A nurse is caring for a client who has experienced a stroke and exhibits parkinsonian effects. The client's cognition fluctuates. Which of the following types of dementia should the nurse expect the client to have?
HIV infection
Prion disease
Lewy body disease
Frontotemporal lobar degeneration
The Correct Answer is C
A. HIV infection can cause dementia, but it typically presents with apathy, social withdrawal, and motor dysfunction—not parkinsonian features with fluctuating cognition.
B. Prion disease (such as Creutzfeldt-Jakob disease) presents with rapid progression of dementia, myoclonus, and ataxia, but not typically with parkinsonian features or fluctuating cognition.
C. Lewy body disease is characterized by fluctuating cognition, visual hallucinations, and parkinsonian motor symptoms. These features strongly suggest dementia with Lewy bodies, especially in the context of stroke or neurodegenerative changes.
D. Frontotemporal lobar degeneration primarily affects behavior, personality, and language. Parkinsonian symptoms and fluctuating cognition are not hallmark features.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Finding comfort in connecting with family is a healthy coping mechanism and a normal part of the grieving process, not an indicator of clinical depression.
B. Loss of appetite can occur with both grief and depression, so it is not specific enough to indicate clinical depression.
C. Intense sadness is a normal reaction to grief, especially shortly after a loss. It is not necessarily pathological.
D. Loss of interest in pleasurable activities (anhedonia) is a hallmark symptom of clinical depression. When sadness persists and interferes with daily functioning and enjoyment of life, it may signal the transition from normal grief to a depressive disorder.
Correct Answer is D
Explanation
A. Speech degrading to a few words is characteristic of the middle stage of Alzheimer's disease. In the terminal phase, speech is often lost completely.
B. Needing assistance with finances typically occurs in the early stage of Alzheimer's, when complex cognitive tasks become difficult.
C. Requiring cueing to eat may be seen in the moderate stage, when the client still retains some functional ability but needs prompting.
D. Unable to sit up is a finding consistent with the terminal phase of Alzheimer’s disease. During this stage, clients lose motor functions and physical abilities, often becoming bedridden, nonverbal, and fully dependent for all activities of daily living.
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