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Dementia And Alzheimer’s Disease > Mental Health

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Total Questions : 5

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Question 1:

A family member of a client experiencing dementia and being treated for normal-pressure hydrocephalus asks the nurse, “Is my father’s dementia reversible?” Which nursing response indicates understanding of primary and secondary dementia? Select all that apply.

A. “Treatment sometimes can reverse secondary dementia.” B. “Unfortunately, primary dementia is not reversible.” C. “Unfortunately, secondary dementia is not reversible.” D. “Treatment sometimes can reverse primary dementia.” E. “Both primary and secondary dementia are always reversible with treatment.”

Answer and Explanation

Choice A:

Secondary dementia arises from conditions such as normal-pressure hydrocephalus, hypothyroidism, or vitamin B12 deficiency. These are potentially reversible because the cognitive decline is linked to a treatable pathology. Correcting the underlying disorder can restore cognitive function

Choice B:

Primary dementia results from neurodegenerative processes such as beta-amyloid plaque and tau protein accumulation. These changes cause permanent neuronal damage and progressive decline. Current therapies only manage symptoms, making reversal of cognitive impairment impossible.

Choice C:

Secondary dementia is not always irreversible. Disorders like hydrocephalus or metabolic disturbances can be corrected, leading to improvement in memory and cognition. Labeling it as never reversible disregards treatable causes.

Choice D:

Primary dementia cannot be reversed because it involves progressive neurodegeneration. No available treatment halts or reverses the disease process, so suggesting possible reversal is scientifically inaccurate.

Choice E:

Neither primary nor secondary dementia is always reversible. While secondary dementia may improve with treatment, primary dementia remains irreversible. Stating both are always reversible misrepresents the nature of dementia syndromes.

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Question 2:

A physician tells family members that their father, who is experiencing confusion and memory loss, has a reversible form of dementia. Which is the likely cause of this disorder?

A. Multiple sclerosis B. Multiple small brain infarcts C. Electrolyte imbalance D. HIV disease

Answer and Explanation

Choice A:

Multiple sclerosis is a chronic demyelinating disease with progressive neurological decline. Cognitive impairment may occur, but axonal damage and demyelination are irreversible, so dementia from MS cannot be reversed.

Choice B:

Multiple small brain infarcts result in vascular dementia. Ischemic injury leads to permanent neuronal death. Once infarcts occur, cognitive deficits are fixed and cannot be reversed by medical treatment.

Choice C:

Electrolyte imbalance alters neuronal excitability and neurotransmission. Severe hyponatremia produces cerebral edema and confusion, while hypercalcemia causes lethargy and impaired memory. These changes are reversible once corrected, making electrolyte imbalance the most likely cause of reversible dementia.

Choice D:

HIV disease can cause HIV-associated neurocognitive disorder. Although antiretroviral therapy may slow progression, neuronal injury from viral replication and inflammation is not fully reversible, making this an incorrect option.

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Question 3:

A client newly diagnosed with vascular dementia isolates themselves because of consistently poor role performance and increasing loss of independent functioning. Which nursing diagnosis reflects this client’s problem?

A. Disturbed thought processes related to decreased cerebral circulation as evidenced by disorientation. B. Risk for injury related to poor role performance as evidenced by decreased functioning. C. Disturbed body image related to loss of independent functioning as evidenced by tearful, sad affect. D. Low self-esteem related to loss of independent functioning as evidenced by social isolation.

Answer and Explanation

Choice A:

Disturbed thought processes are common in vascular dementia, but the stem emphasizes isolation and poor role performance, not disorientation. The problem is primarily psychosocial rather than cognitive in this context, making this less appropriate.

Choice B:

Risk for injury relates to impaired mobility, confusion, or unsafe behaviors. The stem highlights social withdrawal and role loss, not falls or physical hazards. Injury prevention is important but not the priority issue described here.

Choice C:

Disturbed body image involves altered perception of the physical self, often linked to disfigurement or illness. Tearful affect here stems from loss of independence and social isolation, not distorted body perception, so this diagnosis does not fit.

Choice D:

Loss of independent functioning directly impacts the client’s self-esteem. Social isolation reflects withdrawal due to inability to perform roles, consistent with DSM-5 criteria for major neurocognitive disorder. Addressing self-esteem supports psychosocial adaptation and prevents worsening depression.

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Question 4:

A nurse is reviewing examples of treatable (reversible) forms of neurocognitive disorder (NCD). Which of the following causes are treatable? Select all that apply.

A. Multiple sclerosis. B. Multiple small brain infarcts. C. Electrolyte imbalances. D. HIV disease. E. Folate deficiency.

Answer and Explanation

Choice A:

Multiple sclerosis causes chronic, progressive demyelination; cognitive deficits are part of a non-reversible neurodegenerative process, so it is not fully treatable.

Choice B:

Multiple small brain infarcts (vascular dementia) lead to irreversible neuronal loss. While risk factors can be managed, existing cognitive deficits are generally not reversible.

Choice C:

Electrolyte imbalances (e.g., sodium, calcium, or potassium disturbances) can disrupt neuronal function, causing confusion or cognitive deficits. Correcting the imbalance often reverses cognitive impairment quickly.

Choice D:

HIV-related cognitive impairment can be improved with antiretroviral therapy, especially in early stages, making it a reversible cause of NCD if treated appropriately.

Choice E:

Folate deficiency impairs DNA synthesis and neurotransmitter function, leading to cognitive decline. Supplementation with folic acid can restore cognitive function if caught early.

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Question 5:

A client has been diagnosed with neurocognitive disorder (NCD) due to Alzheimer’s disease. The cause of this disorder is which of the following?

A. Multiple small brain infarcts. B. Chronic alcohol abuse. C. Cerebral abscess. D. Unknown.

Answer and Explanation

Choice A:

Multiple small brain infarcts cause vascular NCD, a different, usually treatable or preventable form of cognitive impairment, not Alzheimer’s disease.

Choice B:

Chronic alcohol abuse can lead to alcohol-related NCD (e.g., Wernicke-Korsakoff syndrome), which is distinct from Alzheimer’s.

Choice C:

A cerebral abscess is an infectious lesion that may cause delirium or secondary NCD, but it is not related to Alzheimer’s disease.

Choice D:

Alzheimer’s disease is considered idiopathic, meaning the precise etiology is not fully understood. While genetic, biochemical, and environmental factors contribute to pathophysiology, there is no single identifiable cause.

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