Alzheimer’s Disease is a serious brain disease that is affecting 5 ½ million people in the United States today. Most are over 60 years of age.
Every 67 seconds someone in the United States develops the disease. In fact, Alzheimer’s disease is the 6th leading cause of death in the United States.
One in three seniors die of Alzheimer’s disease, or another dementia. 2/3 of those suffering with this disease are women and the disease affects
blacks about twice as commonly as whites. The number of persons with Alzheimers will grow as the population of those over the age of 65 rises.
It is the only disease in America in the top 10 that cannot be prevented, cured, or slowed.
In this post you will find”
1. A video playlist, which you can watch
by clicking the image here –>
2. NCLEX style questions
3. Link to an audio of the video, which you can find here:
Nursing Exam or NCLEX Style Questions Related to Alzheimer’s disease:
1. The client in stage 2 Alzheimer’s disease is exhibiting symptoms of confusion. The home care nurse does the following appropriate interventions, except:
A. Furnish the client’s room with pictures of her family and familiar possessions, remove hazardous items
B. Orient the client to the environment
C. Place the client in a secluded area where she can be alone and would facilitate independence
D. Call the client by name, identify self and wait for a response
Ans.: C. The confused client should be placed in a less stressful environment and should be reassured and reoriented to her current situation; leaving her alone in a secluded environment could precipitate agitation.
2. Which of the following is known to be the most common cause of dementia in the elderly?
A. Parkinson’s Disease
B. Huntington’s Disease
C. Alzheimer’s Disease
D. Vascular Dementia
Ans.: C. Is the most common cause of dementia in the elderly which causes a person to lose the ability to perform vital mental and physical functions.
3. Which of the following are the risk factors in developing Alzheimer’s disease? Select all that apply:
A. Family history of Alzheimer’s disease
B. Male gender
C. Previous head injury
D. Untreated high blood pressure
E. High levels o f Folic Acid
F. Hormone therapy
Ans.: A, C, D, and F are all risk factors for the development of Alzheimer’s disease. Females are more prone to developing Alzheimer’s as well as having low levels of Folic acid.
4. Which of the following are early symptoms of Alzheimer’s disease? Select all that apply:
A. Poor or decreased judgment
B. Occasionally forgetting meetings
C. Difficulty finding words
D. Frequently misplacing keys
E. Difficulty remembering names of unfamiliar objects
F. Increased attention span
Ans.: A, B, C, and D are early symptoms of Alzheimer’s disease. Other symptoms include difficulty remembering names of familiar objects and decreased attention span.
5. Which of the following is included in the treatment option for the improvement of Alzheimer’s symptoms?
C. Cholinesterase Inhibitors
Ans.: C. Current Alzheimer’s medications such as cholinesterase inhibitors can help for a time with memory symptoms and other cognitive changes. In some cases, certain types of antidepressants, antipsychotics or sedatives may be needed to help control symptoms.
6. The nurse identifies which one of the following medication is specific for Alzheimer’s disease?
A. Memantine (Namenda)
B. Pramipexole Dihydrochloride (Mirapex)
C. Aripiprazole (Abilify)
D. Topiramate (Topamax)
Ans.: A. Namenda is an N-Methyl-D-Aspartate Receptor Antagonist used in moderate to severe types of Alzheimer’s disease. Mirapex is used for Parkinson’s disease; Aripiprazole is an antipsychotic medication that can be used in some cases of Alzheimer’s disease; while Topamax is an anticonvulsant medication.
7. The husband caring for a client in early stage of Alzheimer’s asks the nurse what sort of changes he can do at home to keep her wife safe. The nurse enumerates which of the following appropriate actions? Select all that apply:
A. Remove excess furniture, throw rugs and clear pathways of clutter.
B. Always keep valuables suck as keys, wallets and mobile phones in the same place at home.
C. Make sure appointments are scheduled on different dates at different times as possible.
D. Ask the doctor if the medications can be given at varying times.
E. Reduce the number of mirrors at home
F. Allow independence when possible.
Ans.: A, B, E, and F are appropriate suggestions for a caregiver of a client with Alzheimer disease. It is very important to establish routine schedules by setting appointments on the same day at the same time and to request to doctors if they can simplify the client’s medication regimen to once-daily dosing with the same schedule.
8. Which of the following communication techniques of the nurse is inappropriate to use for a client with Alzheimer’s?
A. Using short, simple sentences
B. Utilizing open-ended questions
C. Avoid arguing or contradicting the client
D. Talking in a calm and patient manner
Ans.: B. Using open-ended questions should be avoided when talking to clients with Alzheimer’s disease for it puts pressure on them causing them to be overwhelmed and stressed.
9. A 67-year-old client asks the nurse if Alzheimer ’s disease is a normal part of aging. Which of the following is an appropriate response by the nurse?
A. “Alzheimer’s is not a normal part of aging.”
B. “Increasing age causes all elderly to have Alzheimer ’s disease later in life.”
C. “Most likely, 95% of people from age 70 and above will have Alzheimer ’s disease.”
D. None of the above
Ans.: A. Increasing age is a risk factor in Alzheimer ’s disease and not a normal part of aging.
10. Which of the following best describes Alzheimer’s Disease?
A. Tumors within the spine which includes intramedullary lesions, extramedullary-intradural lesions, and extramedullary-intradural lesions.
B. It is a chronic, progressive and degenerative brain disorder accompanied by profound effects on memory, cognition and ability for self-care.
C. It is a chronic, progressive, hereditary disease of the nervous system that results in progressive involuntary choreiform movement and dementia.
D. It is a slowly progressing neurologic movement disorder that eventually leads to disability.
Ans.: B. Alzheimer’s diease is a progressive disease that destroys memory and other important mental functions. Option A describes spinal cord tumors, Option C describes Huntington’s disease while option D describes Parkinson’s disease.
11. Which of the following nursing diagnosis should be considered as a priority in caring for the client with Alzheimer’s disease?
A. Risk for injury related to impaired judgment, disorientation and confusion.
B. Impaired verbal communication related to degenerative changes.
C. Anticipatory grieving related to client’s awareness of something “being wrong” with changes of memory.
D. Disturbed sleep pattern related to psychologic stress evidences by interrupted sleep.
Ans.: A. Safety is always a priority especially in clients who exhibit signs of confusion, hyperactivity and wandering.
12. The nurse giving discharge education in caring to the caregiver of a client with Alzheimer’s disease notes that which of the following statements made by the caregiver indicated a need for further teaching?
A. “I should keep our valuables in a safe and secured location in the house.”
B. “I should make sure that he has someone to accompany him in the house at all times.”
C. “I should limit the client from doing activities on his own.”
D. “Clean house of unnecessary clutter to promote safety and reduce sensory overload.”
Ans.: C. The client with Alzheimer’s disease should be provided with activities that promotes intellectual stimulation and keeps them preoccupied as well.
13. The client with Alzheimer’s disease wakes up one morning confused, suspicious and anxious. Which of the following is an appropriate action by the nurse?
A. Give the client time to recognize his environment
B. Make the client feel safe by approaching him in a calm manner and reorienting him to the present.
C. Encourage the client to go back to relieve his anxiousness.
D. Offer the client to talk to other residents of the facility
Ans.: B. To prevent the client from progressing to an aggressive behaviour, the nurse should orient him to his present situation in a calm and non threatening manner. Offering him to talk to other residents that he does won’t recognize may provoke further agitation and giving him time alone and waiting for him to recognize his surroundings does address his anxiety.
14. The 57-year old client with Alzheimer’s disease is brought to the ER with vaginal excoriation, UTI and severe dehydration. The nurse also notes that the client’s hair is unkempt and looks like she has not had a shower in a while and is dehydrated. Which of the following is an not an appropriate action of the nurse?
A. Stay with the client and place her in a safe and non threatening environment.
B. Assess and treat any physical injuries.
C. Report a possible case of client neglect to the social worker.
D. Wait for the caregiver to arrive to interview him on how this had happened.
Ans.: D. In this situation the client should be treated appropriately and the nurse should place her in a safe environment. Since she shows signs and symptoms of elderly neglect, the nurse should adhere to the state and hospital’s policy in reporting such incidences. She should also notify the caseworker or the social worker so that it can be investigated and a follow-up can occur.
15. The client within the early stages of Alzheimer’s disease tells the nurse”I know I will never be cured! I wish my family would stop pushing for treatments and hoping for miracles. I know that symptoms can be helped with medications but why bother so much if they won’t cure this” Which of the following is an appropriate response by the nurse?
A. “You seem angry that your family wants to help you somehow manage your symptoms?”
B. “Have you talked to your family about withholding treatment?”
C. “I understand how you are feeling, I would feel the same if I were in your shoes.”
D. “Why are you feeling like this?”
Ans.: A. Restating is one form of therapeutic communication that focuses on the client’s feelings. The nurse should maintain neutral responses and avoid asking why for it is often interpreted as being accusatory by the client. She can never understand how the client is feeling because she does not have a similar experience with the client.
16. As the nurse enters the client’s room to deliver her food tray, she sees the client agitated and fidgeting because she can’t find her watch. Which of the following is an appropriate action by the nurse?
A. Ask the client to think hard on where she has last seen the item.
B. Clarify with the client if she did brought a watch with her when she was brought in.
C. Ask what the watch looks like and help the client find the misplaced item.
D. Encourage the client to eat first so she can remember if she did had a watch that had indeed gone missing.
Ans.: C. Helping the client in finding the misplaced item would alleviate the client’s agitation. Asking if she did have a watch in the first place that was misplaced could invite anger and promote accusation.
17. The client with Alzheimer’s disease experiences wakefulness during sleeping time, has developed dark circles under eyes and is frequently yawning. Which of the following is an appropriate nursing diagnosis?
A. Risk for injury
B. Disturbed sleep pattern
C. Anticipatory grieving
Ans.: B. Disturbed sleep pattern or sleep deprivation is an appropriate diagnosis for clients experiencing sleep interruption and the inability to identify the need for sleeping.
18. In clients with disturbed sleep pattern, which of the following are appropriate nursing interventions to manage this issue? Select all that apply:
A. Provide soft music or “white noise”
B. Provide and evening meal and encourage the client to drink lots of fluids to make herself fell full
C. Change bed time schedules
D. Restrict daytime sleep as appropriate
E. Reduce mental activity late in the day
F. Avoid use of continuous restraints
Ans.: A, D, E, and F are independent nursing interventions in managing sleep deprivation. Clients may be provided with evening snack or warm milk prior to bedtime but should be restricted or limited with fluids to decrease the need to get up and use the bathroom in the middle of the night. A regular bedtime schedule should be promoted to establish a regular sleeping pattern.
19. The caregiver of a client with Alzheimer’s disease reports to the nurse that there was a time when they were eating out and the client had mixed the salad dressing with his drink and poured that mixture in the salad. Which of the following is an appropriate suggestion of the nurse?
A. Encourage the family to have the client dine alone to promote independence.
B. Encourage the family to firmly correct the behaviour of the client when eating out.
C. Encourage the family to tell the client that what he is doing is socially unacceptable and that it is embarrassing so that it would correct the behaviour.
D. Encourage the family to accept the behaviour to promote self esteem, decrease irritability or refusal to eat as a result of anger and frustration.
Ans.: D. The family should accept the client when he has whimsical mixtures preserve self esteem. Early separation can result in client feeling upset and rejected and can result in decreased food intake.
20. Which of the following is an appropriate snack for a client with Alzheimer ’s disease?
A. Hot clam chowder
B. Grilled chicken pita wraps
C. Baby foods
D. Apple pie
Ans.: B. Pita wraps are easy to carry and does not require cutting. Clients with Alzheimer’s disease feel like they are always on the go and foods that can be carried around may encourage them to eat. They should not be offered hot foods because they may result in mouth burns while baby foods lack the needed nutrition and fiber and can make the client feel humiliated.
21. The wife of the client with Alzheimer’s disease tells the nurse that she forgot to eat the other day and that their phone line was cut because she forgot to pay their bills last month. The nurse noticed that the wife also has dark circles under her eyes and has lost weight since she last saw her. Which of the following should the nurse suggest to the wife of the client?
A. Determine available support, resources currently in use and resources in the community.
B. Tell the wife that she can lock the client in his room when she goes out to run errands.
C. Ask the wife if she can afford to pay home health services.
D. Direct the client to the physician for she may also be exhibiting signs of Alzheimer’s as well.
Ans.: A. The wife of the client is exhibiting signs of caregiver role strain. Before giving any suggestions, the nurse should first assess the current resources in use so that she can determine which alternate–care resources she can refer the SO to. Locking the client in his room can promote agitation and may endanger the client.
22. The caregiver of a client with Alzheimer’s disease tells the nurse that the client started to have black stools and vomits his meals with blood a few days ago. Which of the following should be the nurse’s next action?
A. Have the client take activated charcoal
B. Note it in the client’s chart
C. Inform the caregiver that this a common side effect of Alzheimer’s medications
D. Report these symptoms to the physician
Ans.: D. The client is experiencing adverse effects of Alzheimer’s medication which should be reported to his physician immediately. Activated charcoal is used to treat drug poisoning and is not appropriate for this case.
23. The nurse knows that which of the following is an example of agnosia?
A. The client does not know the name of the object that he holding
B. The client shows abnormal, uncoordinated movements
C. The client cannot express his feelings
D. The client cannot perform previously learned action
Ans.: A. Agnosia is the inability to recognize objects. Abnormal and uncoordinated movements is seen in ataxia, inability to express feelings is expressive aphasia and inability to perform previously learned actions is apraxia.
24. The client with Alzheimer’s disease is exhibiting signs of expressive aphasia, which of the following nursing interventions is appropriate when communicating with this client?
A. Fill-in words that the client might be expressing
B. Provide the client with hearing aid
C. Teach the client sign language
D. Use close-ended questions when conversing with the client
Ans.: D. Close-ended questioning assist in comprehension and overall communication in clients with difficulty expressing their thoughts. Filling-in words put further pressure on the client, teaching the client a new skill may be difficult for him to retain and providing the client with a hearing aid does not address the problem of expression.
25. The nurse knows that the following activities does not warrant supervision in clients with late stage Alzheimer’s disease, except?
A. Water house plants
B. Playing crossword puzzles
C. Cook dinner
D. Write a journal or a diary
Ans.: C. Cooking dinner should warrant supervision as it involves cutting and operating the stove which poses the client at a great risk.