Question 1

The nurse administers a mental status examination to assess the client's cognitive function. The client's spouse is present during the exam.
This exam includes which component?

Appetite.

Judgment.

Pupillary response.

Babinski's reflex.

Accepted Answer

Judgment.
Evaluation of cognitive function includes assessment of attention, concentration, judgment, perception, learning, memory, communication, language, and speed of processing information.

Question 2

When the nurse is conducting the pt's cognitive func, which components of mental status exam best assess the client's cognition?Select all that apply
Level of consciousness.
Level of eye contact.
Remote memory
Speech articulation.
Facial expression.

Accepted Answer

Level of consciousness.
Level of consciousness is an assessment of the client's congition.

Remote memory.
Remote memory is an assessment of the client's congition.

Question 3

(MRI) and (PET). The client's spouse asks the nurse what these tests will show.
Which is the best explanation by the nurse?

Accepted Answer

The provider is looking for changes in brain that are consistent w Alzheimer's disease or for other conditions that can cause the pts sx. No tests that provide a definitive dx of Alzheimer's disease, some imaging tests provide data that show changes consi

Question 4

How should the nurse explain normal labs?
Results likely indicate that disease is in early stages.
It is common for test results to change as the disease progresses.
norm labs are not typical and may need to be repeated.
Norm lab results help r/o othe

Accepted Answer

Normal laboratory test results help rule out other causes for the symptoms.
There are many causes of dementia, especially in the older client. Laboratory tests help rule out treatable causes before a diagnosis of Alzheimer's disease is established.

Question 5

Which understanding by nurse regarding Alzheimer's disease is accurate?
Changes in behavior & personality often occur in early Alzheimer's disease.
Behavior changes may indicate that she has already progressed to a later stage of the disease.
Behavior

Accepted Answer

Changes in behavior and personality often occur in early Alzheimer's disease.
Subtle changes in behavior and personality, which would easily be recognized by a loved one, occur even in early Alzheimer's disease.

Question 6

Pt's spouse asks nurse what typical behaviors for early-stage Alzheimer's disease. 
Frequently misplacing the keys to the car.
Needs assistance choosing clothes appropriate for the season.
Wandering off and losing perspective of location.
Requiring as

Accepted Answer

Frequently misplacing the keys to the car.
Losing or misplacing valuable objects is seen in searly-stage Alzheimer's disease. The client is still able to function independently.

Question 7

Which nursing intervention is best when interviewing the client and her spouse to elicit information about possible risk factors for Alzheimer's disease?
Ask if there is a family history of depression or manic behavior.
Ask if the client has a history o

Accepted Answer

Ask if there is any family history of Alzheimer's disease.
There seems to be a genetic predisposition to the development of Alzheimer's disease for many individuals. Genetic testing may be useful for the differential diagnosis because four genes are curr

Question 8

How should the nurse explain the therapeutic effect of donepezil to the couple?

Improves thinking and functioning abilities.

Restores destroyed cells.

Decreases hallucinations and delusions.

Reduces periods of depression.

Accepted Answer

Improves thinking and functioning abilities.
Donepezil, classified as an acetylcholinesterase inhibitor, is used in Alzheimer's disease to delay the onset of cognitive decline.

Question 9

Which side effect  of donepezil should the nurse instruct the spouse to report immediately?

Incontinence.

Insomnia.

Muscle cramps.

Dizziness.

Accepted Answer

Dizziness.
Dizziness may be a predictor of a serious side effect of syncope and should be reported immediately.

Question 10

Which information indicates the trazodone is having the desired effect?

The client sleeps through the night.

The client is able to control her bladder at times.

The client often wanders around the house.

The client denies feeling any pain.

Accepted Answer

The client sleeps through the night.
Trazodone is an antidepressant often used to improve sleep in the client with Alzheimer's disease.

Question 11

A pt is being d/c on (ER) metoprolol. Which statement by pt indicates an understanding of metoprolol ER?
"I can open content & mix it w food.”
“I can let it dissolve in juice prior to taking it.”
“I should take the drug whole.”
“I can skip next dose s

Accepted Answer

“I should take the drug whole.”

Question 12

In which division of the nervous system are catecholamines blocked by metoprolol, resulting in drowsiness?

Parasympathetic nervous system

Somatic nervous system

Sympathetic nervous system

Peripheral nervous system

Accepted Answer

Sympathetic nervous system

Question 13

The nurse reports which assessment finding as contributing to the cardioprotective effect in pt receiving metoprolol?
The pulse is palpated more strongly.
The freq of premature beats increased to 8 from 3.
The bp increased to 128/68 mm Hg from 110/60 m

Accepted Answer

The HR decreased from 130 to 98 beats/min.

Question 14

The patient refuses to take metoprolol because of its effects on the lungs. The nurse explains that metoprolol will not affect the lungs because it affects which type of cell receptors?

Alpha1

Alpha2

Beta1

Beta2

Accepted Answer

Beta1

Question 15

Propranolol is prescribed to a patient for management of hypertension. Which assessment finding would concern the nurse?

Tachycardia

Wheezing

Insomnia

Nausea

Accepted Answer

Wheezing
Propranolol, a nonselective beta blocker, can cause bronchoconstriction. Wheezing is an indication of bronchoconstriction.

Question 16

pt prescribed beta blocker with v/s: BP 118/68 mm Hg; HR 54; and resp 14. Which action would the nurse take?

Administer the medication.

Notify the health care provider.

Hold the medication.

Discontinue the prescription.

Accepted Answer

Hold the medication.

Question 17

A nurse is assessing a patient who has been taking metoprolol. Which assessment finding would be most concerning?

Decrease in pulse by 4 points

Weight gain of 4 lb within 24 hours

Oxygen saturation of 96%

Diastolic blood pressure of 86 mm Hg

Accepted Answer

Weight gain of 4 lb within 24 hours
Metoprolol decreases the force of ventricular contraction, which can worsen preexisting heart failure. A weight gain of 4 lb within 24 hours is indicative of fluid retention.

Question 18

A patient taking propranolol complains of dizziness when getting out of bed. Which action would the nurse take first?

Accepted Answer

Obtain blood pressure and heart rate.
Propranolol has a negative chronotropic property to the heart and reduces the workload of the heart. Bradycardia and hypotension can occur. The nurse must first assess the patient, which should include bp and hr on a

BSN 346

Alzheimer's Disease Case study

Question	Answer
The nurse administers a mental status examination to assess the client's cognitive function. The client's spouse is present during the exam. This exam includes which component? Appetite. Judgment. Pupillary response. Babinski's reflex.	Judgment. Evaluation of cognitive function includes assessment of attention, concentration, judgment, perception, learning, memory, communication, language, and speed of processing information.
When the nurse is conducting the pt's cognitive func, which components of mental status exam best assess the client's cognition?Select all that apply Level of consciousness. Level of eye contact. Remote memory Speech articulation. Facial expression.	Level of consciousness. Level of consciousness is an assessment of the client's congition. Remote memory. Remote memory is an assessment of the client's congition.
(MRI) and (PET). The client's spouse asks the nurse what these tests will show. Which is the best explanation by the nurse?	The provider is looking for changes in brain that are consistent w Alzheimer's disease or for other conditions that can cause the pts sx. No tests that provide a definitive dx of Alzheimer's disease, some imaging tests provide data that show changes consi
How should the nurse explain normal labs? Results likely indicate that disease is in early stages. It is common for test results to change as the disease progresses. norm labs are not typical and may need to be repeated. Norm lab results help r/o othe	Normal laboratory test results help rule out other causes for the symptoms. There are many causes of dementia, especially in the older client. Laboratory tests help rule out treatable causes before a diagnosis of Alzheimer's disease is established.
Which understanding by nurse regarding Alzheimer's disease is accurate? Changes in behavior & personality often occur in early Alzheimer's disease. Behavior changes may indicate that she has already progressed to a later stage of the disease. Behavior	Changes in behavior and personality often occur in early Alzheimer's disease. Subtle changes in behavior and personality, which would easily be recognized by a loved one, occur even in early Alzheimer's disease.
Pt's spouse asks nurse what typical behaviors for early-stage Alzheimer's disease. Frequently misplacing the keys to the car. Needs assistance choosing clothes appropriate for the season. Wandering off and losing perspective of location. Requiring as	Frequently misplacing the keys to the car. Losing or misplacing valuable objects is seen in searly-stage Alzheimer's disease. The client is still able to function independently.
Which nursing intervention is best when interviewing the client and her spouse to elicit information about possible risk factors for Alzheimer's disease? Ask if there is a family history of depression or manic behavior. Ask if the client has a history o	Ask if there is any family history of Alzheimer's disease. There seems to be a genetic predisposition to the development of Alzheimer's disease for many individuals. Genetic testing may be useful for the differential diagnosis because four genes are curr
How should the nurse explain the therapeutic effect of donepezil to the couple? Improves thinking and functioning abilities. Restores destroyed cells. Decreases hallucinations and delusions. Reduces periods of depression.	Improves thinking and functioning abilities. Donepezil, classified as an acetylcholinesterase inhibitor, is used in Alzheimer's disease to delay the onset of cognitive decline.
Which side effect of donepezil should the nurse instruct the spouse to report immediately? Incontinence. Insomnia. Muscle cramps. Dizziness.	Dizziness. Dizziness may be a predictor of a serious side effect of syncope and should be reported immediately.
Which information indicates the trazodone is having the desired effect? The client sleeps through the night. The client is able to control her bladder at times. The client often wanders around the house. The client denies feeling any pain.	The client sleeps through the night. Trazodone is an antidepressant often used to improve sleep in the client with Alzheimer's disease.
A pt is being d/c on (ER) metoprolol. Which statement by pt indicates an understanding of metoprolol ER? "I can open content & mix it w food.” “I can let it dissolve in juice prior to taking it.” “I should take the drug whole.” “I can skip next dose s	“I should take the drug whole.”
In which division of the nervous system are catecholamines blocked by metoprolol, resulting in drowsiness? Parasympathetic nervous system Somatic nervous system Sympathetic nervous system Peripheral nervous system	Sympathetic nervous system
The nurse reports which assessment finding as contributing to the cardioprotective effect in pt receiving metoprolol? The pulse is palpated more strongly. The freq of premature beats increased to 8 from 3. The bp increased to 128/68 mm Hg from 110/60 m	The HR decreased from 130 to 98 beats/min.
The patient refuses to take metoprolol because of its effects on the lungs. The nurse explains that metoprolol will not affect the lungs because it affects which type of cell receptors? Alpha1 Alpha2 Beta1 Beta2	Beta1
Propranolol is prescribed to a patient for management of hypertension. Which assessment finding would concern the nurse? Tachycardia Wheezing Insomnia Nausea	Wheezing Propranolol, a nonselective beta blocker, can cause bronchoconstriction. Wheezing is an indication of bronchoconstriction.
pt prescribed beta blocker with v/s: BP 118/68 mm Hg; HR 54; and resp 14. Which action would the nurse take? Administer the medication. Notify the health care provider. Hold the medication. Discontinue the prescription.	Hold the medication.
A nurse is assessing a patient who has been taking metoprolol. Which assessment finding would be most concerning? Decrease in pulse by 4 points Weight gain of 4 lb within 24 hours Oxygen saturation of 96% Diastolic blood pressure of 86 mm Hg	Weight gain of 4 lb within 24 hours Metoprolol decreases the force of ventricular contraction, which can worsen preexisting heart failure. A weight gain of 4 lb within 24 hours is indicative of fluid retention.
A patient taking propranolol complains of dizziness when getting out of bed. Which action would the nurse take first?	Obtain blood pressure and heart rate. Propranolol has a negative chronotropic property to the heart and reduces the workload of the heart. Bradycardia and hypotension can occur. The nurse must first assess the patient, which should include bp and hr on a

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