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A patient diagnosed with stage 2 moderate Alzheimer's disease calls the police saying, 'An intruder is in my home.' Police investigate and discover the patient misinterpreted a reflection in the mirror as an intruder. This phenomenon can be characterized using which term?
- A. Hyperorality
- B. Aphasia
- C. Apraxia
- D. Agnosia
Correct Answer: D
Rationale: Agnosia is the inability to recognize familiar objects, parts of one's body, or one's own reflection in a mirror. Hyperorality refers to placing objects in the mouth. Aphasia refers to the loss of language ability. Apraxia refers to the loss of purposeful movements, such as being unable to dress.
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An older adult diagnosed with moderate-stage Alzheimer's disease forgets where the bathroom is and has episodes of incontinence. Which intervention should the nurse suggest to the patient's family?
- A. Labeling the bathroom door
- B. Taking the older adult to the bathroom hourly
- C. Placing the older adult in disposable adult diapers
- D. Making sure the older adult does not eat nonfood items
Correct Answer: A
Rationale: A patient with moderate Alzheimer's disease has memory loss that begins to interfere with activities. This patient may be able to use environmental cues such as labels on doors to compensate for memory loss. Regular toileting may be helpful, but a 2-hour schedule is often more reasonable. Placing the patient in disposable diapers is more appropriate as a later stage intervention. Making sure the patient does not eat nonfood items will be more relevant when the patient demonstrates hyperorality.
Which description of patient behavior best applies to a hallucination?
- A. Looking at shadows on a wall and says, 'I see scary faces'
- B. Stating, 'I feel bugs crawling on my legs and biting me'
- C. Becoming anxious when the nurse leaves his or her bedside
- D. Trying to hit the nurse when vital signs are taken
Correct Answer: B
Rationale: A hallucination is a false sensory perception occurring without a corresponding sensory stimulus. Feeling bugs on the body when none are present is a tactile hallucination. Misinterpreting shadows as faces is an illusion. An illusion is a misinterpreted sensory perception. The incorrect options are examples of behaviors that sometimes occur during delirium and are related to fluctuating levels of awareness and misinterpreted stimuli.
Consider these health problems: Lewy body disease, Pick disease, and Parkinson's disease. Which term unifies these problems?
- A. Intoxication
- B. Dementia
- C. Delirium
- D. Amnesia
Correct Answer: B
Rationale: The listed health problems are all forms of dementia.
A hospitalized patient experiencing delirium misinterprets reality and a patient diagnosed with dementia wanders about the home. Which outcome is the priority in both scenarios?
- A. Patient will remain safe in the environment.
- B. Patient will participate actively in self-care.
- C. Patient will communicate verbally.
- D. Patient will acknowledge reality.
Correct Answer: A
Rationale: Risk for injury is the nurse's priority concern in both scenarios. Safety maintenance is the desired outcome. The other outcomes may not be realistic.
When used for treatment of patients diagnosed with Alzheimer's disease, which medication would be expected to antagonize N-methyl-D-aspartate (NMDA) channels rather than cholinesterase?
- A. Donepezil
- B. Rivastigmine
- C. Memantine
- D. Galantamine
Correct Answer: C
Rationale: Memantine blocks the NMDA channels and is used in moderate-to-late stages of the disease. Donepezil, rivastigmine, and galantamine are all cholinesterase inhibitors. These drugs increase the availability of acetylcholine and are most often used to treat mild-to-moderate Alzheimer's disease.