Neurocognitive Disorders: Delirium and Dementia

A comprehensive set of flashcards covering key learning outcomes, symptoms, treatments, and nursing care strategies for neurocognitive disorders, particularly delirium and dementia.

A client presents with clinically significant deficits in cognition and memory, which interfere with their ability to think, remember, and make sound decisions. The nurse would identify this as which type of disorder?
A. Anxiety disorder
B. Mood disorder
C. Psychotic disorder
D. Neurocognitive disorder

Neurocognitive disorder.

A client's family reports a sudden change in mental status, noting acute confusion that began rapidly. The nurse suspects which condition, often linked to an organic underlying issue?
A. Depression
B. Dementia
C. Schizophrenia
D. Delirium

Delirium.

A client's family reports a gradual decline in cognitive functioning over several months, impacting daily activities. The nurse recognizes this as a characteristic of which progressive condition?
A. Delirium
B. Depression
C. Anxiety disorder
D. Dementia

Dementia.

A nurse is assessing an older adult client admitted with new-onset delirium. Which of the following factors should the nurse identify as common potential causes? (Select all that apply)
A. Dehydration
B. Hypoxia
C. Long history of Alzheimer's
D. Infection
E. Medication mismanagement
F. Depression
G. Alcohol use

Dehydration, hypoxia, infection, medication mismanagement, depression, alcohol use.

An elderly patient with confusion experiences increased agitation and disorientation specifically in the late afternoon and evening hours. The nurse identifies this phenomenon as directly associated with:
A. Acute anxiety
B. Nocturnal delirium
C. Major depressive episode
D. Early-stage dementia

Nocturnal delirium (sundowning).

A nursing student asks about the prevalence of delirium in older hospitalized patients. The nurse explains that approximately what percentage of hospitalized elderly patients may experience delirium?
A. 5-10%
B. 15-25%
C. 29-64%
D. 70-80%

29-64%.

When planning care for a client with delirium, what are the primary focuses of nursing interventions? (Select all that apply)
A. Finding and treating the underlying cause
B. Administering sedatives to induce sleep
C. Controlling agitation
D. Preventing complications
E. Referring for long-term psychological counseling

Finding and treating the underlying cause, controlling agitation, and preventing complications.

The nurse understands that dementia primarily impacts which key areas of cognitive functioning? (Select all that apply)
A. Memory
B. Language
C. Executive functioning
D. Attention
E. Motor coordination (in early stages)

Memory, language, executive functioning, and attention.

According to the DSM-V, dementia is officially classified under what diagnostic category?
A. Mood disorder of late life
B. Psychotic spectrum disorder
C. Neurocognitive disorder
D. Developmental disorder

Neurocognitive disorder.

The nurse explains to a new graduate that neurocognitive disorders are broadly categorized into which two main types?
A. Acute and chronic
B. Mild and major
C. Reversible and irreversible
D. Genetic and acquired

Mild and major neurocognitive disorder.

A pathology report indicates the presence of amyloid plaques in a deceased client's brain tissue. The nurse recognizes this finding as a hallmark of which degenerative condition?
A. Parkinson's disease
B. Huntington's disease
C. Alzheimer's disease
D. Vascular dementia

Alzheimer's disease.

When discussing degenerative dementias, which type is most commonly identified as the primary form?
A. Vascular dementia
B. Frontotemporal dementia
C. Lewy-body dementia
D. Alzheimer's type

Alzheimer's type.

Which demographic group is most commonly affected by Alzheimer's disease in the United States?
A. Americans under 30 years old
B. Americans between 30-50 years old
C. Americans over 65 years old
D. Americans of Hispanic ethnicity

Americans over 65 years old.

In advanced stages of Alzheimer's disease, what are considered leading causes of death for affected individuals? (Select all that apply)
A. Aspiration
B. Infections
C. Falls
D. Immobility
E. Malnutrition

Aspiration, infections, falls, immobility, and malnutrition.

The nurse explains the typical progression of Alzheimer's disease. What are the three broad phases commonly recognized?
A. Acute, subacute, and chronic
B. Preclinical, mild impairment, and dementia
C. Initial, intermediate, and terminal
D. Early, middle, and late-onset

Preclinical, mild impairment, and dementia (mild, moderate, severe).

A client's family expresses concern about their loved one exhibiting increasing memory loss, difficulty solving everyday problems, and frequent confusion about the current time and location. The nurse identifies these as common symptoms of which condition?
A. Generalized anxiety disorder
B. Major depressive disorder
C. Schizophrenia
D. Alzheimer's disease

Alzheimer's disease.

While definitive diagnosis of Alzheimer's is complex, what is often considered the main initial method for assessment, possibly supplemented by advanced imaging or CSF analysis?
A. Genetic testing alone
B. Cognition tests
C. Electroencephalogram (EEG)
D. Liver function tests

Cognition tests, possibly with PET scans or lumbar puncture.

A client in the early stages of Alzheimer's disease is being started on medication. Which class of drugs is typically effective in managing symptoms during this phase?
A. Antipsychotics
B. Benzodiazepines
C. Cholinesterase inhibitors
D. Mood stabilizers

Cholinesterase inhibitors.

When a patient with Lewy-body dementia requires antipsychotic medication, the nurse understands the importance of careful titration and monitoring due to heightened sensitivity related to which symptoms?
A. Tremors and rigidity
B. Delusions and hallucinations
C. Severe memory loss
D. Sleep disturbances

Delusions and hallucinations.

A nurse is caring for a patient with dementia who becomes agitated. What immediate interventions should the nurse prioritize? (Select all that apply)
A. Remain calm
B. Restrain the patient immediately
C. Redirect the patient to a calming activity
D. Administer medication PRN if agitation escalates
E. Engage in a lengthy debate about their concerns

Remain calm, redirect, and consider medication PRN.

Which of the following describes an important nursing intervention when caring for a client with dementia?
A. Debating factual inaccuracies calmly
B. Providing emotional support and clear communication
C. Encouraging maximum independence without assistance
D. Limiting family visits to prevent overstimulation

Provide emotional support and clear communication.

The nurse contributes to the management of dementia symptoms by implementing which strategies in the care environment? (Select all that apply)
A. Maintaining an appropriate milieu
B. Minimizing patient engagement to avoid confusion
C. Engaging patients in meaningful activities
D. Constantly changing the environment to stimulate new learning
E. Restricting access to common areas

Maintaining an appropriate milieu and engaging patients.

To prevent wandering in patients with dementia, the nursing staff should establish which key elements in the care setting? (Select all that apply)
A. Unrestricted access to all exits
B. Safe environments
C. Flexible, unstructured routines
D. Structured schedules
E. Verbal warnings only

Safe environments and structured schedules.

A patient with dementia suddenly becomes agitated and restless. What is the nurse's initial priority intervention?
A. Administering a sedative immediately
B. Calling the physician for new orders
C. Staying calm and attempting to redirect the patient
D. Leaving the patient alone to calm down

Stay calm and attempt to redirect the patient.

The nurse is aware that which common condition in elderly patients can present with symptoms similar to cognitive decline, leading to potential misdiagnosis of dementia?
A. Hypothyroidism
B. Depression
C. Vitamin B12 deficiency
D. Urinary tract infection

Depression.

When providing long-term care for a client with dementia, what is the primary focus of nursing interventions?
A. Curing the disease and reversing cognitive decline
B. To support daily functioning and minimize distress
C. Isolating the patient to prevent harm to others
D. Strictly adhering to standardized care plans for all patients

To support daily functioning and minimize distress.

A client is suspected of having dementia, but the nurse notes atypical symptoms. Which assessment is crucial to rule out other causes that might mimic dementia?
A. Immediate referral to a neurologist
B. A thorough medical workup including labs and medication reconciliation
C. Advising the family that it's likely irreversible dementia
D. Starting a high dose of anti-anxiety medication

A thorough medical workup including labs and medication reconciliation.

The nursing care plan for a client with delirium should prioritize which primary goal?
A. Masking symptoms with continuous sedation
B. To find and address the underlying cause of the delirium
C. Teaching the patient relaxation techniques for long-term management
D. Focusing solely on memory enhancement exercises

To find and address the underlying cause.

To best engage a patient with dementia and minimize confusion, the nurse should provide activities within which kind of environment?
A. A constantly changing, stimulating environment
B. A calm and familiar environment
C. A noisy and busy group setting
D. An environment with minimal supervision

A calm and familiar environment.

A client with Lewy-body dementia frequently experiences hallucinations. How are these hallucinations typically characterized, and what impact do they often have?
A. Auditory, leading to withdrawal
B. Visual, often leading to confusion and agitation
C. Olfactory, causing appetite changes
D. Tactile, resulting in self-harm

Visual, often leading to confusion and agitation.

The nurse understands that the most effective approach to managing symptoms in a dementia treatment plan involves which key principle?
A. Using a one-size-fits-all medication regimen
B. Focusing primarily on physical restraints for safety
C. Tailoring interventions to the individual's specific needs
D. Encouraging group activities exclusively

Tailoring interventions to the individual's needs.

During the intake assessment for a client presenting with cognitive changes, which finding would require immediate priority and further investigation by the nurse?
A. Mild forgetfulness of names
B. Occasional difficulty with complex tasks
C. High fever or other signs of infection
D. Reports of occasional sadness

High fever or signs of infection.

A family member asks the nurse about the prognosis of Alzheimer's disease for their loved one. Which statement accurately describes the disease's trajectory?
A. It is fully reversible with aggressive treatment.
B. It is progressive and often leads to a full recovery.
C. It is usually stable once diagnosed and does not worsen.
D. It is progressive and irreversible.

It is progressive and irreversible.

Implementing good sleep hygiene practices for a client with dementia is crucial for which primary reasons? (Select all that apply)
A. To increase daytime napping
B. To help patients sleep through the night
C. To reduce nocturnal confusion
D. To promote alertness during sundowning
E. To decrease overall medication needs

To help patients sleep through the night and reduce confusion.

A client with dementia frequently experiences increased agitation. The nurse should assess for the presence of which common triggers? (Select all that apply)
A. Environmental stimuli
B. Changes in routine
C. Adequate pain management
D. Opportunities for social interaction
E. Familiar surroundings

Environmental stimuli or changes in routine.

In the comprehensive care of a client with dementia, what is the crucial role of family planning discussions with the healthcare team?
A. To decide on invasive procedures without family input
B. Providing support to the family and discussing future care needs and decisions
C. To inform the family that their involvement is not needed
D. To dictate end-of-life decisions without patient's prior wishes

Providing support and discussing future care needs.