Nokea
An 83-year-old man becomes lost while driving. He pulls into a driveway to turn around and cannot figure out how to put his car in reverse, so he drives into the yard, makes a circle, and drives back out of the driveway. He is stopped by police, who take him to the emergency department. The physician diagnoses him with Alzheimer's disease and refers him to the neurology clinic for follow-up. Given this diagnosis, which behaviors should the clinic nurse anticipate?
- A. Does not know today's date.
- B. Unable to shower without help.
- C. Denial of mental impairment.
- D. None of the above.
Correct Answer: A
Rationale: The correct answer is A: Does not know today's date. This behavior is commonly associated with Alzheimer's disease due to memory impairment. The inability to recall the current date is a key symptom of cognitive decline. In this case, the man's difficulty with reversing his car and getting lost are indicative of cognitive impairment.
Choice B, Unable to shower without help, is a functional impairment and not specific to Alzheimer's disease. Choice C, Denial of mental impairment, may occur in some individuals with Alzheimer's but is not a consistent behavior. Choice D, None of the above, is incorrect as memory deficits, such as not knowing the date, are commonly seen in Alzheimer's disease.
You may also like to solve these questions
Which of the following will lead one to need to consider autism spectrum disorder as a likely diagnosis?
- A. A girl spoke her first words at 14 months, enjoyed playing with Peppa Pig characters at age 2 daily. She tended to sit away from her classmates at recess at age 7 but when asked, would say she had 30 friends. She was very good at the piano and had strong knowledge of all the great composers at age 8. She entered the Gifted Education Programme at 10. At 13, she did poorly at group work, often talked about death and the afterlife, and became progressively silent
- B. A boy walked at 18 months, spoke his first words at 2 , and enjoyed playing Minecraft at 4 together with his friends. He participated at birthday parties. He struggled with composition writing, both for ideas and also for the efforts in writing in school, but managed an AL score of 18 and was promoted to secondary school
- C. A boy walked at 13 months and was a happy child in preschool. He started speaking at 18 months but did not recognise letters and numbers consistently until 4.5 years of age. He did not read until 7 . He was sometimes forgetful with instructions but did not cause disruption in school, though he was often the clown in class. He tended to not finish his work unless his parents sat with him. Nonetheless, he completed primary school with some extra time for exams and went on to secondary school
- D. A girl walked at 16 months and was often clumsy though she did not fall. She would bump into things and might drop items in her hands. She disliked writing and was slow to write. She could never complete her work in class. She would shade the wrong answers on the optical answer sheet although she knew the right answers. She had trouble with mathematics thoughout school but she enjoyed reading
Correct Answer: A
Rationale: Option A shows social withdrawal, poor group interaction, and restricted interests (music, death themes), aligning with ASD criteria in DSM-5, unlike the others with more typical development or specific learning/motor issues.
After a person was abducted and raped at gunpoint by an unknown assailant, which trauma syndrome is most likely to occur?
- A. Decreased motor activity.
- B. Confusion and disbelief.
- C. Flashbacks and dreams.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B: Confusion and disbelief. After experiencing a traumatic event like abduction and rape at gunpoint, it is common for individuals to feel confused and in disbelief due to the overwhelming nature of the experience. This reaction is part of the acute stress response and is a normal psychological defense mechanism. Decreased motor activity (choice A) is less likely to be the immediate response to such a traumatic event. Flashbacks and dreams (choice C) are more characteristic of post-traumatic stress disorder (PTSD), which may develop later on but are not the initial trauma syndrome. Choice D is incorrect as trauma responses are expected in this situation.
A woman with Alzheimer's disease has significant apraxia and poor hygiene. Which intervention would be most appropriate for ensuring that the patient completes a shower?
- A. Remind her of the need for a shower and where the shower is, and repeat this every 30 minutes until the shower is completed.
- B. Discuss with her the importance of showers as part of daily self-care, and elicit and resolve any obstacles to the patient's showering.
- C. Walk her to the shower, and provide occasional reminders of what she should do next if she seems to be unsure or begins to repeat previous actions.
- D. Walk her to the shower, assist her to undress, start the water, supply the soap and washcloth, and instruct her to rub her face with the washcloth.
Correct Answer: D
Rationale: The correct answer is D because it provides the most direct and hands-on assistance to ensure completion of the shower. By walking her to the shower, assisting with undressing, starting the water, and providing necessary supplies and instructions, the patient is guided through each step of the showering process. This approach is essential for someone with significant apraxia and poor hygiene due to Alzheimer's disease.
Choice A is incorrect because simply reminding the patient every 30 minutes may not address the physical assistance needed for shower completion. Choice B is also incorrect as discussing the importance of showers may not be enough to overcome the challenges of apraxia and poor hygiene. Choice C is not as effective as choice D as occasional reminders may not provide the comprehensive assistance required for the patient to successfully complete the shower.
The nurse who works in a sleep clinic knows that approximately __________% of adults experience some form of sleep disorder.
- A. 10 to 20.
- B. 30 to 40.
- C. 50 to 60.
- D. None of the above.
Correct Answer: B
Rationale: The correct answer is B (30 to 40%). This range is supported by research indicating that around 30-40% of adults experience some form of sleep disorder. This percentage reflects the prevalence of various sleep disorders such as insomnia, sleep apnea, and restless leg syndrome among adults. The range of 10 to 20% (choice A) is too low based on current data. Likewise, the range of 50 to 60% (choice C) is too high and does not align with the established prevalence rates of sleep disorders in adults. "None of the above" (choice D) is incorrect as there is a documented prevalence of sleep disorders in adults, making it necessary to provide an estimate within a certain range.
Which of the following personality disorders describes a person who has an extremely unstable self image, is moody, and does not develop stable relationships?
- A. borderline
- B. histrionic
- C. narcissistic
- D. schizoid
Correct Answer: A
Rationale: Borderline personality disorder involves unstable self-image, mood swings, and relationship difficulties.