The nurse is assessing an older adult with cognitive complaints. Which characteristic is more typical of dementia (neurocognitive disorders) than depression?
Disorientation to time and place
Frequent expressions of guilt
Poor concentration and slowed thinking
Sudden onset of symptoms
The Correct Answer is A
A. Disorientation to time and place: Progressive disorientation is a hallmark feature of dementia and other neurocognitive disorders. Impairment in orientation often reflects underlying cognitive decline affecting memory, executive function, and spatial awareness.
B. Frequent expressions of guilt: Persistent guilt is more characteristic of depression, reflecting negative self-perception and mood disturbance rather than primary cognitive impairment.
C. Poor concentration and slowed thinking: While both depression and dementia can present with cognitive changes, slowed thinking and poor concentration in depression often fluctuate and may improve with mood treatment, unlike the steady decline seen in dementia.
D. Sudden onset of symptoms: Acute onset is more typical of delirium or depression-related cognitive changes. Dementia usually develops gradually and progresses over months to years.
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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