Gerontological Nurse Test Dementia and Cognitive Disorders 2 — Questions and Answers
Question 1: Validation therapy, developed by Naomi Feil, is primarily used to:
- Reorient patients with dementia to current time and place
- Acknowledge and communicate with patients in their own reality (Correct answer)
- Teach cognitive strategies to slow memory decline
- Assess the stage and severity of dementia progression
Correct answer: Acknowledge and communicate with patients in their own reality
Validation therapy focuses on empathetically acknowledging the feelings and subjective reality of a person with dementia rather than correcting or reorienting them.
Question 2: A nurse is caring for a patient with vascular dementia. Which risk factor most directly contributes to the development of this type of dementia?
- Accumulation of amyloid plaques
- Cerebrovascular disease and multiple small strokes (Correct answer)
- Lewy body protein deposits in neurons
- Frontotemporal lobe atrophy
Correct answer: Cerebrovascular disease and multiple small strokes
Vascular dementia results from cerebrovascular disease, where reduced blood flow to the brain due to small strokes or ischemia causes progressive cognitive decline.
Question 3: Which stage of the Global Deterioration Scale (GDS) indicates moderate Alzheimer's disease where patients require assistance with activities of daily living?
- Stage 2
- Stage 3
- Stage 5 (Correct answer)
- Stage 7
Correct answer: Stage 5
GDS Stage 5 represents moderate Alzheimer's disease; patients need assistance with ADLs such as choosing appropriate clothing but can still recall their own name.
Question 4: A nurse notes that a patient with dementia has been refusing meals for 3 days. The most therapeutic initial nursing action is to:
- Insert a nasogastric tube for enteral nutrition immediately
- Explore potential causes such as pain, medication side effects, or depression (Correct answer)
- Restrict fluids to stimulate appetite
- Document the refusal and reassess in one week
Correct answer: Explore potential causes such as pain, medication side effects, or depression
Identifying and addressing reversible underlying causes of decreased appetite—such as oral pain, constipation, or depression—is the priority before escalating to invasive interventions.
Question 5: Which assessment tool is specifically designed to identify pain in patients with advanced dementia who cannot self-report?
- Numeric Rating Scale (NRS)
- Wong-Baker FACES Scale
- PAINAD (Pain Assessment in Advanced Dementia) (Correct answer)
- Visual Analog Scale (VAS)
Correct answer: PAINAD (Pain Assessment in Advanced Dementia)
The PAINAD scale assesses behavioral indicators of pain—breathing, vocalization, facial expression, body language, and consolability—in patients unable to self-report.
Question 6: A patient with frontotemporal dementia (FTD) exhibits disinhibited behavior and inappropriate social conduct. The nurse understands this is primarily due to:
- Memory centers being affected first
- Degeneration of the frontal and temporal lobes affecting personality and behavior (Correct answer)
- Cholinergic deficit similar to Alzheimer's disease
- Subcortical white matter damage from hypertension
Correct answer: Degeneration of the frontal and temporal lobes affecting personality and behavior
FTD primarily affects the frontal and temporal lobes, which regulate behavior, personality, and social conduct, resulting in disinhibition and inappropriate social behavior.
Gerontological Nurse Test Dementia and Cognitive Disorders 2
Validation therapy, developed by Naomi Feil, is primarily used to: