Question 1

An older client is demonstrating signs of a brain attack. What will the nurse do to assess the degree of cerebral infarct?

Accepted Answer

A)   Assess the client's ability to cry
B)   Assess the client's motor strength
C)   Assess the client's ability to sleep
D)   Assess the client's ability to digest food B

Question 2

Which assessment finding places an older patient at the greatest risk factor for the development of Alzheimer's disease?

Accepted Answer

A)   Age
B)   Genetic predisposition
C)   Environmental exposure
D)   History of previous head injury A

Question 3

An older client with moderate stage dementia frequently cannot remember which room he is assigned in a long-term care facility. Which nursing intervention would help this client?

Accepted Answer

A)   Reorient the client when it happens again.
B)   Establish landmarks.
C)   Investigate placing the client in a private room.
D)   Accompany the client on walks. B

Question 4

An older client is being evaluated for frontotemporal dementia. Of the following, which manifestation would be present to make this diagnosis?

Accepted Answer

A)   Abrupt onset of dementia
B)   Loss of personal awareness
C)   Lewy bodies in the midbrain
D)   Cerebrovascular low-density areas

Question 5

The nurse is preparing an educational session on vascular dementia for a group of senior citizens. He wants to include information on factors that can potentially reduce the risk of this type of dementia. What information would be important for the nurse to provide to these participants? Select all that apply.

Accepted Answer

A)   Control blood pressure
B)   Discontinue alcohol consumption
C)   Control weight
D)   Take a daily, low-dose aspirin
E)   Control blood sugar level

Question 6

An older client with mild Alzheimer's disease abruptly stops taking the prescribed medication donepezil (Aricept). When assessing the patient for withdrawal symptoms of the the sudden discontinuation of the medication, on which area should the nurse focus?

Accepted Answer

A)   The client's reflexes
B)   The client's rest and sleep pattern
C)   The client's cognitive function
D)   The client's cardiovascular function

Question 7

An older patient begins to experience status epilepticus. Which action will the nurse take to help this patient?

Accepted Answer

A)   Measure vital signs.
B)   Orient the patient between seizures.
C)   Prevent chilling with warmed bed linens.
D)   Ensure an intravenous access line is available.

Question 8

An older patient is diagnosed with early-mild Alzheimer's disease. Which should be done at the time of diagnosis?

Accepted Answer

A)   Discuss treatment options and wishes with the patient.
B)   Identify a long-term care facility for immediate transfer.
C)   Explain that this stage of the disorder can last up to 10 years.
D)   Instruct family members to slowly improve the home environment for safety.

Question 9

The nurse suspects an older client is having a grand mal seizure. What is the nurse's highest priority?

Accepted Answer

A)   To use the head-tilt/chin-lift method
B)   To prevent the seizure from lasting more than five minutes
C)   To document the progression of symptoms
D)   To prevent the client from being injured

Question 10

The nurse is preparing an educational session on stroke prevention for a group of senior citizens. What information would be important for the nurse to provide to these participants? Select all that apply.

Accepted Answer

A)   Stop smoking.
B)   Stop drinking alcohol.
C)   Maintain a healthy body weight.
D)   Follow a low-sodium diet as prescribed.
E)   Take blood pressure medication as prescribed.

Question 11

A care conference is being held with the family of an older patient in the late stages of Alzheimer's disease. The family wants to know if a feeding tube should be placed. How should this question be answered?

Accepted Answer

A)   Tube feeding will aid the patient to gain weight.
B)   Tube feeding is associated with a reduced risk of aspiration.
C)   Tube feeding reduces the discomfort associated with dehydration.
D)   The absence of tube feeding promotes dehydration which reduces pain sensitivity.

Question 12

The nurse suspects that an older client is experiencing Parkinson's disease. What did the nurse observe in this patient? Select all that apply.

Accepted Answer

A)   Chorea
B)   Tremor
C)   Epileptic seizures
D)   Restless leg syndrome
E)   Dystonia

Question 13

An older client is being evaluated for delirium. Of the following, which is not a manifestation typically used to make a diagnosis of this disorder?

Accepted Answer

A)   Unable to physically swallow when asked to
B)   Unable to remember who visited earlier in the day
C)   Unable to sleep at night, but able to sleep through the day
D)   Unable to maintain attention

Question 14

An older patient with Alzheimer's disease has a feeding tube. The family wants to know if the patient will ever be able to eat solid food again. What information should the nurse include when responding to this family's question?

Accepted Answer

A)   The dietitian will decide if this can be done.
B)   It depends upon the patient's functional eating abilities.
C)   This can be done but the feeding tube has to be removed first.
D)   In the patient with dementia, the restoration of natural feeding is highly unlikely.

Question 15

An older client with Alzheimer's disease has wandered away from the home several times. What can the nurse suggest that the spouse do to reduce the client's risk for wandering? Select all that apply.

Accepted Answer

A)   Use hospital-approved belt restraints.
B)   Install motion detectors on the door of the client's room.
C)   Disguise the door so it looks like a mirror.
D)   Alert neighbors.
E)   Place emergency telephone numbers on the refrigerator door.

Question 16

After a neurologic assessment, the nurse determines that an older patient is exhibiting normal signs of aging. What did the nurse assess in this patient? Select all that apply.

Accepted Answer

A)   Slow movements
B)   Intermittent hand tremor
C)   Ataxia with position changes
D)   Decreased sensation in the feet
E)   Slight impairment of coordination

Question 17

An older patient is being evaluated for dementia. What manifestations need to be present to diagnose this disorder? Select all that apply.

Accepted Answer

A)   Intermittent forgetfulness
B)   Inability to manage finance
C)   Misplacing personal belongings
D)   Repetitive questions or conversations
E)   Difficulty thinking of common words while speaking

Question 18

An older client with advanced Alzheimer's disease is being treated for pneumonia. The daughter is not sure if resuscitation efforts should be a part of the plan of care. What information should the nurse provide to the daughter?

Accepted Answer

A)   "Resuscitation is often effective for older adults."
B)   "After resuscitation, the patient will return to the same level of functioning."
C)   "As long as the resuscitation efforts are initiated quickly, the patient will survive."
D)   "Resuscitation for cardiac or respiratory arrest can be effective for older adults."

Question 19

What should the nurse teach the family of an older patient with Alzheimer's disease to help with spatial disorientation? Select all that apply.

Accepted Answer

A)   Use color to contrast objects and items.
B)   Keep furniture in the same familiar place.
C)   Fill the patient's room with memorabilia.
D)   Remove cues for exiting the home away from the doors.
E)   Place family photos or recognizable familiar items in a prominent spot.

Question 20

An older client is prescribed gabapentin (Neurontin) for a seizure disorder. When instructing the client on this medication, which common side effects should the nurse include? Select all that apply.

Accepted Answer

A)   Headache
B)   Increased thirst
C)   Irritability
D)   Black, tarry stools
E)   Weight gain

Exam 22: The Neurologic System