Chapter 36- Cognitive Processes Nursing School Test Banks

 

1.

The nurse is caring for a client who is difficult to arouse and when aroused is confused. The nurse would document the clients condition as:

A)

lethargic.

B)

obtunded.

C)

somnolent.

D)

depressed.

Ans:

B

Feedback:

Obtunded describes the patient who is difficult to arouse and when aroused is confused. Lethargic describes the patient who is not fully awake and tends to drift off to sleep when not actively stimulated. Somnolent describes a client who is sleepy. Depressed is an emotional feeling.

2.

A nurse is caring for a client with schizophrenia. The nurse understands that patients suffering from schizophrenia have problems in which of the following areas? Select all that apply.

A)

Processing information

B)

Inappropriate social behavior

C)

Communication

D)

Memory

E)

Decision making

Ans:

A, B, C, D, E

Feedback:

People with schizophrenia experience problems with thinking, memory, attention, communication, decision making, emotions, social behavior, and ability to perceive reality accurately.

3.

The nurse is caring for a patient with altered cognitive function who has recently been admitted to the hospital from a long-term care facility. Which of the following interventions would address the clients safety? Select all that apply.

A)

Place the client in a room close to the nurses station.

B)

Keep the bed in the lowest position possible.

C)

Use a night light in the patients room.

D)

Keep the patients door closed to reduce noise.

E)

Leave the television on at all times.

Ans:

A, B, C

Feedback:

Safety measures such as orienting patients to the room and the nurse call system, using lights at night to help orient patients to their environment, keeping beds in the lowest possible position, and placing patients in rooms closest to the nursing station for closer observation help to prevent accidents and injuries. Keeping the door closed and leaving the television on may lead to perception issues, which could increase the clients risk of falling.

4.

The nurse is working with a patient experiencing minimal memory problems. The nurse is teaching the patient about memory training programs. Which statement by the patient would indicate a need for further education?

A)

I will do a crossword puzzle every day.

B)

I will start making lists of things I need to remember.

C)

I will not try to learn any new hobbies.

D)

I will take a nap every day.

Ans:

C

Feedback:

For people with minimal memory problems, memory training programs and devices may be beneficial. Making lists, using mnemonic devices (formulas or patterns of letters to aid in remembering), putting things on a calendar/planner, repeating what you want to remember, and developing other association techniques can assist with remembering tasks or information. The regular practice or rehearsal of retrieving information from the memory helps maintain the skill.

5.

The nurse is caring for a client who has had a stroke. Since the stroke, the client has trouble saying words correctly and his speech seems slurred. The nurse documents this speech pattern as:

A)

dysarthria.

B)

anomic aphasia.

C)

dysphasia.

D)

expressive aphasia.

Ans:

A

Feedback:

Patients with dysarthria usually have normal auditory comprehension and can select and order words correctly. They have a motor speech disorder that causes them difficulty in saying words and sounds precisely using appropriate stress, loudness, pitch, and control. The result is speech described as slurred, heavy, or unclear. Expressive aphasia (also called Brocas, motor, or nonfluent aphasia) is characterized by limited speech that is slow and halting with great effort, reduced grammar, and poor articulation. Anomic or amnesic aphasia is characterized predominantly by word-finding problems of a milder nature than expressive aphasia. The speech is fluent and grammatically correct.

6.

The nursing instructor has completed a presentation regarding ways to help clients with cognitive deficits to remain oriented. What statement by a student would indicate a need for further education?

A)

I will place clocks and calendars in the clients rooms.

B)

I will change the activity schedule on a daily basis.

C)

I will be consistent when making nursing care assignments.

D)

I will provide frequent orientation reminders for the clients.

Ans:

B

Feedback:

Maintaining a structured environment assists patients in adapting to cognitive alteration and in reestablishing communication. Structured routines minimize the number of factors on which patients must focus. Sequenced events, consistent daily schedules and care providers, calendars, and frequent reminders contribute to structure.

7.

The nurse is caring for a client who has suffered a stroke. The client is now unable to speak, read, or write. She is also unable to understand spoken language. The nurse would document this as:

A)

anomic aphasia.

B)

expressive aphasia.

C)

receptive aphasia.

D)

global aphasia.

Ans:

D

Feedback:

Anomic or amnesic aphasia is characterized predominantly by word-finding problems of a milder nature than expressive aphasia. Expressive aphasia (also called Brocas, motor, or nonfluent aphasia) is characterized by limited speech that is slow and halting with great effort, reduced grammar, and poor articulation. Receptive aphasia (also called Wernickes, sensory, or fluent aphasia) is characterized by speech that is well articulated and has good melody and normal or slightly faster rate. The major manifestations are impaired auditory comprehension and feedback. Global aphasia results from severe and extensive damage to all language areas (Brocas and Wernickes). These patients have no consistent functional skills in any language modality.

8.

A nurse is caring for a client who had difficulty finding the correct names for particular objects. The nurse would document this as:

A)

anomic aphasia.

B)

receptive aphasia.

C)

expressive aphasia.

D)

global aphasia.

Ans:

A

Feedback:

Anomic or amnesic aphasia is characterized predominantly by word-finding problems of a milder nature than expressive aphasia. Expressive aphasia (also called Brocas, motor, or nonfluent aphasia) is characterized by limited speech that is slow and halting with great effort, reduced grammar, and poor articulation. Receptive aphasia (also called Wernickes, sensory, or fluent aphasia) is characterized by speech that is well articulated and has good melody and normal or slightly faster rate. The major manifestations are impaired auditory comprehension and feedback. Global aphasia results from severe and extensive damage to all language areas (Brocas and Wernickes). These patients have no consistent functional skills in any language modality.

9.

The nurse is caring for a client recently diagnosed with Alzheimers dementia. Which assessment finding would cause the client to question this diagnosis?

A)

Sudden onset of confusion

B)

Short term memory loss

C)

Increased agitation at sundown

D)

Inattention to ADLs

Ans:

A

Feedback:

People with Alzheimers dementia experience a gradual decline in all cognitive processes. A sudden onset of confusion would not be suggestive of Alzheimers. Increased agitation at sundown and inattention to ADLs are both symptoms of Alzheimers dementia.

10.

The most appropriate diagnosis for the elderly client with Alzheimers disease who requires bathing is

A)

Chronic confusion related to disease process as evidenced by the inability to manage activities of daily living

B)

Chronic confusion related to dementia and biochemical imbalances as evidenced by hallucination

C)

Altered thought processes related to confusion, biochemical imbalances, and Alzheimers disease

D)

Confusion as evidenced by inability to remain oriented to place and time resulting from Alzheimers disease

Ans:

A

Feedback:

The priority nursing diagnosis is chronic confusion related to disease process as evidenced by the inability to manage daily activities.

11.

To assess a newly admitted adult clients perception of reality, the nurse asks the client about

A)

Person, place, and time

B)

Family history

C)

Memory ability

D)

Confusional state

Ans:

A

Feedback:

Assessing perception of reality includes determining the persons orientation to time, place, and person.

12.

The nurse recognizes that the client diagnosed with global aphasia will

A)

Have difficulty with grammar and articulation

B)

Demonstrate unintelligible speech

C)

Express comments that do not make sense

D)

Be unable to speak, read, or write

Ans:

D

Feedback:

Global aphasia results from severe extensive damage to all language areas (Brocas and Wernickes).

13.

Which of the following types of aphasia occurs in the brain-injured person and results in limited speech that is slow and halting, is completed with great effort, and is poorly articulated?

A)

Brocas

B)

Receptive

C)

Global

D)

Anomic

Ans:

A

Feedback:

Expressive aphasia (Brocas) is characterized by limited speech that is slow and halting, with great effort, reduced grammar, and poor articulation.

14.

When an elderly client is alert and calm during the day but becomes confused and agitated every night, the nurse recognizes that the client is experiencing

A)

Hallucinations

B)

Delirium

C)

Sundown syndrome

D)

Delusions

Ans:

C

Feedback:

Sundown syndrome is defined as an increase in confusion and agitation that occurs at the end of the day.

15.

Which of the following statements accurately characterizes dementia? The disease is

A)

Equivalent to organic brain syndrome

B)

A result of the normal aging process

C)

Reversible with early diagnosis and treatment

D)

Irreversible with gradual cognitive decline

Ans:

D

Feedback:

People with dementia experience a gradual decline in all cognitive processes which is irreversible, as contrasted to acute confusion ordelirium , in which dysfunction may be reversible.

16.

The most common form of dementia is

A)

Organic brain syndrome

B)

Senile dementia

C)

Delirium tremens

D)

Alzheimers type

Ans:

D

Feedback:

The most common form of dementia is Alzheimers type, which is primary neuronal degeneration of unknown cause.

17.

When a nurse makes a home visit and finds that a previously alert and oriented elderly client is demonstrating early signs of confusion, the nurse suspects that the client may be experiencing the onset of

A)

Infection

B)

Hyperglycemia

C)

Hepatic encephalopathy

D)

Hyperkalemia

Ans:

A

Feedback:

Altered cognitive function in an older adult may be the earliest indication of an infectious process anywhere in the body.

18.

Which of the following problems is the most likely physical cause of an elderly clients altered cognition?

A)

Hypothyroidism

B)

Hyperthyroidism

C)

Hypopituitarism

D)

Hyperparathyroidism

Ans:

A

Feedback:

Disorders that impair metabolic processes and oxygen use, such as hypothermia and hypothyroidism, can also alter cognition. The bodys inadequate intake or impaired use of glucose will limit the quantity available for the brains metabolic demands.

19.

For optimal functioning, the brain requires a large amount of

A)

Sodium

B)

Magnesium

C)

Glucose

D)

Vitamin A

Ans:

C

Feedback:

The brain cells need glucose for metabolic energy and other nutrients for optimal functioning. The brain consumes 25% of the glucose the body uses.

20.

A 78-year-old client has suffered a cerebrovascular accident. The family inquires about the clients speech. The client has expressive aphasia. The nurse explains the client will require a(n)

A)

Speech pathologist

B)

Physical therapist

C)

Occupational therapist

D)

Physiatrist

Ans:

A

Feedback:

Approximately 20% of all stroke survivors require the specialized services of a speech pathologist to help them regain communication skills.

21.

An elderly male client who has been smoking a pipe and cigar for more than 30 years develops chronic hoarseness. The nurse understands that the client is a risk for which alteration in cognitive function?

A)

Memory

B)

Thinking

C)

Communication

D)

Muscular dysfunction

Ans:

C

Feedback:

Communication may be altered by the functional impairment of speech apparatus of the larynx, the ability to move air, the use of the tongue and oral pharynx, and/or the innervation to each of these structures.

22.

When the elderly client seems very forgetful and often fails to dress appropriately, the nurse determines that the client is demonstrating

A)

Normal aging

B)

Confusion

C)

Cognitive impairment

D)

Chronic senile dementia

Ans:

C

Feedback:

Although the brain undergoes some degenerative changes as the ventricles enlarge slightly and brain weight decreases, significant cognitive impairment in older persons is never normal but is indicative of a disorder.

23.

An adolescent client states, I am tired of everything and I am very bored. The nurse should encourage

A)

Peer relationships

B)

Time for prayer

C)

Ability to think

D)

Activity therapy

Ans:

A

Feedback:

During illness, peer relationships provide support and companionship for adolescents.

24.

The thinking patterns of a 4-year-old will typically demonstrate

A)

Categorization

B)

Abstract thought

C)

Conservatism

D)

Egocentrism

Ans:

D

Feedback:

Preschoolers have concrete thinking patterns and demonstrate pronounced egocentrism, or self-concern.

25.

The toddler begins to label familiar items such as the stove is hot, and the ball bounces at age

A)

Less than one

B)

1 to 3 years

C)

3 to 5 years

D)

5 to 7 years

Ans:

B

Feedback:

During the toddler years, the toddler develops the concept of object permanence, and begins to label familiar items.

26.

The nurse instructs the newly delivered, first-time mother that to enhance the newborns cognitive development, the mother should

A)

Teach the infant to hold the bottle

B)

Frequently stimulate and interact with him

C)

Reinforce the newborns environment with symbols

D)

Encourage the neonate to coo and babble

Ans:

B

Feedback:

Providing stimulation through varied objects, different sounds, and face-to-face communication and interaction enhances cognitive development.

27.

The process of receiving and interpreting the sensory stimuli that functions as a basis for understanding, knowing, and learning is termed

A)

Perception

B)

Attending

C)

Thinking

D)

Memory

Ans:

A

Feedback:

Perception is the process of receiving and interpreting sensory stimuli that functions as a basis for understanding, knowing, and learning.

28.

Sensory receptors that respond to stimuli from deeper tissues such as bone are termed

A)

Neuroreceptors

B)

Interoceptors

C)

Proprioceptors

D)

Exteroceptors

Ans:

B

Feedback:

Interoceptors are located in and respond to stimuli from the bodys viscera and deeper tissues such as bone.

29.

Sensory receptors that are located in the ear, muscles, tendons, and joints that relate to the bodys physical state are termed

A)

Neuroreceptors

B)

Interoceptors

C)

Proprioceptors

D)

Exteroceptors

Ans:

C

Feedback:

Proprioceptors are located in the inner ear, muscles, tendons, and joints.

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