Alzheimer's: The Elusive Mind Stealer

Independent Analysis

10 Contact Hours - Course 9010

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Instructions:
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
         D. Parkinson'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
         D. Kuru

5.	What part of the brain is associated with higher mental functions?

         A. the brain stem
         B. the cerebellum
         C. the cerebrum
         D. the small brain

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
         D. All of the above

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 forgetfulness

11.	Where does 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 cup of herbal tea and a high carbohydrate snack prior to retiring
         B phone call from Mary's daughter
         C 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 dementiCardiovascular 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

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. American Psychiatric Association

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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