Exam (elaborations)
Gerontological Nursing, 4e (Tabloski) Chapter 22 The Neurologic System
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Gerontological Nursing, 4e (Tabloski) Chapter 22 The Neurologic System
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Gerontological Nursing, 4e (Tabloski)Chapter 22 The Neurologic System
1) Whichrassessmentrfindingrplacesranrolderrpatientratrthergreatestrriskrfactorrforrtherdev
elopmentrofrAlzheimer'srdisease?
1. Age
2. Geneticrpredisposition
3. Environmentalrexposure
4. Historyrofrpreviousrheadrinjuryr
Answer:r 1
Explanation:r 1.rAdvancedragerisrthersinglergreatestrfactorrforrtherdevelopmentrofrAlzheimer'srdis
ease.
2. Geneticrcausesrarerresponsiblerforrfewerrthanr5%rofrthercasesrofrAlzheimer'srdisease.
3. EnvironmentalrexposurerisrnotridentifiedrasrarriskrfactorrforrtherdevelopmentrofrAlzheimer'srdis
ease.
4. HistoryrofrarpreviousrheadrinjuryrisrconsideredrarmedicalrriskrforrtherdevelopmentrofrAlzheimer'sr
diseaserbutradvancedragerisrthersinglergreatestrriskrfactorrforrtherdevelopmentrofrtherdisorder.
PagerRef:r619
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNurs/Inte
grConc.:rNursingrProcess:rAssessmentrLearningrOutco
me:rr2.rIdentifyrprogressiverdementias.
2) Anrolderrclientrisrbeingrevaluatedrforrdelirium.rOfrtherfollowing,rwhichrisrnotrarmanifestationrtypi
callyrusedrtormakerardiagnosisrofrthisrdisorder?
1. Unablertorphysicallyrswallowrwhenraskedrto
2. Unablertorrememberrwhorvisitedrearlierrinrtherday
3. Unablertorsleepratrnight,rbutrablertorsleeprthroughrtherday
4. Unablertormaintainrattentionr
Answer:r 1
Explanation:r 1.rDeliriumrisrardisturbancerinrmentalrabilities.rTherphysicalrabilityrofrswallowingrisrn
otraffectedrbyrdelirium.
2. Short-
termrmemoryrimpairmentrsuchrasrbeingrunablertorrememberrwhorvisitedrearlierrinrtherdayrisrarsym
ptomrofrdelirium.
3. Sleep-
wakercyclerdisturbance,rsuchrasrbeingrablertorsleeprthroughrtherdayrbutrnotratrnight,risrarsymptomrofrd
elirium.
4. Notrbeingrablertormaintainrattentionrisranrimpairmentrthatrisrarsymptomrofrdelirium.rPag
erRef:r589
CognitiverLevel:r Analyzing
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rPhysiologicalrAdaptationrNurs/Inte
grConc.:r NursingrProcess:rImplementation
LearningrOutcome:r 2.rIdentifyrprogressiverdementiasrandrotherrneurologicrillnessesrsuchrasrPa
rkinson'srdisease.
1
Copyrightr©r2019rPearsonrEducation,rInc.
,3) AnrolderrpatientrnewlyrdiagnosedrwithrAlzheimer'srdiseaserisrprescribedrgalantaminer(Razadyn
e).rHowrwillrthernurserinstructrtherpatientraboutrthisrmedication?rSelectrallrthatrapply.
1. Takeratrbedtime.
2. Takerthermedicationrwithrfood.
3. Therdosagermayrberchangedreveryr4rweeks.
4. Sidereffectsrofrthisrmedicationrarerminimal.
5. DornotrtakerthermedicationrwithranrNSAID.rA
nswer:r 2,r3,r5
Explanation:r 1.rThisrmedicationrisrnotrspecificallyrtorbergivenratrbedtime.
2. Thisrmedicationrcanrcausergastrointestinalrupsetrandrshouldrbertakenrwithrfood.
3. Thisrmedicationrisrtitratedratr4-weekrintervals.rTherdosagermayrberchangedreveryr4rweeks.
4. Thersidereffectsrofrthisrmedicationrincludergastrointestinalrupsetrandrbleeding,rarrhythmias,ruri
naryrobstruction,rsomnolence,rtremor,rabdominalrpain,randrrhinitis.
5. ThisrmedicationrshouldrberusedrwithrcautionrifralsorprescribedrNSAIDsrsincerthisrcouldrinc
reasertherriskrofrgastrointestinalrbleeding.
PagerRef:r622
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:r PharmacologicalrandrParenteralrTherapiesrN
urs/IntegrConc.:r NursingrProcess:rImplementation
LearningrOutcome:r 4.rApplyrarcontextualrmodelrtordirectrbehavioralrandrpharmacologicalrint
erventionsrforrbehavioralrsymptomsrofrAlzheimer'srdisease.
4) AnrolderrclientrisrdiagnosedrwithrdementiarcausedrbyrLewyrbodies.rWhatrwillrthernursermostrlike
lyrassessrinrthisrclient?rSelectrallrthatrapply.
1. Tremor
2. Rigidity
3. Posturalrinstability
4. Sleeprapnea
5. Visualrhallucinationsr
Answer:r 1,r2,r3,r5
Explanation:r 1.rClinicalrsymptomsrofrdementiarcausedrbyrLewyrbodiesrincluderartremor.
2. ClinicalrsymptomsrofrdementiarcausedrbyrLewyrbodiesrincluderrigidity.
3. ClinicalrsymptomsrofrdementiarcausedrbyrLewyrbodiesrincluderposturalrinstability.
4. SleeprapnearisrnotrarclinicalrsymptomrofrdementiarcausedrbyrLewyrbodies.
5. ClinicalrsymptomsrofrdementiarcausedrbyrLewyrbodiesrincludervisualrhallucinations.rPa
gerRef:r618
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:r PhysiologicalrAdaptationrNurs/Integr
Conc.:rNursingrProcess:rAssessmentrLearningrOutcome
:r 2.rIdentifyrprogressiverdementias.
2
Copyrightr©r2019rPearsonrEducation,rInc.
, 5) Anrolderrpatientrisrdiagnosedrwithrearly-
mildrAlzheimer'srdisease.rWhichrshouldrberdoneratrthertimerofrdiagnosis?
1. Discussrtreatmentroptionsrandrwishesrwithrtherpatient.
2. Identifyrarlong-termrcarerfacilityrforrimmediatertransfer.
3. Explainrthatrthisrstagerofrtherdisorderrcanrlastruprtor10ryears.
4. Instructrfamilyrmembersrtorslowlyrimprovertherhomerenvironmentrforrsafety.rA
nswer:r 1
Explanation:r 1.rEarlyrdiagnosisrprovidesrtherfamilyrandrtherolderrpersonrwithrtheropportunityrtordisc
ussrtreatmentroptionsrandrwishesrwhilertherolderrpersonrstillrhasrdecision-makingrcapacity.
2. Itrisrnotrnecessaryrtoridentifyrarlong-
termrcarerfacilityrforrtherolderrpatientratrthisrstagerofrtherdisorder.
3. Thererisrnorspecificrtimerintervalrforrearly-mildrAlzheimer'srdisease.
4. Therfamilyrshouldrpreparertherhomertoravoidrsafetyrissuesrasrsoonrasrpossible.rPa
gerRef:r622
CognitiverLevel:r Applying
ClientrNeed:r PhysiologicalrIntegrity
ClientrNeedrSub:rReductionrofrRiskrPotentialrNurs/Int
egrConc.:r NursingrProcess:rImplementation
LearningrOutcome:r 3.rRecognizertherstagesrofrAlzheimer'srdiseaserandrimplicationsrforrnursingrcar
e.
3
Copyrightr©r2019rPearsonrEducation,rInc.
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