A 65-year-old woman presents to her primary care physician with complaints of new-onset memory loss. Her family reports that she has been forgetting recent events, repeating questions, and misplacing items more frequently over the past few months. She has no significant medical history but has noticed a decline in her cognitive abilities. On examination, she demonstrates difficulty recalling recent events and exhibits word-finding difficulties. Her Mini-Mental State Examination (MMSE) score is 20/30. What is the most likely diagnosis for this patient, and what are the hallmark clinical manifestations? (Select all that apply)
Loss of short-term memory
Alzheimer’s disease
Vascular dementia
Word-finding difficulties
Correct Answer : A,B,D,E
Choice A reason: Loss of short-term memory is a hallmark of Alzheimer’s disease, as seen in the patient’s difficulty recalling recent events. This reflects early hippocampal damage, impairing new memory formation, making it a correct clinical manifestation for this diagnosis.
Choice B reason: Alzheimer’s disease is the most likely diagnosis, given progressive memory loss, word-finding difficulties, and an MMSE score of 20/30 in a 65-year-old. These symptoms align with Alzheimer’s neurodegenerative pattern, making this the correct diagnosis.
Choice C reason: Vascular dementia typically presents with stepwise cognitive decline and focal neurological signs, often with vascular risk factors. The patient’s gradual memory loss without such history better fits Alzheimer’s, making vascular dementia incorrect.
Choice D reason: Word-finding difficulties, as exhibited, are a hallmark of Alzheimer’s, reflecting language cortex involvement. This progressive aphasia, common in early stages, impairs communication, making it a correct clinical manifestation for this patient.
Choice E reason: Disorientation to time and place, though not explicitly stated, is a hallmark of Alzheimer’s, often emerging as memory declines. Given the patient’s MMSE score and symptoms, this is likely, making it a correct manifestation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A reason: The initial stage of Alzheimer’s involves subtle short-term memory loss, mild personality changes, and forgetting details. This accurately describes early disease progression, aligning with clinical staging, making it a correct choice for Alzheimer’s stages.
Choice B reason: The moderate stage includes impaired higher cortical functions (language, spatial skills), not “no change.” This incorrect description of cognitive decline makes it an inaccurate choice for Alzheimer’s moderate stage characteristics.
Choice C reason: The moderate stage involves global cognitive impairment, including language and spatial deficits, disorientation, and inability to perform daily activities. This accurate description of moderate Alzheimer’s makes it a correct choice for the disease’s stages.
Choice D reason: The severe stage of Alzheimer’s includes loss of environmental response, requiring total care and often bedridden status. This reflects advanced disease progression, making it a correct selection for Alzheimer’s stages.
Choice E reason: Initial Alzheimer’s affects short-term, not long-term, memory. Long-term memory loss occurs later, so this inaccurate description of the initial stage makes it incorrect for Alzheimer’s early manifestations.
Choice F reason: The severe stage involves complete, not slight, loss of environmental response. This underestimation of severe Alzheimer’s dependency and disability makes it incorrect for the disease’s advanced stage.
Correct Answer is C
Explanation
Choice A reason: SIADH causes water retention, not loss, leading to sodium dilution from excess fluid. Sodium dilution and water retention are the effects, so sodium dilution with water loss is incorrect for SIADH’s solute impact.
Choice B reason: SIADH does not cause sodium retention or water loss; it retains water, diluting sodium. The correct effect is sodium dilution with water retention, so this is incorrect for the syndrome’s solute effects.
Choice C reason: SIADH results in water retention due to excess ADH, diluting serum sodium levels (hyponatremia). This sodium dilution and water retention are hallmark effects, making this the correct choice for the solute impact.
Choice D reason: SIADH causes water retention, not sodium retention, leading to diluted sodium. Sodium and water retention would increase sodium levels, which doesn’t occur, so this is incorrect for SIADH effects.
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