A)

B)
C)
D)

The nurse is
assessing a
client with early
signs of
dementia. The
nurse asks the
client what he
1.
ate for breakfast
that morning.
The purpose of
this question is
to determine
which of the
following?
Orientation
Food
preferences
Recent memory
Remote memory
2. The nurse is

A)

B)

working with a
client who has
hallucinations
and delusions.
The client tells
the nurse she
cannot take a
shower because
she is waiting
for her husband
to take her
home. Which of
the following
responses by
the nurse is best
in this situation?
It would be
best if you just
took your
shower now.
You seem
anxious and
upset.

C)

D)

You have
plenty of time to
shower before
it's time to go
home.
Why are you
thinking you're
going home?
3. The nurse is
caring for a
client with
Alzheimer's
disease. The
nurse observes
that the client's
pacing and
mumbling to
himself increase
at mealtime and
shift change.
Which of the

A)

B)

C)
D)

following
interventions
should the nurse
implement first?
Administer an
antianxiety drug
such as
lorazepam
(Ativan) at these
times.
Explain the unit
routine and the
reasons for
increased
activity to the
client.
Keep unit
activity to a
minimum.
Move the client
to a quieter area
during these

times.

A)
B)
C)

The nurse is
developing
interventions to
promote
socialization in a
client with
4. moderate
dementia. Which
of the following
would provide a
safe and secure
environment for
the client?
A card game
with other
clients
An activity with
the nurse
Decorating a

D)

A)

B)
C)

bulletin board
with the group
Morning stretch
group with
music
The nurse can
distinguish
delirium from
5.
dementia by
knowing which
of the following?
Delirium has an
acute onset and
is progressive in
course.
Delirium has a
gradual onset
and can be
resolved.
Dementia has a

D)

A)
B)

gradual onset
and is
progressive in
course.
Dementia has
an acute onset
and can be
resolved.
A client with
dementia is
unable to
recognize
ordinary objects,
6.
such as a pen or
notebook. The
nurse
recognizes this
symptom as
Agnosia
Amnesia

C)
D)

Apraxia
Aphasia
7. The grown
daughter of a
woman with
Alzheimer's
disease reports
to the nurse that
she is trying to
keep her
mother's
condition from
worsening by
asking her
questions
whenever they
are together.
The nurse
recognizes that
this activity is
likely to do

A)

B)
C)
D)

A)

which of the
following?
Decrease
environmental
misinterpretatio
n
Improve
memory
retention
Increase
frustration
Slow the
progress of the
disease
Which of the
following clients
8. would have an
increased risk
for delirium?
Elderly woman

B)

C)

D)

with abdominal
pain
3-year-old child
with a
temperature of
103.2 F
Middle-aged
woman newly
diagnosed with
multiple
sclerosis
Young adult
male with
gastroenteritis
and dehydration
9. A client with
moderate
Alzheimer's
disease is living
with her grown

A)

B)

C)
D)

daughter. Which
of the following
statements by
the daughter
would indicate
the need for
intervention by
the nurse?
It's distressing
when my
mother forgets
my name.
I wish my sister
would come to
visit more
often.
Mother won't
let anyone else
do anything for
her.
Taking care of
my mother is a

big
responsibility.

A)
B)
C)
D)

The most
effective
intervention for
10.
clients with
delirium is which
of the following?
Giving detailed
explanations
Managing
environmental
stimuli
Promoting rest
with PRN
medications
Providing
activities for
distraction

A)
B)

At the change of
shift report the
nurse learns
that a patient in
the intensive
care unit has
developed signs
of delirium over
the past 8
11.
hours. Which of
the following
behaviors
documented in
the nursing
notes is the
most probable
indication of
delirium?
Unable to
identify a water
pitcher
Unable to

C)
D)

transfer to
sitting position
Difficulty with
verbal
expression
Disoriented to
person
12. A nurse working
in an assisted
living facility is
holding an inservice for the
nursing
assistants. The
nurse reviews
common
behaviors
associates with
cognitive
deterioration

A)

B)
C)

associated with
dementia. The
nurse would
evaluate the
assistants
correct
understanding if
which of the
following were
expressed
during a posttest?
The patients
should be able
to ask us for
items they need
The patients
may not
recognize family
when they come
to visit
The patients
who are

D)

A)

ambulatory can
still carry out
activities of
daily living
independently
The patients
should know
when to come to
the dining room
for meals
Which of the
following is
believed to be a
13. risk factor
specific to the
development of
delirium?
Co-occurring
general medical
condition

B)
C)
D)

Older age
Baseline
cognitive
impairment
Gradual decline
in functioning
14. The nurse is
caring for a
patient with
cognitive
impairment. To
determine
whether the
patient is
suffering from
delirium or
dementia, the
nurse reviews
the symptoms
and course of

A)
B)
C)
D)
E)

each disorder.
Which of the
following terms
describe
delirium?
Rapid Onset
Progressive
Decline
Long-term
memory
impairment
Slurred Speech
Hallucinations
15. The daughter of
a woman with
dementia asks
the nurse if the
patient will ever
be able to live
independently

A)

B)

C)

again. The most

appropriate
response by the
nurse would be:
You sound like
you arent ready
for her to be
dependent on
caregivers.
Her confusion
is a temporary
complication of
her physical
illness and
should subside
when the illness
gets better.
Symptoms of
dementia
gradually get
worse.
Unfortunately
she will not be

D)

independent
again.
"With early
treatment mild
dementia can be
reversed. It may
be possible
16. The nurse is
performing a
health history
with a patient
exhibiting signs
of delirium. The
nurse asks the
patient and
family members
about possible
causes of the
delirious state.
Which of the
following would

A)
B)
C)
D)
E)
F)

the nurse likely

attribute as
underlying
causes for the
patients
delirium? (Select
all that apply)
Recent alcohol
use
Dehydration
Lack of
spontaneity
Sleep
disturbances
Use of mega
doses of
vitamins
Exposure to
paint or gasoline
17. A patient

A)

voluntarily
admitted to the
inpatient
psychiatric unit
is currently
experiencing
mild delirium.
The patient
approaches the
nurse and
states, Im
going to take
walk outside. Ill
be back in about
10 minutes.
The most
appropriate
nursing action is
which of the
following?
Further assess
the patients
motives for

B)

C)

D)

wanting to walk
Give the patient
permission to go
on a walk on the
grounds
Tell the patient
the walk is not
allowed and
restrict him to
the unit
Designate a
staff member to
accompany the
patient on the
walk
18. A patient with
dementia is
starting
pharmacotherap
y to slow the

A)
B)
C)
D)

progression of
cognitive
decline. The
patient has a
history of
moderate but
steady alcohol
use over the
past 45 years.
Which of the
following
medications
should the nurse
question as
least suitable for
this patient?
Tacrine (Cognex)
Memantine
(Namenda)
Donepezil
(Aricept)
Rivastigmine

(Exelon)

A)

The nursing
supervisor in an
extended care
facility is
managing the
environment to
best help the
19. patients with
dementia. Which
of the following
should the nurse
include in
planning the
living
environment?
Plan for the
same caregivers
to provide care
to individuals as
much as

B)

C)

D)

possible
Open the
windows and
doors to allow
fresh air to
circulate
through the
environment
Provide a buffetstyle menu with
many food
choices
Assign peer-led
exercise
activates on a
daily basis
20. The nurse
encourages the
patient with
dementia to

A)

B)

C)

meet nutritional
needs. Which of
the following is
the best
approach to
assist in
meeting
adequate
dietary intake?
Sit with the
patient as long
as necessary to
complete the
meal
Provide
entertainment
during meals
such as
television or
music
Avoid betweenmeal snacks to
encourage

D)

appetite
Serve meals in
small, bite-size
pieces
21. The nurse caring
for an elderly
woman with
dementia has
asked the
womans
children to bring
old photo
albums when
they visit. Which
of the following
best describes
the usefulness
of viewing
photos when
caring for the
dementia

A)

B)

C)

D)

patient?
Viewing photos
will help
stimulate
remote memory
Sharing photos
will encourage
interaction with
other patients
Creating a
scrapbook with
photos will
provide for a
recreational
activity
Talking about
the photos will
encourage the
patient to live in
the past

A)

B)

The nurse is
encouraging a
group of
patients with
dementia to join
in upper body
range of motion
22.
exercises using
light dumbbells.
Which technique
will most likely
result in the
greatest amount
of participation?
Show an
instructional
video just prior
to the activity
Describe the
exercise
immediately
before
performing it

C)

D)

A)

Demonstrate
the exercises
while patients
simultaneously
perform them
Perform the
same routine
daily to avoid
the need for
repeated
instruction
When planning
care for a client
newly diagnosed
23. with Alzheimer's
disease, the
nurse should
focus on
Providing a safe,
structured

B)

C)
D)

environment
Helping the
client recognize
physical
limitations
Helping to
reverse the
disease
Preventing loss
of cognitive
functions
24. A patient with
dementia gets
angry and
begins to yell at
the nurse during
mealtime. The
nurse leaves the
patients side for
5-10 minutes

A)

B)

C)

D)

and then
returns. Which
of the following
best explains
the nurses
behavior?
The nurse was
unsure of how to
calm the patient
The nurse was
frustrated and
needed to take
a time out
The nurse gave
the patient a
chance to calm
down before
resuming the
meal
The nurse
stepped away to
verify the safety

of other patients

A)
B)
C)
D)

Which of the
following terms
is used to
25. describe
deterioration in
language
function?
Agnosia
Apraxia
Aphasia
Executive
functioning
26. The daughter of
a patient with
dementia has
been the
primary

A)
B)

caregiver for 5
months. The
daughter
expresses to the
nurse, At times
it is so
overwhelming! I
feel I do not
have a life
anymore!
Which of the
following is the
most helpful
response by the
nurse?
Are you saying
you dont want
to care for your
mother
anymore?
I know it is
really hard. It
takes a lot of

C)

D)

work and you

are doing such a
good job.
Your mother
really
appreciates
what you do for
her. You are the
best one to care
for her.
Here is the
number of a
caregivers
support group.
How do you
think you would
feel talking with
others in the
same situation?
27. A nurse is

A)
B)
C)
D)

educating a
group of elderly
community
members about
cognitive
disorders. Which
of the following
would the nurse
include as a
measure most
likely to prevent
Alzheimers
disease and
other
dementias?
Crafts
Cooking
Watching
television
Reading

A)

The caregiver of
an Alzheimers
patient reports
to the nurse that
often the patient
will suddenly
become angry
during meals
and nothing
seems to calm
him down. The
28.
nurse teaches
the caregiver to
use distraction
techniques.
Which of the
following
responses would
be best to teach
as an example
of this
technique?
Lets look at

B)
C)

D)

what is on
television.
If you stop
yelling I will get
your dessert.
Dont you want
to finish your
meal?
I dont
understand
what you are
saying.
29. The adult son of
a patient with
dementia asks
the nurse how
he should
respond when
his mother
repeatedly says

A)

B)

C)

she has had a

busy day at
work. The
mother has not
worked in over
20 years. The
best guidance
the nurse can
give is which of
the following?
Ask her to
explain what
she did at work
today that kept
her busy
Go along with
her thought of it
having been a
busy day, but do
not refer to her
work
Reorient her
that she is at

D)

home and did

not go to work
Give her 5-10
minutes of rest
and she will
have no
memory of the
incident
30. A new nurse has
been working
with Alzheimers
patients for
almost 6
months. During
a staff meeting
the nurse
expresses
frustration
because the
same
instructions

A)

B)

have to be
giving to
patients on a
daily basis. The
nurse states, I
feel like all my
work doesnt do
them any good.
The nurses
supervisor
should
encourage the
nurse to do
which of the
following?
Cease giving
instructions
because the
patients will not
remember them
anyway
Try to stay
supportive and

C)

D)

meet the
patients needs
at the current
moment
Seek counseling
if personal
feelings get in
the way of
patient care
Consider
transferring to a
different patient
care specialty
area

Answer Key
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.

C
C
D
B
C
A
C
B
C
B
D
B
A
A, D, E
C
A, B, C, D, F
D
A
A
D

21.
22.
23.
24.
25.
26.
27.
28.
29.
30.

A
C
A
C
C
D
D
A
B
B