Dementia, Alzheimer's Disease, Delirium,

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Sample questions from Dementia, Alzheimer's Disease, Delirium,

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.An 82-year-old woman with moderate Alzheimer disease is admitted to a medical unit with fever, dysuria, and new inattention that began this morning. Her temperature is 38.6 C (101.5 F), blood pressure 132/76 mm Hg, and oxygen saturation 97% on room air. Which action should the nurse take first?

   • A.Assess for reversible causes of the acute change, including infection, hypoxia, and medication effects
   • B.Document that the dementia has progressed to its next stage
   • C.Place the patient in a room with a television to improve orientation
   • D.Administer a sedative to reduce the patient's restlessness

   Rationale: The sudden change from baseline suggests delirium, so the nurse should assess and address its underlying cause promptly. Documenting disease progression (B) overlooks the acute onset, and a television (C) does not treat the cause and may increase stimulation. A sedative (D) can worsen confusion and increase fall risk. Acute cognitive change requires assessment for a reversible cause.

2. 2.An 86-year-old man with Alzheimer disease is admitted from home after a fall. He is awake but repeatedly tries to climb out of bed; his vital signs are stable, and he has no focal neurologic deficits. Which nursing action is best to reduce injury risk while supporting his independence?

   • A.Apply wrist restraints until his behavior improves
   • B.Keep the bed low, place a call light within reach, and offer frequent supervised toileting
   • C.Raise all four side rails and leave the room quiet
   • D.Ask the family to remain at the bedside but provide no further safety measures

   Rationale: A low bed, accessible call light, and scheduled supervised toileting reduce fall risk using the least restrictive measures. Restraints (A) can cause injury and worsen agitation, while all four rails (C) can function as a restraint and may prompt climbing. Family presence (D) can help but does not replace environmental safety measures. Use individualized, least restrictive fall-prevention strategies.

3. 3.A 79-year-old woman with mild Alzheimer disease is seen in an outpatient clinic with her daughter. The patient asks the same question several times and has difficulty following long explanations; vital signs are stable. Which communication approach is most appropriate?

   • A.Give several instructions at once so the patient can choose which to follow
   • B.Speak loudly and rapidly to keep the patient's attention
   • C.Use short, simple sentences and allow time for the patient to respond
   • D.Direct all questions to the daughter to avoid frustrating the patient

   Rationale: Short, simple statements and adequate response time support comprehension while preserving the patient's participation. Multiple instructions (A) may overwhelm her, and rapid, loud speech (B) can increase confusion without improving understanding. Directing all communication to the daughter (D) disregards the patient's autonomy. Adapt communication to the person's cognitive abilities.

4. 4.A 76-year-old man with Alzheimer disease is brought to the emergency department by his spouse after becoming acutely confused over 8 hours. His temperature is 37.2 C (99.0 F), oxygen saturation is 88% on room air, and he is drowsy. What should the nurse do first?

   • A.Ask the spouse about the patient's usual memory and behavior
   • B.Obtain a urine specimen to check for infection
   • C.Reorient the patient to the date and location
   • D.Apply oxygen and assess respiratory status

   Answer and rationale are in the full material.

5. 5.A 73-year-old woman with mild Alzheimer disease lives with her husband and manages basic self-care. At a clinic visit, her blood pressure is 128/72 mm Hg, and her husband reports that she still chooses her clothing but forgets appointments. Which plan best promotes safe independence?

   • A.Have her husband take over all decisions immediately
   • B.Use a visible calendar and simple written reminders while reviewing safety needs
   • C.Move her to a locked memory-care unit before she has further decline
   • D.Discourage familiar activities to prevent frustration

   Answer and rationale are in the full material.