An elderly client is experiencing progressive changes in memory that have interfered with personal, social, and occupational functioning. The client exhibits poor judgment and has a short attention span. A nurse should recognize these as classic signs of which condition?
Neurocognitive disorder
Pseudodementia
Delirium
Mania
The Correct Answer is A
A. Neurocognitive disorder: Progressive memory decline that interferes with personal, social, and occupational functioning is a defining feature of neurocognitive disorders. Impaired judgment and reduced attention span reflect declining executive function and cortical involvement. The gradual progression distinguishes this condition from acute or reversible cognitive changes.
B. Pseudodementia: Pseudodementia is associated with depression and often presents with abrupt onset and fluctuating cognitive complaints. Clients are usually aware of and distressed by their deficits, and cognitive function may improve with treatment of the underlying mood disorder. The course is not typically progressive.
C. Delirium: Delirium is characterized by an acute onset of confusion, fluctuating levels of consciousness, and impaired attention. It is usually triggered by an underlying medical condition, medication, or infection. The rapid onset contrasts with the progressive changes described.
D. Mania: Mania presents with elevated mood, decreased need for sleep, pressured speech, and impulsive behavior. Cognitive impairment is not the primary feature, and memory loss is not typically progressive. Attention may be increased rather than shortened due to heightened activity.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Provide education on medication adherence: Education on medication adherence supports effective management of depressive symptoms and underlying Alzheimer’s disease. Clear instruction helps prevent missed doses and reduces the risk of symptom exacerbation. Involving caregivers enhances understanding and follow-through with treatment plans.
B. Monitor for suicidal ideation: Expressions of passive death wishes indicate increased risk for suicidal thinking. Ongoing monitoring allows early identification of escalating ideation or changes in intent. Regular assessment supports patient safety and timely intervention.
C. Encourage participation in groups and cognitive stimulation activities: Structured social and cognitive activities can improve mood, reduce isolation, and support cognitive functioning. Engagement in familiar group settings may help maintain routine and provide emotional support.
D. Provide low-stimulation environment at all times: A constantly low-stimulation environment may increase social withdrawal and worsen depressive symptoms. Individuals with depression benefit from appropriate sensory input and social engagement. Environmental modification should balance calmness with meaningful interaction.
Correct Answer is B
Explanation
A. Involve family in treatment: Family involvement helps address relational stressors and improves communication and support systems. Education and collaboration with caregivers can reduce triggers for self-harm and reinforce healthy coping strategies. Inclusion is guided by safety, consent, and therapeutic goals.
B. Encourage secrecy to maintain trust: Encouraging secrecy can increase risk by limiting safety planning and preventing appropriate monitoring. Nursing care emphasizes transparency, safety, and appropriate information sharing when self-harm is present. Trust is built through honest communication and protective collaboration.
C. Refer for dialectical behavior therapy (DBT): DBT is an evidence-based approach for adolescents who engage in self-injury. It focuses on emotion regulation, distress tolerance, interpersonal effectiveness, and mindfulness. Referral supports development of safer coping skills.
D. Teach alternative coping strategies: Teaching skills such as grounding, journaling, sensory modulation, or reaching out for support provides practical alternatives to self-harm. These strategies target emotional regulation and reduce reliance on injurious behaviors.
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