Gerontological Nurse Test Dementia and Cognitive Disorders 1 — Questions and Answers
Question 1: Which feature best distinguishes delirium from dementia in an older adult?
- Memory impairment
- Acute onset with fluctuating course (Correct answer)
- Personality changes
- Language difficulties
Correct answer: Acute onset with fluctuating course
Delirium is characterized by acute onset and a fluctuating level of consciousness, whereas dementia typically has a gradual, progressive onset without acute fluctuation.
Question 2: The Mini-Mental State Examination (MMSE) is used in gerontological nursing primarily to:
- Diagnose Alzheimer's disease definitively
- Screen for and monitor cognitive impairment (Correct answer)
- Assess a patient's capacity for informed consent
- Evaluate activities of daily living function
Correct answer: Screen for and monitor cognitive impairment
The MMSE is a standardized screening tool that assesses multiple cognitive domains and tracks changes over time; it cannot independently diagnose a specific dementia type.
Question 3: A patient with Alzheimer's disease exhibits sundowning. The nurse should anticipate that this behavior typically occurs:
- Early morning upon waking
- Late afternoon and evening hours (Correct answer)
- After taking medications
- Only during medical procedures
Correct answer: Late afternoon and evening hours
Sundowning refers to increased confusion, agitation, and behavioral disturbances that commonly occur in late afternoon and evening in patients with dementia.
Question 4: Which non-pharmacological intervention is most appropriate for managing agitation in a patient with moderate dementia?
- Restraint application to prevent injury
- Consistent routine, familiar music, and a calm environment (Correct answer)
- Increasing stimulation with bright lighting and television
- Encouraging the patient to recall distressing events to process emotions
Correct answer: Consistent routine, familiar music, and a calm environment
Consistent routines, familiar sensory stimuli like music, and a calm low-stimulation environment are evidence-based non-pharmacological interventions for dementia-related agitation.
Question 5: Lewy body dementia is distinguished from Alzheimer's disease by the presence of which hallmark feature?
- Memory loss as the first symptom
- Recurrent vivid visual hallucinations (Correct answer)
- Aphasia occurring early in the disease
- Rapid onset over days to weeks
Correct answer: Recurrent vivid visual hallucinations
Recurrent, well-formed visual hallucinations are a core diagnostic feature of Lewy body dementia and are not typically prominent early in Alzheimer's disease.
Question 6: When communicating with a patient who has moderate Alzheimer's disease, the nurse should:
- Use complex sentences to stimulate cognitive function
- Use short, simple sentences and allow extra time for responses (Correct answer)
- Correct the patient each time they make a factual error
- Avoid eye contact to prevent overstimulation
Correct answer: Use short, simple sentences and allow extra time for responses
Short, simple sentences reduce cognitive load for patients with dementia, and allowing extra response time respects their slowed processing without adding pressure.
Gerontological Nurse Test Dementia and Cognitive Disorders 1
Which feature best distinguishes delirium from dementia in an older adult?