A client with a history of cerebrovascular accident is brought to an emergency department experiencing memory problems, confusion, and disorientation. Based on this client's assessment data, on which medical diagnosis would the nurse focus the plan of care?
Delirium due to adverse effects of cardiac medications
Vascular neurocognitive disorder
Neurocognitive disorder due to Huntington's disease
Alzheimer's disease
The Correct Answer is B
A. Delirium due to cardiac medications is a possibility, but the patient’s history of cerebrovascular accident (CVA) makes vascular neurocognitive disorder more likely. Delirium typically presents acutely and is often associated with medical or environmental triggers.
B. Vascular neurocognitive disorder (formerly vascular dementia) is often seen in clients with a history of cerebrovascular accidents (strokes). The client’s symptoms of memory problems, confusion, and disorientation could indicate this type of cognitive impairment, which is caused by reduced blood flow to the brain due to vascular damage.
C. Neurocognitive disorder due to Huntington's disease typically presents with movement disorders (chorea), mood changes, and gradual cognitive decline, rather than sudden memory loss and disorientation.
D. Alzheimer’s disease typically presents with gradual memory decline and cognitive impairment, but the sudden onset of symptoms in a patient with a history of CVA makes vascular neurocognitive disorder more probable.
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Related Questions
Correct Answer is C
Explanation
A. This statement describes a long-term reaction to a traumatic event, which is more consistent with post-traumatic stress disorder (PTSD) rather than acute stress disorder (ASD), which occurs within 3 days to 4 weeks of a traumatic event.
B. This statement refers to dissociation related to a past trauma but doesn’t specifically indicate the timeframe for acute stress disorder, which typically involves symptoms that occur shortly after a trauma.
C. Acute stress disorder occurs within 3 days to 4 weeks of a traumatic event and can include symptoms like nightmares, intrusive thoughts, and flashbacks. This statement is consistent with ASD, which is characterized by immediate reactions to a traumatic event.
D. This statement suggests long-term PTSD symptoms (such as flashbacks) after childhood trauma, not acute stress disorder. PTSD typically develops after the symptoms persist for more than a month.
Correct Answer is B
Explanation
A. Although reporting abuse may be necessary, the priority action is ensuring the client’s immediate safety. Addressing safety first is fundamental before proceeding with other interventions.
B. The first priority in trauma-informed care is to ensure that the client is safe. Safety is essential to help the client begin the healing process, both physically and emotionally.
C. While encouraging the client to talk about their experience may be part of the therapeutic process, it is not the priority before ensuring safety. Forcing the client to talk too soon can increase distress.
D. Assessing social and family support is important but should be done after ensuring the client’s immediate safety.
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