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An elderly client with severe cardiovascular disease is given the diagnosis of dementia. Which type of dementia does the client most likely have?
- A. Frontal
- B. Lewy body
- C. Alzheimer's
- D. Vascular dementia
Correct Answer: D
Rationale: Frontal (frontotemporal) dementia affects personality and behavior, not directly tied to cardiovascular issues. Lewy body dementia involves protein deposits and symptoms like hallucinations, not primarily cardiovascular-related. Alzheimer’s is common but linked to neurodegenerative changes, not specifically cardiovascular disease. Vascular dementia results from impaired blood flow to the brain, often due to cardiovascular conditions, making it the most likely here.
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A nurse is caring for a client who was admitted with delirium five days ago. The client seeks permission from the nurse before performing ADLs. Which of the following actions should the nurse take?
- A. Quiz the client with orientation questions.
- B. Allow the client to function independently.
- C. Prepare the client for discharge.
- D. Determine the client's level of awareness.
Correct Answer: D
Rationale: Quizzing assesses but isn’t first. Independence is good but needs assessment first. Discharge is premature without evaluation. Determining awareness guides support, fitting delirium’s fluctuating nature.
Which medication would the nurse expect to be prescribed for a client with moderate stages of Alzheimer's disease?
- A. Risperidone (Risperdal)
- B. Alprazolam (Xanax)
- C. Donepezil (Aricept)
- D. Haloperidol (Haldol)
Correct Answer: C
Rationale: Risperidone is an antipsychotic used for behavioral issues in dementia, not cognitive decline. Alprazolam is an anxiolytic, not indicated for Alzheimer’s cognitive symptoms. Donepezil is a cholinesterase inhibitor commonly prescribed to improve cognition and slow symptom progression in moderate Alzheimer’s. Haloperidol, an antipsychotic, treats agitation but doesn’t enhance cognition and has higher side effect risks.
Which of the following is a physical clinical finding of depression in older adults?
- A. Increased anxiety
- B. Slowed memory
- C. Slowed intellect
- D. Headache
Correct Answer: D
Rationale: Increased anxiety is a psychological symptom, not a physical finding, though it may accompany depression. Slowed memory and intellect are cognitive symptoms related to depression’s impact on thinking, not physical manifestations. Physical symptoms of depression can include changes in sleep, appetite, or pain, such as headaches, which are commonly reported in older adults as a somatic expression of the disorder.
A nurse in an acute care facility is assisting with the admission of an older adult client who has late stage Alzheimer's disease. The nurse notes that the client's partner appears exhausted. He states that he is finding it more and more difficult to care for his partner. Which of the following actions should the nurse take first?
- A. Suggest that the client's partner see a counselor to help him cope with his exhaustion.
- B. Encourage the client's partner to call a family meeting to ask for help.
- C. Ask the partner to talk about his difficulties in caring for the client.
- D. Recommend that the client's partner place the client in a long-term care facility.
Correct Answer: C
Rationale: Counseling helps later, not first. Family meetings follow understanding needs. Asking about difficulties assesses the situation, guiding support. Recommending placement is premature without discussion.
A nurse in an assisted-living facility is caring for a client who is in early stages of dementia. The client has been oriented to name and place and is usually cooperative. Which of the following nursing actions is appropriate if the client refuses to take morning medications?
- A. Notify the charge nurse of the need for evaluation of the client's level of competence.
- B. Ask the client to express her reasons for refusing the morning medications and document the event.
- C. Crush the pills, if not contraindicated, and hide them in the client's applesauce.
- D. Try to talk the client into adherence by telling her the possible implications of missing a dose.
Correct Answer: B
Rationale: Competence evaluation follows understanding refusal. Asking reasons respects autonomy and informs care. Crushing pills without consent is unethical and risky. Coercion dismisses client rights; understanding is better.