An elderly client presents to the emergency room with a family member. The family member reports that the elderly client has been vomiting and not eating or drinking for 2 days. This morning the elderly client became confused, which is new. The nurse knows the elderly client probably has which of the following?

Delirium

New onset Alzheimer's disease

New onset Huntington's disease

New onset Parkinson's disease

Answer and Explanation

The Correct Answer is A

A. Delirium is an acute, temporary state of confusion, often caused by factors such as dehydration, infection, or metabolic disturbances. In this case, the elderly client’s confusion following vomiting and not eating or drinking for 2 days suggests that dehydration or an underlying illness is likely causing the delirium.

B. Alzheimer's disease is a progressive, degenerative condition that leads to chronic memory loss and cognitive decline. It does not typically cause sudden confusion, as seen in this case.

C. Huntington's disease is a genetic neurodegenerative disorder that causes motor dysfunction and cognitive decline. It does not present suddenly with confusion in an elderly client.

D. Parkinson's disease is a progressive neurological disorder that primarily affects motor function, causing tremors, rigidity, and bradykinesia. It does not typically present with sudden confusion or the symptoms described in this case.

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Correct Answer is C

Explanation

A. A thrombotic stroke is typically caused by a blood clot that forms in an artery supplying blood to the brain, usually due to atherosclerosis. While it is a possible cause of stroke, it is not the most likely in this patient with atrial fibrillation.

B. A cerebral aneurysm involves a weakness in the blood vessel wall that can lead to rupture and bleeding, causing a hemorrhagic stroke, but this is not the most common type of stroke in patients with atrial fibrillation.

C. Embolic stroke occurs when a clot or other debris (such as a thrombus) breaks off from a distant part of the body (like the heart in atrial fibrillation) and travels to the brain, blocking a cerebral artery. This is the most common type of stroke in patients with atrial fibrillation due to the formation of clots in the left atrium that can embolize to the brain.

D. Hemorrhagic stroke is caused by the rupture of a blood vessel in the brain, leading to bleeding. It is not the most common type of stroke in patients with atrial fibrillation, though it can occur if there is coagulopathy or anticoagulant therapy.

A. Attempt to determine what the client was looking for. B. Reprimand the client for invading the other client's privacy. C. Explain the client's Alzheimer's diagnosis to the frightened client. D. Ask the client to apologize for his behavior.

Correct Answer is A

Explanation

A. Attempt to determine what the client was looking for is the best response. In Alzheimer's disease, clients may exhibit wandering behavior and confusion, often seeking something familiar or trying to meet an unmet need. Understanding what the client was looking for can help address their needs and prevent further agitation.

B. Reprimanding the client for invading the other client's privacy is not appropriate. Clients with Alzheimer's disease may not be aware of the concept of privacy or the impact of their actions. Reprimanding can cause distress and confusion.

C. Explaining the client's Alzheimer's diagnosis to the frightened client may help provide understanding, but it does not address the immediate concern of calming the frightened client. The focus should be on managing the behavior in the moment.

D. Asking the client to apologize for his behavior is not appropriate, as the client may not have the cognitive ability to understand or remember the need to apologize. This could cause frustration and confusion.

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Naxlex Comprehensive Predictor Exams

A post myocardial infarction patient experiences atrial fibrillation is most at risk for which type of stroke?

Correct Answer is C

Explanation

A nurse is caring for a client who has Alzheimer's disease. The nurse discovers the client entering the room of another client, who becomes upset and frightened. Which of the following actions should the nurse take?

Correct Answer is A

Explanation

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