The PMHNP works on an inpatient geriatric psychiatric unit. She knows that which of the following features is commonly present in Lewy body dementia?
A steadily progressive, gradual decline in reasoning and increased incidence of sleepwalking
Motor abnormalities with a low incidence of depression and psychosis
Recurrent visual hallucinations; affected patients adversely react to antipsychotics
A slowly progressive and fatal disorder that manifests with depression, psychosis, personality changes, and dementia
The Correct Answer is C
Choice A reason: This choice is incorrect because Lewy body dementia does involve cognitive decline, but sleepwalking is not a characteristic feature. The hallmark symptoms include fluctuating cognition, visual hallucinations, and parkinsonism.
Choice B reason: This choice is incorrect because Lewy body dementia is associated with both motor abnormalities and a higher risk of psychiatric symptoms, including depression and hallucinations, not a low incidence of these.
Choice C reason: This choice is correct because recurrent visual hallucinations and sensitivity to antipsychotic medications are hallmark features of Lewy body dementia. Patients often have parkinsonian motor symptoms and can deteriorate rapidly when exposed to antipsychotics.
Choice D reason: This choice is partially correct in describing some aspects of dementia but is more representative of Alzheimer’s disease or other neurodegenerative disorders. It does not capture the specific hallmark features of Lewy body dementia.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Bipolar I disorder requires at least one manic episode, not just hypomania, making this inconsistent with the presentation.
Choice B reason: Bipolar II disorder is characterized by at least one hypomanic episode and at least one major depressive episode without a history of full mania, matching the client’s symptoms.
Choice C reason: Cyclothymic disorder involves chronic, milder mood fluctuations but does not meet criteria for full hypomanic or major depressive episodes.
Choice D reason: Schizoaffective disorder includes mood episodes along with psychotic symptoms, which are not reported in this client’s history.
Correct Answer is B
Explanation
Choice A reason: Estrogen is not indicated because Klinefelter syndrome involves low testosterone; giving estrogen could worsen feminization and does not address the underlying hormone deficiency.
Choice B reason: Testosterone replacement therapy is the mainstay of treatment in Klinefelter syndrome to promote the development of secondary sexual characteristics, improve muscle mass and bone density, and support overall physical and psychological health.
Choice C reason: Doing nothing would allow the effects of testosterone deficiency to persist, including delayed puberty, reduced muscle mass, decreased bone density, and potential psychosocial difficulties.
Choice D reason: Progesterone is not used in Klinefelter syndrome; it does not address testosterone deficiency and has no role in managing the condition.
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