leave is likely to increase the patients anxiety and
alter test results. Use of the MMSE is an integral component of the assessment and
must not be deleted. Testing in the more familiar, comfortable surroundings of the
home will yield more reliable results.
3. A patient has been admitted with a diagnosis of hypoactive delirium. Which
nursing intervention is supported by this diagnosis?
a. Encouraging fluids to minimize constipation
b. Frequently assessing both visual and auditory hallucinations
, c. Scheduling frequent changing of position to prevent skin breakdown
d. Dimming the lights to help control eye discomfort resulting from cataracts
ANS: C
Because of inactivity, hypoactive delirium patients are more likely to develop further
complications, including decubiti that could be minimized by frequent repositioning.
The remaining options identify interventions that are not generally a result of this
diagnosis.
4. Which of the following should the nurse use as a basis for explaining the etiology
of Alzheimers disease to the family of a patient with this disease?
It is a secondary dementia indicated by loss of recent memory and
a. disorientation to time and place.
It is a primary dementia that is incurable, irreversible, and fatal. It is caused by
the presence of a beta-amyloid protein in the neurons resulting in senile
b. plaques.
c. It is a secondary dementia that is treatable with analysis of the diet and
d. removal of toxic substances from the diet and environment.
ANS: B
It is a primary dementia characterized by stepwise decreases in cognitive
abilities. It is irreversible but treatable with antihypertensive medications.
This option provides accurate information about Alzheimers disease. Alzheimers
disease is not a secondary dementia nor is it treated with antihypertensive
medications.
5. Which outcome is realistic for a patient with stage 1 Alzheimers disease?
a. Caregiver will assume role of decision maker for patient to reduce stress.
The patient will maintain the highest possible functional level to preserve
b. ANS: B
c.
d.
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