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GEORGE PALO VSIM PRE & POST Q&A 2024 -19.
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GEORGE PALO VSIM PRE & POST Q&A 2024 -19.
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GEORGE PALO VSIM PRE & POST Q&A 2024 #191. Pretest
What is the therapeutic value of a cholinesterase inhibitor for a patient diag- nosed with Alzheimer
disease?: Temporarily slows the progress of the dementia. Rationale: Donepezil (Aricept),
rivastigmine (Exelon), and galantamine (Reminyl, Razadyne, Nivalin) are cholinesterase inhibitor
that have shown modest thera- peutic effects and that temporarily slow the progress of
dementia-related cognitive decline. They have no effect, however, on the overall course of the
disease or on life expectancy.
2. Pretest
What is the fundamental characteristic of anhedonia?: Lack of pleasure and enjoyment.
Rationale: Patients experiencing depression may describe themselves as hopeless, helpless,
down, or anxious and often experience anhedonia, defined as the loss
Of any sense of pleasure from activities they formerly enjoyed. Although the other options
identify possible characteristics of depression, none is associated with anhedonia.
3. Pretest
An older adult diagnosed with dementia has presented with behaviors that suggest a disturbance in
executive functioning. Which assessment finding supports this finding?: Needs to be reminded to
use toothpaste when brushing teeth.
Rationale: A disturbance in executive functioning, which is the ability to think ab- stractly and to
plan, initiate, sequence, monitor, and stop complex behavior, would include the need to be
reminded to use toothpaste when brushing one's teeth.
Having fallen three times in the last month is likely a result of apraxia, or impaired ability to
execute motor activities despite intact motor functioning. Referring to a cup as "that blue thing"
is an example of agnosia, which is failure to recognize or identify objects despite intact sensory
function. Speaking in only short phrases of no more than three or four words is an example of
aphasia, or alterations in language ability.
4. Pretest
When considering conditions that result in cognitive impairment, which char- acteristic is associated
primarily with dementia, including Alzheimer dis- ease?: Initially presents with progressive memory
impairment.
Rationale: Dementia refers to a disease process marked by progressive cognitive impairment
with no change in the level of consciousness. It involves multiple cog- nitive deficits—initially,
memory impairment. Delirium is a syndrome that involves a disturbance of consciousness
accompanied by a change in cognition. Delirium
Usually develops over a short period (sometimes a matter of hours) and fluctuates, or changes,
throughout the course of the day.
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, GEORGE PALO VSIM PRE & POST Q&A 2024 #19
5. Pretest
An older adult has been diagnosed with Alzheimer disease and is currently demonstrating behaviors
associated with the mild stage of the disorder. When considering social interaction, the nurse should
expect which classic patient response?: Has begun to avoid social situations.
Rationale: Dementia such as Alzheimer disease is described in stages. Forget- fulness is the
hallmark of beginning, mild dementia. As the disorder progresses the person has difficulty
finding words, frequently loses objects, and begins to experience anxiety about these losses.
These deficiencies make social interaction less enjoyable and the individual may begin to
attempt to avoid such situations.
Seeking the opportunity to socialize with friends is not associated with behaviors regularly
observed with dementia. Forgetting the names of friends and family as well as dramatic social
isolation is observed in later stages of the disorder.
6. Pretest
When considering dementia, which mood-related characteristic is most likely observed in a patient in
the early stages of this cognitive disorder?: Depres- sion.
Rationale: Depression is a characteristic of dementia, especially in the early stages, whereas
anger is demonstrated in later stages of cognitive impairment. Irritability is more likely noted in
patients experiencing delirium. Elation is not a characteristic of a patient in the early stages of
dementia.
7. Pretest
What is the primary risk factor for the development of cognitive disorders such as Alzheimer disease?:
Age.
Rationale: Risk for Alzheimer disease increases with age. Although all the options are considered
risk factors, the primary risk factor is advancing age (65 years of age and older).
8. Pretest
Which biological assessment or assessments should be given initial priority for an older patient
diagnosed with dementia who has begun to demonstrate signs of depression? (Select all that apply.)
Hydration Appetite
Elimination patterns Weight
change
Sleep patterns: Weight change,
Hydration,
Appetite.
Rationale: Adequate nutrition and hydration are of primary importance to the patient
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