A nurse working in an assisted living facility is holding an in-service for the nursing assistants. The nurse reviews common behaviors associated with cognitive deterioration associated with dementia. Which would cause the nurse to know that the assistants correctly understood if it were expressed during a posttest?

Choice A reason: Expecting dementia clients to consistently ask for needed items is incorrect, as short-term memory loss from hippocampal degeneration impairs their ability to articulate needs. Cognitive deterioration disrupts executive function and communication, making this assumption inaccurate and reflecting a misunderstanding of dementia’s neurobiological impact on memory and expression.

Choice B reason: Assuming ambulatory dementia clients can independently perform activities of daily living is incorrect. Dementia’s progressive neuronal loss, particularly in the cortex and hippocampus, impairs planning and execution of tasks like dressing or hygiene, despite physical mobility. This reflects a misunderstanding of cognitive versus motor function in dementia’s pathology.

Choice C reason: Expecting dementia clients to know meal times is incorrect, as temporal disorientation from hippocampal and prefrontal cortex damage impairs memory and time perception. Cognitive deterioration disrupts routine recall, making this assumption inaccurate. It fails to recognize the neurobiological basis of memory deficits central to dementia’s progression.

Choice D reason: Not recognizing family is a common dementia symptom, as long-term memory impairment from cortical and hippocampal neurodegeneration disrupts autobiographical memory. This reflects accurate understanding of dementia’s progressive impact on memory systems, where familiar faces become unrecognizable, aligning with the disease’s neurobiological effects on recognition and recall.

Choice A reason: Previous psychiatric history increases PTSD risk, as pre-existing conditions like depression or anxiety indicate heightened amygdala sensitivity and dysregulated stress responses. These predispose individuals to exaggerated fear responses post-trauma, as the brain’s stress circuitry is already compromised, amplifying the impact of traumatic events on neural pathways.

Choice B reason: PTSD is not associated only with personal characteristics; it requires exposure to a traumatic event, as defined by DSM-5 criteria. Trauma triggers neurobiological changes, including amygdala hyperactivity and hippocampal volume reduction, causing symptoms like flashbacks. Personal characteristics modulate risk, but event exposure is essential, making this statement false.

Choice C reason: A causative trauma is required for PTSD, per DSM-5, involving exposure to actual or threatened death, serious injury, or sexual violence. This triggers neurobiological changes, such as elevated cortisol and amygdala activation, leading to intrusive memories and hyperarousal. This criterion is fundamental to the disorder’s pathophysiology and diagnosis.

Choice D reason: Lack of social support increases PTSD risk, as it exacerbates stress responses by reducing oxytocin-mediated emotional regulation and prefrontal cortex modulation. Social isolation heightens amygdala activity, prolonging trauma-related symptoms. Support systems buffer stress responses, making this a scientifically valid factor in the etiology of PTSD.