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Chapter 10: Cognition and Perception Test Bank MULTIPLE CHOICE 1. What does perception refer to in the environment? a. Intellect b. Memory c. Judgment d. Interpretation ANS: D
Perception refers mainly to the ability to interpret situations in the environment. DIF: Cognitive Level: Knowledge REF: p. 180 OBJ: 1 TOP: Perception vs. Cognition KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 2. What observation would cause the nurse to suspect cataracts in the older adult? a. Holds the newspaper a good distance away while attempting to read small print b. Seeks an area in a room that is free from glare in order to read the newspaper c. Holds a hand over one eye while attempting to read small print d. Uses only peripheral vision while attempting to read a newspaper ANS: B
Cataracts blur the vision and increase the sensitivity to glare. DIF: Cognitive Level: Analysis REF: p. 181 OBJ: 3 TOP: Cataracts KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 3. How should the nurse approach a patient who has profound hearing loss? a. Knock on the door before entering. b. Touch the patient on the hand to gain attention. c. Give the patient a list of interventions that the nurse plans to perform. d. Speak in a higher tone of voice. ANS: B
Touching on the hand to gain attention before giving care is thoughtful. Giving a lengthy list is not necessary. Knocking on the door may be futile, and speaking in higher tones is not helpful because the hearing-impaired lose the ability to hear high tones first. DIF: Cognitive Level: Comprehension REF: p. 183 OBJ: 7 TOP: Hearing Impairment KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 4. When attempting to communicate with a patient who is hearing-impaired, what should the
nurse consider? a. Keep the message simple. b. Provide lengthy explanations and information. c. Assume understanding if the patient does not ask for clarification.
d. Use many hand gestures. ANS: A
Keeping the message simple will assist the hard of hearing to understand. Long explanations and the use of many hand gestures may be confusing. It is the responsibility of the nurse to check to confirm understanding. DIF: Cognitive Level: Comprehension REF: p. 183 OBJ: 7 TOP: Communication with the Hearing-Impaired KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 5. How should the nurse adapt the environment for a person with right-sided hemianopsia? a. Approach the patient from the right side. b. Arrange personal articles on the left side of the bed. c. Remind the patient to avoid turning his or her head to reduce added perceptual
problems. d. Touch the patient on the right side to get his or her attention. ANS: B
Arrangement of personal items on the “good” left side is supportive to independence. DIF: Cognitive Level: Application REF: p. 184 OBJ: 7 TOP: Hemianopsia KEY: Nursing Process Step: Planning MSC: NCLEX: Physiological Integrity: Physiological Adaptation 6. The nurse hears a high whistling noise coming from the hearing aids that are lying on the
bedside table of the sleeping patient. What would be the most appropriate action by the nurse? a. Replace the hearing aids in the patient’s ears. b. Turn off the hearing aids. c. Place the hearing aids in a drawer to prevent loss. d. Ask that an audiologist be notified of the problem. ANS: B
The noise is feedback between the two active hearing aids. They should be turned off to preserve the batteries. DIF: Cognitive Level: Application REF: pp. 184-185 OBJ: 7 TOP: Hearing Aids KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 7. What assessment finding would be indicative of delirium? a. The onset of the behavior was rapid. b. There is no change in the level of consciousness. c. The absence of disorientation. d. The absence of hallucinations. ANS: A
Delirium comes on suddenly and is accompanied by a change in the level of consciousness, disorientation, and hallucinations. DIF: Cognitive Level: Application REF: p. 186 TOP: Delirium KEY: Nursing Process Step: Assessment
OBJ: 4
MSC: NCLEX: Physiological Integrity: Physiological Adaptation 8. Which condition could cause delirium in the older adult? a. Uncontrolled pain b. Death of a loved one c. Relocation to a long-term care facility d. Altered sleep patterns ANS: A
Delirium results from physiological influences such as uncontrolled pain, metabolic disturbances, or drug toxicity. DIF: Cognitive Level: Comprehension REF: p. 186 OBJ: 3 TOP: Delirium KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 9. The physician states that the patient with Alzheimer disease has progressed from the
preclinical stage of the disease to the mild cognitive impairment stage. What would the nurse expect to find upon assessment of the patient? a. Inability to communicate b. Incontinent episodes c. Total dependency d. Forgetfulness ANS: D
Patients in the mild cognition impairment stage of Alzheimer disease will have some forgetfulness. The inability to communicate, incontinent episodes, and total dependency are indicative of the dementia stage of the disease. DIF: Cognitive Level: Application REF: Box 10-5, p. 188 OBJ: 4 TOP: Stages of Alzheimer Disease KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 10. How can continuity of care be provided for a demented patient in the hospital setting? a. Keep the patient in the room. b. Reduce environmental stimuli such as the TV or radio. c. Assign care to a consistent group of staff. d. Attach a bed alarm to the patient. ANS: C
Assigning the same personnel helps the demented patient have continuity of care. DIF: Cognitive Level: Application REF: p. 190 OBJ: 7 TOP: Dementia KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 11. What is an appropriate response by the nurse to a demented resident in a long-term care
facility who becomes combative when being prepared for a shower? a. Call for assistance to complete the shower. b. Say, “I understand you don’t want a shower, so I’ll give you a sponge bath.” c. Medicate the patient with a sedative and complete the bath when the patient is
more cooperative. d. Say, “Okay. It’s your right to remain dirty.” ANS: B
Focusing on feelings or offering an alternative is helpful with a combative demented patient. Arguing serves no purpose other than to make the resident more upset. DIF: Cognitive Level: Application REF: p. 189 OBJ: 7 TOP: Combative Patient KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 12. Antipsychotic medication can be prescribed to control which of the following? a. Disruptive verbal behavior b. Constant yelling and hitting others c. Hallucinations d. Disorientation ANS: B
The current Omnibus Budget Reconciliation Act (OBRA) prohibits the use of antipsychotic drugs to control nonaggressive behavior. However, antipsychotic drugs may be prescribed for the control of constant yelling and hitting others. DIF: Cognitive Level: Application REF: p. 190 OBJ: 7 TOP: Use of Antipsychotic Drugs KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Pharmacological Therapies 13. What would be the most effective intervention by the nurse when a patient with a cognitive
disorder begins to exhibit delusional behavior as a result of excessive stimulation? a. Medicate with a psychoactive drug such as lorazepam or diazepam. b. Send the patient to his or her room for “time out.” c. Remind the patient that acting out behavior will not be tolerated. d. Distract the patient with a quiet activity. ANS: D
Distraction with a quiet activity and with interpersonal contact frequently distracts the patient and allows the nurse to regain control. DIF: Cognitive Level: Application REF: p. 191 OBJ: 7 TOP: Acting Out Behavior KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 14. The home health nurse is caring for a patient who has been recently diagnosed with a
cognitive disorder. How can the nurse best prepare the family for the patient’s care? a. Leave them literature about the disorder. b. Instruct them about the physiological changes that cause the disorder. c. Allow them time for expression of their feelings and grief. d. Discuss options for placement in a long-term care facility. ANS: C
Allowing time for expression of their feelings will help the family cope and begin planning how best to care for their loved one.
DIF: Cognitive Level: Application REF: pp. 191-192 TOP: Impact of Cognitive Disorder on Family KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
OBJ: 3
15. An older adult has expressive aphasia. What would be the most effective intervention for the
nurse to use to improve the patient’s communication? a. Provide flash cards with text and pictures. b. Be patient and ask him to repeat himself. c. Encourage him to practice slow speech. d. Arrange with him to blink the eyes once for “yes” and twice for “no.” ANS: A
Flash cards or pen and paper help the patient with expressive aphasia communicate. Blinking only allows the patient to answer, not communicate needs. DIF: Cognitive Level: Comprehension REF: p. 194 OBJ: 7 TOP: Expressive Aphasia KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 16. The nurse in an extended-care facility finds an 86-year-old female resident in tears and her
hearing aids on the floor. The resident says, “I’ll just be deaf! I can’t stand those things in my ears! All I can hear is static, hums, and whistles!” What would be the most helpful response by the nurse? a. “Everybody says that. I’m going to put these back in the box in your bedside table.” b. “Those are very expensive pieces of equipment. Because you paid for them, it seems to me to just be good sense to use them.” c. “Let’s put them back in. You’ll get used to them in a few days.” d. “It’s frustrating to have something not work. Let me help you replace them and after 10 minutes, I’ll help you take them out.” ANS: D
Many people who have new hearing aids report that the sounds are “tinny” and “noisy.” When first fitted, the person may be able to tolerate the hearing aids for only a few minutes a day. DIF: Cognitive Level: Comprehension REF: p. 184 OBJ: 7 TOP: Hearing Aid Adjustment KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 17. The nurse reading the history of a newly admitted 88-year-old man with dementia sees that
this resident is prone to catastrophic reactions. What behavior does the nurse expect to see in the patient? a. Excessive emotional reactions b. Combativeness with little stimulus c. Displays of self-destructive behaviors d. Displays of public exposure or sexual advances ANS: A
Catastrophic reactions are reactions that are excessively emotional. DIF: Cognitive Level: Comprehension
REF: p. 188
OBJ: 3
TOP: Catastrophic Reactions KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 18. An 84-year-old female resident with dementia in an extended-care facility rapidly paces the
halls and the common areas from right after breakfast to bedtime. What should be included in the nursing plan of care? a. Restrain the resident from pacing. b. Apply a bracelet that sounds an alarm if the resident leaves the building. c. Encourage rest by asking her to sit and have a glass of juice or a snack. d. Pace with her and engage her in conversations. ANS: C
Encourage rest periods during the day by offering a snack or juice. Pacers should not be restrained from pacing. An alarm bracelet is not necessary if no attempt to leave the building is made. Pacing with her does not result in rest periods. DIF: Cognitive Level: Application REF: p. 189 TOP: Pacing KEY: Nursing Process Step: Planning MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
OBJ: 7
MULTIPLE RESPONSE 19. Which of the following are indicators of hearing loss? (Select all that apply.) a. Understanding the female voice better than the male voice b. Reluctance to have telephone conversations c. Becoming irritable with background noise d. Turning the TV up to the loudest volume e. Responding with “off-the-wall” answers to a question ANS: B, C, D, E
Because of the higher register of the female voice and that of children, the person with a hearing impairment does not understand them well. All other options are valid indicators of hearing loss. DIF: Cognitive Level: Knowledge REF: Box 10-1, p. 182 OBJ: 4 TOP: Sensory Deficit KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 20. A nurse is teaching a family member about her mother’s memory loss. Which of the following
would be included in the teaching regarding memory loss? (Select all that apply.) a. Increases with age b. Decreases in a person with more education c. Increases with the use of antihistamines d. Decreases with the use of vitamin A e. Decreases in persons who have many varied memories ANS: A, B, E
The use of vitamin A has no memory enhancement capability. Antihistamines do not have a history of being a cause of memory loss.
DIF: Cognitive Level: Comprehension REF: p. 182 OBJ: 2 TOP: Memory Loss KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Physiological Adaptation 21. The nurse instructs a hearing-impaired patient on some methods to improve communication,
which include __________. (Select all that apply.) a. informing others of the hearing deficit b. focusing on the speaker c. facing the speaker d. requesting the speaker to shout if necessary e. asking the speaker to repeat what is not clear ANS: A, B, C, E
Shouting does not help a hearing-impaired patient to understand. All other options improve communication for a hearing-impaired person. DIF: Cognitive Level: Comprehension REF: p. 185 OBJ: 7 TOP: Hearing Impairment KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 22. What are the three types of confusion? (Select the three that apply.) a. Acute confusion b. Mixed confusion c. Idiopathic confusion d. Generic confusion e. Dementia ANS: A, C, E
The three types of confusion are acute confusion or delirium, idiopathic confusion, and dementia. DIF: Cognitive Level: Knowledge REF: pp. 185-188 OBJ: 3 TOP: Types of Confusion KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Physiological Adaptation 23. In what ways can a nurse help a demented person maintain orientation? (Select all that apply.) a. Consistently calling the patient by name, usually the first name b. Referring the patient to a calendar to note special events c. Reminding the patient about the time of day by pointing to the clock d. Calmly taking the patient to an appointment without explanation e. Reminding the patient of her or his whereabouts frequently ANS: A, B, C, E
Demented persons need a simple explanation of all procedures involved in their care. All other options are helpful in maintaining orientation for a demented patient. DIF: Cognitive Level: Application REF: pp. 189-190 OBJ: 7 TOP: Orientation Methods KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation 24. The nurse should include which factor(s) in a pain assessment? (Select all that apply.) a. What provokes it
b. c. d. e.
Location Race Severity Frequency
ANS: A, B, D, E
A patient’s race would not be included in a pain assessment. All other options are significant parts of a pain assessment. DIF: Cognitive Level: Knowledge REF: pp. 195-197 OBJ: 4 TOP: Pain Assessment KEY: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity: Basic Care and Comfort 25. What should be stressed in a teaching plan for a family caring for an older adult who is
experiencing pain? (Select all that apply.) a. Give medication before the pain becomes severe. b. Distract the patient instead of medicating. c. Pain reported by the older adult may be exaggerated. d. Delay administration to reduce the risk of addiction. e. Observe the effectiveness of the medication. ANS: A, E
Giving medication before pain is severe alleviates pain better and results in the patient requiring less medication. Assessment of the drug’s effectiveness is important to relay to the physician in the event the drug needs to be changed or the dose increased. DIF: Cognitive Level: Application REF: pp. 198-199 OBJ: 7 TOP: Pain Control KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: Basic Care and Comfort COMPLETION 26. The nurse explains that the term that describes the ability to make judgments quickly on the
basis of unfamiliar stimuli is __________ __________. ANS: fluid intelligence DIF: Cognitive Level: Knowledge REF: p. 181 OBJ: 1 TOP: Fluid Intelligence KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 27. The center for speech located in the brain is the __________ area. ANS: Broca DIF: Cognitive Level: Knowledge REF: p. 193 TOP: Broca Area KEY: Nursing Process Step: N/A
OBJ: 1 MSC: NCLEX: N/A
28. The person who is unable to identify time, place, or person to the point that he or she is unable
to make appropriate decisions is described as __________.
ANS: confused DIF: Cognitive Level: Knowledge REF: p. 186 TOP: Confusion KEY: Nursing Process Step: N/A
OBJ: 3 MSC: NCLEX: N/A