A 62-year-old woman presents to the PMHNP for an evaluation. She is concerned she is developing dementia due to her significant family history. Which of the following would help the PMHNP make a diagnosis of pseudodementia rather than dementia?
Patients with pseudodementia are more likely to say "I don't know" when uncertain.
In patients with dementia, attention and concentration are variable.
Patients with true dementia are less likely to have language impairment and to confabulate.
In patients with pseudodementia, intellectual performance is usually global, and impairment is consistently poor.
The Correct Answer is A
Choice A reason: Individuals with pseudodementia, often related to depression, tend to respond to cognitive testing with "I don’t know" when uncertain, showing awareness of deficits. This contrasts with true dementia, where patients often confabulate or attempt to answer despite impaired memory.
Choice B reason: In dementia, attention and concentration are consistently impaired, not highly variable. This makes the statement inaccurate for distinguishing pseudodementia.
Choice C reason: True dementia commonly involves language impairment and confabulation. The statement is incorrect in suggesting the opposite.
Choice D reason: In pseudodementia, intellectual performance is typically intact outside of depressive episodes, and deficits are inconsistent, making the statement inaccurate.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Providing limited information without consent still breaches patient confidentiality and legal protections under HIPAA.
Choice B reason: The patient, being 18, is legally an adult and has the right to confidentiality regarding her medical and psychiatric care. Consent must be obtained before sharing any information.
Choice C reason: Health insurance coverage does not give a parent the right to access a patient’s medical details; legal protections ensure patient privacy.
Choice D reason: Telling the father to make an appointment does not resolve the confidentiality issue and could lead to inappropriate disclosure.
Correct Answer is B
Explanation
Choice A reason: A lithium level of 5 mEq/L is critically high and would indicate severe toxicity, not subtherapeutic dosing.
Choice B reason: A lithium level of 0.5 mEq/L is at the low end or below the therapeutic range for acute mania (0.8–1.2 mEq/L), suggesting subtherapeutic dosing and a need for an increased dose.
Choice C reason: A lithium level of 1.2 mEq/L is within the therapeutic range for acute mania and would not indicate underdosing.
Choice D reason: A lithium level of 15 mEq/L is lethally toxic and requires immediate medical intervention, not dose escalation.
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