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?
The clients should be able to ask us for items they need
The clients who are ambulatory can still carry out activities of daily living independently
The clients should know when to come to the dining room for meals
The clients may not recognize their family when they come to visit
The Correct Answer is D
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.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is B
Explanation
Choice A reason: Mutism, the absence of speech, is not typical in acute mania, where dopamine-driven hyperactivity increases verbal output. Mutism is more associated with catatonia or severe depression, where psychomotor inhibition or serotonin deficits reduce communication, making this inconsistent with mania’s neurobiological profile.
Choice B reason: Flight of ideas, characterized by rapid, disjointed speech, typifies acute mania due to dopamine and norepinephrine hyperactivity in the prefrontal cortex and limbic system. This leads to accelerated thought processes and pressured speech, reflecting the manic state’s heightened neural excitability and reduced inhibitory control.
Choice C reason: Hesitant speech is not characteristic of acute mania, where dopamine-driven hyperactivity results in rapid, pressured speech. Hesitancy may occur in anxiety or depression, linked to serotonin dysregulation or prefrontal inhibition, contrasting with mania’s uninhibited, accelerated verbal output driven by neurochemical overstimulation.
Choice D reason: Psychomotor retardation, slowed speech and movement, is typical of depression, driven by serotonin and dopamine deficits. In acute mania, heightened dopamine and norepinephrine activity cause rapid speech and agitation, making psychomotor retardation incompatible with the neurobiological profile of manic speech patterns.
Correct Answer is D
Explanation
Choice A reason: Aricept (donepezil) is a cholinesterase inhibitor that increases acetylcholine levels in the brain, temporarily improving cognitive symptoms in Alzheimer’s disease. It does not stop disease progression, as Alzheimer’s involves progressive neuronal loss due to amyloid plaques and tau tangles. This statement is scientifically inaccurate, as no medication halts Alzheimer’s neurodegenerative process.
Choice B reason: Taking Aricept on an empty stomach is not required, as it can be taken with or without food. Its absorption is not significantly affected by food, as it is metabolized hepatically via CYP2D6 and CYP3A4. This statement is incorrect, as it misrepresents the administration guidelines, potentially causing unnecessary restrictions for the patient.
Choice C reason: While Aricept may improve concentration by enhancing cholinergic activity in Alzheimer’s, this statement focuses on expectation rather than understanding its therapeutic role. It does not address the drug’s primary effect of temporarily slowing cognitive decline. Concentration improvement is a secondary benefit, not the primary mechanism, making this less precise scientifically.
Choice D reason: Aricept temporarily slows Alzheimer’s disease progression by inhibiting acetylcholinesterase, increasing acetylcholine, and supporting cognitive function in mild to moderate cases. It does not cure or stop the disease, as neuronal degeneration continues due to amyloid and tau pathology. This statement accurately reflects the drug’s mechanism and temporary symptomatic relief, aligning with clinical evidence.
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