Basic Concepts of Psychiatric-Mental Health Nursing, 8th Edition

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Explaining to the client why this behavior cannot be tolerated would be ineffective, because the client has memory impairment and would not remember not to go into the rooms of others. Escorting the client to her room for napping allows the client her own space and reinforces the reality of her personal room. Unless daytime napping interferes with nighttime sleep, there is no reason to eliminate short napping periods. The nurse assesses which of the following additional characteristics of this disorder? Instead, general changes in personality, wandering, and the inability to perform purposeful, goal-directed movements are impaired.

Basic Concepts of Psychiatric-Mental Health Nursing

Heindel and Salloway identified four distinct, yet mutually interacting, memory systems as being affected in dementia. Which of the following is not one of them?

Rather, it is composed of four distinct, yet mutually interacting, memory systems: working memory, episodic memory, semantic memory, and procedural memory. Short-term memory refers to the length of time during which material is remembered, not to a distinct type of memory system. A client was admitted to the ICU after a motor vehicle accident.

She sustained a right parietal injury, resulting in an acute confusional state or delirium. The nurse understands what? A Such hallucinations suggest preexisting schizophrenia. B Transient tactile hallucinations are sometimes seen in delirium. C Such symptoms indicate increasing brain damage and poor prognosis. D The client is more prone to such episodes early in the morning. Ans: B Feedback: With delirium, as is the case with the client, transient tactile hallucinations are seen in many cases. This type of tactile hallucination would not indicate schizophrenia or brain damage, nor would the client be any more prone to them at any time of the day.

Which of the following suggestions would be effective for assisting the family in daily orienting of their family member when the client returns home? A Provide a flexible schedule and change the activities each day. B Use daily newspapers, calendars, and a set routine. C Read to the client for long periods at a time. D Use a daily current events quiz, making sure that the client participates.

Principles in Psychiatric Nursing - - By Asst. Prof. Suresh Yadav

Ans: B Feedback: Using daily newspapers, calendars, and a set, unchanging routine would be a more effective way to provide daily orientation for the family member. Changing daily activities would make it more difficult to maintain orientation. Reading to the client for long periods of time would not maintain client involvement and appropriate stimulation. Using daily quizzes would place stressful demands on the client and not provide functionally appropriate tasks.

A client was admitted with multi-infarct dementia. Nursing assessment and interview of the client would include what? The medical assessments, which are important, are not as critical to nursing assessment as the actions in the correct answer.

Basic Concepts Of Psychiatric Mental Health Nursing 8th Edition by Louise Rebraca ShivesTest Bank

Exploring early parent—child conflict and relational patterns would not be helpful with dementive process. A Neurohistologic lesion in basal ganglia B Small infarctions in the white matter of brain C Bilateral temporal and parietal perfusion defects D Infarction of small- and medium-sized cerebral vessels Ans: C Feedback: The predominate finding of bilateral posterior temporal and parietal perfusion defects is thought to be highly predictive of DAT. Vascular dementia is thought to result from infraction of small- and medium-sized vessels causing parenchymal lesions to occur over wide areas of the brain.

A client with dementia is sleeping throughout the day at the nursing home. The client is most likely exhibiting which of the following? A Agnosia B Sundown syndrome C Confabulation D Preservation Ans: B Feedback: Sundown syndrome may be caused by a misinterpretation of the environment, lower tolerance for stress at the end of the day, or overstimulation due to increased environmental activity later in the day. Clients may exhibit altered sleep patterns, such as sleeping throughout the day.

Agnosia is the failure to recognize or identify objects despite intact sensory function. Confabulation is the filling in of memory gaps with false but sometimes plausible content to conceal the memory deficit. Preservation is the inappropriate continuation or repetition of a behavior. A client who has had a right-sided stroke is being very aggressive toward the caregiver.

The nurse would suspect CNS pathology in which of the following lobes of the brain? Damage to the parietal lobe causes neglect or inattention to left half of space.


Temporal lobe pathology causes inability to store or retrieve information. Occipital lobe damage causes visual disturbances such as agnosia. A client with amnestic disorder is being evaluated for dementia. Which of the following is a diagnostic characteristic of amnestic disorder? A History and physical examination indicative of memory impairment B Memory minimally decreased from usual C Memory impairment limited to periods of delirium D No significant problems with occupational or social functioning Ans: A Feedback: Diagnostic characteristics of amnestic disorder include memory impairment not solely limited to periods of delirium, history and physical examination indicative of medical condition underlying the memory impairment, demonstration of significant problems with social or occupational functioning, and memory significantly decreased from usual level.

A year-old man has been brought to the emergency department by his daughter and son-in-law due to abrupt and uncharacteristic changes in behavior, including impairments of memory and judgment.

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The subsequent history and diagnostic testing have resulted in a diagnosis of delirium. Delirium is never considered a normal, age-related change. A nurse is providing care for a client whose recent cognitive and behavioral changes have been attributed to dementia with Lewy bodies DLB. The nurse understands that the organic brain changes accompanying this disease result in alterations in the normal action of which neurotransmitters? A woman in her fifties has contacted her care provider because of concerns for her husband, who has suddenly begun behaving uncharacteristically in recent days. Diagnostic testing has ruled out delirium and he had been previously healthy. Onset is generally abrupt, with fluctuating, rapid changes in memory and other cognitive impairment.

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