Answer
each of the following questions (there is only one correct answer to
each question).
1
Which of the following statements about Alzheimer’s disease is true?
A. Alzheimer’s is a chronic progressive
disease with a plateau-like progression
B. Alzheimer’s is a progressive, degenerative,
irreversible brain
disorder
C. Alzheimer’s is a brain disease that
is reversible with the proper medication
D. Alzheimer’s is a progressive, degenerative
disease with definable
cause(s)
2
Which of the following is the most common type of dementing illness for people over age 65?
A. Multi-infarct dementia
B. Binswanger’s disease
C. Alzheimer’s disease
3
Symptoms of dementia include all of the following except
A. motor impairment
B. visual and auditory impairment
C. memory impairment
D. difficulty with concentration and
judgment
4
A condition associated with age that includes some memory impairment but no accompanying functional decline is called
A. senile dementia of the Alzheimer’s
type
B. benign senescent forgetfulness
C. Binswanger’s disease
5
What part of the brain is associated with higher mental functions?
A. the brain stem
B. the cerebellum
C. the cerebrum
6
Which of the following is a neurotransmitter believed to be deficient in persons with Alzheimer’s disease?
A. choline acetyltransferase
B. norepinephrine
C. serotonin
7
In normal message transmission, neurotransmitters
A. block production of choline acetyltransferase
B. stimulate electrical impulses from
cell to cell
C. suppress the release of high energy
chemicals
D. are funneled through the cell
axon
8
Which of the following is NOT characteristic of the normal aging brain?
A. weight loss
B. brain atrophy
C. neuronal loss specific to the hippocampus
D. senile or neuritic plaque formation
9
What are the two PRIMARY defining
characteristics of Alzheimer’s disease?
A. Pick’s bodies and neurofibrillary
tangles
B. senile plaques and neurofibrillary
tangles
C. brain weight loss and atrophy
D. neuronal loss in the parietal and
occipital lobe
10
When Alzheimer’s occurs in people
under age 65, what is it often called?
A. chronic organic brain syndrome
B. senile dementia of the Alzheimer’s
type
C. dementia of the Alzheimer’s type
D. benign senescent forgetfulnesses
11
Where do the loss of neurons predominantly
occur in people with Alzheimer's
A. temporal lobe
B. parietal lobe
C. occipital lobe
D. frontal lobe
12
The hippocampus is the area of the
brain most important to
A. long-term memory
B. coordination and balance
C. short-term memory
D. voluntary control functions
13
Fibrous plaque formation and neurofibrillary
tangles are believed to
A. facilitate message transmission
from neuron to neuron
B. disrupt electrical impulse transmission
from cell to cell
C. be caused by excess aluminum
salts deposits
D. occur secondary to circulatory impairment
14
Acetylcholine and choline acetyltransferase
are believed to be missing or
present in decreased amounts in the
A. cerebellum and hippocampus
B. brain stem and parietal lobe
C. cerebral cortex and hippocampus
D. frontal and parietal lobe
15
The degree of progressive decline in
Alzheimer’s disease is believed to be
related to:
A. the age of onset
B. the degree of pathological involvement
affecting neurons
C. usually about the same for all
people
D. dependency on the amount of aluminum
in the brain
16
A person in early stage Alzheimer’s
who may be using more words than
necessary to express themselves is
engaging in
A. confabulation
B. circumlocution
C. echolalia
D. perseveration
17
A person who is constantly tapping
his/her fingers on the table is engaging
in
A. ataxic behavior
B. automaticity
C. atypical behavior
D. agraphic behavior
18
Death is most often precipitated in
people with dementia by
A. an infectious process
B. seizures
C. fluid and electrolyte imbalances
D. hepatotoxicity
19
Primary triggers that often alert family
members of people with Alzheimer’s
include
A. incontinency and personality
changes
B. profound long-term memory loss
C. a crisis that compromises coping
mechanisms
D. gradual memory loss
20
Reasons for obtaining an early evaluation
include
A. the need to make plans as a family
B. opportunities to take advantage of
experimental drug programs
C. the need to rule out reversible causes
of dementia whose symptoms may
mimic those of Alzheimer’s
D. all of the above
21
Multi-infarct dementia is a chronic
dementia characterized by
A. progressive, global decline that occurs
over time
B. generalized neurological impairment
C. periods of time when there is no
perceived change in intellectual
impairment
D. complete reversal of symptoms once
treated
22
Risk factors for multi-infarct dementia
include
A. vascular disease
B. hypertension
C. diabetes
D. all of the above
23
Which of the following clusters of
symptoms best describes a person
suffering from Parkinson’s disease?
A. severe memory impairment,
marked personality disorders
B. bradykinesia, joint stiffness, slow
speech
C. petit mal seizure activity, general
paresis
D. gait disorder, involuntary facial and
limb movements, depression
24
The most important diagnostic tool for
evaluating any dementia is a
A. computer axial tomogram
B. detailed medical and social history
C. mini-mental status exam
D. complete blood count
25
If a person is asked to explain a phrase
like “A bird in the hand is worth two
in the bush,” what cognitive function
is being tested?
A. abstract reasoning
B. remote memory
C. orientation
D. judgment
26
A type of dementia that may be diagnosed
through a psychiatric interview
is called
A. anxiety-produced dementia
B. SDAT
C. pseudodementia
D. sporadic dementia
27
Some defining characteristics of late
stage Alzheimer’s that can be observed
with CT scans are all of the following
EXCEPT:
A. narrowed ventricles of the brain
B. enlarged ventricles of the brain
C. brain atrophy
D. fluid in the inner spaces of the
brain
28
One principle that will help Anna
function better in her own home is
A. maintaining a predictable routine
B. providing for new activities each
day so Anna won’t get bored
C. having a home health aide come
in daily and give Anna a complete
bath
D. teach the family reality orientation
exercises they can use with Anna
when they visit her
29
George’s speech pattern often seems
nonsensical. The best course of action
for a nurse or family member to take
is to
A. walk away and come back later
when George may make more
sense
B. tell George you do not understand
him and ask him to try and rephrase
his sentence
C. listen carefully and repeat back repeated
words or phrases to George
to reassure him that you are listening
to him
D. tune out George’s verbalizations
and listen instead to his body language
30
Catastrophic reactions are common as
Alzheimer’s disease progresses. Which
of the following is a TRUE statements
about catastrophic reactions?
A. They may result in cognitive impairment
B. They may be related to the person’s
perceived loss of self
C. They are triggered by hallucinations
D. They may be accompanied by
extreme anxiety and verbal outbursts
31
Mary West is a new patient on your
hospital unit; she has been admitted
for an evaluation of a cardiac arrhythmia
and also has second stage Alzheimer’s disease. Her family tells
you Mary has a habit of going through
all the dresser drawers in the house at
night, taking things out of the drawers
and stashing them under her mattress.
Which of the following is NOT a
term that describes Mary’s behavior?
A. sorting
B. rummaging
C. pillaging
D. hoarding
32
Mary’s wandering behavior is known
to worsen around 5:00 PM each afternoon.
Which of the following is NOT
considered a contributing cause of
sundowning?
A. fatigue
B. sensory changes
C. overstimulation
D. routine and predictability
33
Which of the following interventions
might help Mary most to calm down?
A. Letting her sit in a Gerichair with a
locked tray table for an hour before
dinner
B. Assigning an aide to walk with
Mary and offer her a snack around
4:00 PM
C. Give Mary prn haloperidol that is
ordered for agitation as needed at
4:30 PM and monitor for effectiveness
D. Encourage Mary to take a nap at
the time her restlessness is at its
peak
34
The best place for Mary to sit in the
late afternoon might be
A. a quiet corner of the dining room
B. in the hall near the nurse’s station
C. at the dining room table with several
other residents
D. in front of the television in the
recreation room
35
Which of the following might be helpful
to minimize Mary’s nocturnal
wandering?
A. A cup of herbal tea and a high carbohydrate
snack prior to retiring
B. A phone call from Mary’s daughter
C. A warm bath
D. All of the above
36
A patient in the home has ingested
some poisonous cleaning solution in
the bathroom. His caregiver immediately
calls the poison control center
because she is aware that the following
set of symptoms is indicative of
poisoning;
A. severe abdominal pain, profuse
sweating, slow breathing and slow
pulse
B. profuse sweating, rapid breathing
and pulse, vomiting
C. cramping, diarrhea, profuse sweating,
rapid pulse
D. odors on the breath, salivation,
hyperventilation, nausea
37
Xerostomia is a side effect that can be
caused by:
A. antidepressants
B. bronchodilators
C. anti-hypertensives
D. all of the above
38
Which of the following is NOT a primary
goal to strive for in persons with
dementia?
A. To maintain bowel and bladder
continence for as long as possible
B. to maintain natural emptying of
the bladder and bowel
C. To toilet on a regular (every two
hour) basis
D. to maintain a person’s dignity
39
Categories of pharmacologic medications
used to enhance cognitive
processes are all of the following EXCEPT
A. nootropics
B. miscellaneous agents that act on
catecholaminergic sites
C. cholinergic agents
D. neuroleptics
40
An experimental drug that often elevates
liver enzymes and can result
in hepatotoxicity is
A. piracetam
B. Hydergine
C. tetrahydroaminoacridine
D. Tenilsetam
41
Anticholinergic side effects may result
when a person is taking an antidepressant
drug such as amitriptyline.
Which of the following is NOT an
anticholinergic side effect?
A. constipation
B. blurred vision
C. drowsiness
D. hyperactivity
42
All of the following are extrapyramidal
side effects of neuroleptic drugs
EXCEPT
A. dystonia
B. dyskinesia
C. akathisia
D. ataxia
43
Beta-adrenergic receptor antagonists
are sometimes used to treat anxiety
associated with Alzheimer’s dementia.
Cardiovascular side effects that
may occur are all of the following
EXCEPT
A. hypotension
B. tachycardia
C. congestive heart failure
D. pulmonary edema
44
Which phenomenon related to spiritual
distress in the nursing diagnosis
literature is easiest to assess in people
with dementia?
A. conflict between religious beliefs
and health regimen
B. inability to practice religious rituals
C. conflict between religious practices
and health regimen
D. anger at God
45
In caring for a person with Alzheimer’s
who is dying, all of the following may
be helpful EXCEPT
A. positioning with extra pillows to
maintain body alignment
B. encouraging nondairy drinks such
as cranberry juice
C. maintaining a dark room for the
person to be in
D. sitting with the person and holding
or stroking their hand
46
The single most helpful source identified
by family caregivers to help them
deal with Alzheimer’s disease is
A. literature
B. a nurse’s aide manual
C. support groups
D. their physician
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Complete
47
The “straw”’ that often precipitates
institutionalization of a person with
Alzheimer’s is
A. an increased need for management
with drug therapy
B. a caregiver’s failing health
C. increased language and memory
loss
D. increased dependency on the part
of the person with dementia on the
caregiver
48
Which of the following sets of needs
BEST describes the range of spiritual
needs caregivers may have?
A. The need for love and relationship,
the need to maintain dignity and
respect, the need for hope
B. The need for love and relationship,
the need to make sense of life and
suffering, the need to be relieved of
guilt
C. The need for safety and security,
the need for self actualization
D. The need for meaning and purpose,
the need to maintain a balanced
state of equilibrium in crisis
49
The best resource for both family and
professional caregivers to learn more
about Alzheimer’s disease is
A. The National Institute on Aging
B. local Offices on Aging
C. the Alzheimer’s Association
D. ADRDA
50
Professional caregivers can gain needed
support and a better understanding
of Alzheimer’s disease and caregiving
by
A. getting to know family caregivers
B. forming support groups at work for
encouragement
C. getting in touch with personal emotional
and spiritual needs
D. all of the above
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