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The nurse is caring for a client with cognitive impairment. To determine whether the client is suffering from delirium or dementia, the nurse reviews the symptoms and course of each disorder.
- A. Rapid onset
- B. Progressive decline
- C. Long-term memory impairment
- D. Slurred speech
- E. Hallucinations
Correct Answer: A : Delirium, B: Dementia, C: Dementia, D: Delirium ,E: Delirium
Rationale: Delirium features rapid onset, slurred speech, and hallucinations, while dementia involves progressive decline and long-term memory impairment.
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Which is believed to be a risk factor specific to the development of delirium?
- A. Increased severity of physical illness
- B. Older age
- C. Baseline cognitive impairment
- D. Gradual decline in functioning
Correct Answer: A
Rationale: Increased severity of physical illness is a primary trigger for delirium, unlike gradual decline, which is characteristic of dementia.
The nursing supervisor in an extended care facility is managing the environment to best help the clients with dementia. Which should the nurse include in planning the living environment?
- A. Plan for the same caregivers to provide care to individuals as much as possible.
- B. Open the windows and doors to allow fresh air to circulate through the environment.
- C. Provide a buffet-style menu with many food choices.
- D. Assign peer-led exercise activities on a daily basis.
Correct Answer: A
Rationale: Consistent caregivers provide familiarity and reduce confusion in clients with dementia.
A new nurse has been working with clients with Alzheimer's disease for almost 6 months. During a staff meeting, the nurse expresses frustration because the same instructions have to be given to clients on a daily basis. The nurse states, 'I feel like all my work doesn't do them any good.' Which should the nurse's supervisor encourage the nurse to do?
- A. Cease giving instructions because the clients will not remember them anyway.
- B. Try to stay supportive and meet the clients' needs at the current moment.
- C. Seek counseling if personal feelings get in the way of client care.
- D. Consider transferring to a different client care specialty area.
Correct Answer: B
Rationale: Remaining supportive and focusing on current needs helps manage frustration and maintains client-centered care.
Which are possible sources of frustrations for nurses caring for persons with dementia? Select all that apply.
- A. The clients do not retain explanations or instructions, so the nurse must repeat the same things continually.
- B. The nurse may get little or no positive response or feedback from clients with dementia.
- C. It can be difficult to remain positive and supportive to clients and family because the outcome is so bleak.
- D. It can be helpful for the nurse to talk to colleagues or even a counselor about personal feelings of depression and grief as the dementia progresses.
- E. The clients may seem not to hear or respond to anything the nurse does.
Correct Answer: A,B,C,E
Rationale: Repetition, lack of response, bleak outcomes, and non-responsiveness contribute to nurse frustration, while discussing feelings is a coping strategy, not a source of frustration.
Which patient is most likely suffering from dementia?
- A. A 90-year-old male who has experienced progressive mental decline that started with forgetfulness
- B. An 80-year-old female who has been in excellent health until she was admitted through the emergency department with a severe urinary tract infection and is now very anxious and is threatening staff
- C. A 6-year-old child who has just been administered conscious sedation for a closed reduction of a fractured wrist and says that her parents have three sets of eyes
- D. A 22-year-old male who was involved in a motorcycle crash without wearing a helmet now unable to remember where he is
Correct Answer: A
Rationale: Dementia involves progressive memory impairment starting with forgetfulness, unlike delirium or amnestic disorders seen in the other cases.