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HERE IS A SAMPLE – NOT THE FULL CHAPTER ***

Nursing: A Concept-Based Approach to Learning, Volume II, 2e (Pearson)
Module 23 Cognition

The Concept of Cognition

1) The family of an 82-year-old client is concerned about the changes in the client’s behavior. The client used to be a wonderful cook but now cannot even remember how to use a blender. For which causes of impaired cognitive function should the nurse assess the client?
Select all that apply.
A) Obesity
B) Nutritional deficiencies
C) Medication reactions
D) Stroke
E) Snoring
Answer: B, C, D
Explanation: A) Any change or deviation from normal in an individual’s cognitive function should be evaluated. Nutritional deficiencies, medication reactions, and stroke are conditions that can result in impaired cognitive ability. Snoring and obesity are not conditions noted to result in impaired cognitive functioning.
B) Any change or deviation from normal in an individual’s cognitive function should be evaluated. Nutritional deficiencies, medication reactions, and stroke are conditions that can result in impaired cognitive ability. Snoring and obesity are not conditions noted to result in impaired cognitive functioning.
C) Any change or deviation from normal in an individual’s cognitive function should be evaluated. Nutritional deficiencies, medication reactions, and stroke are conditions that can result in impaired cognitive ability. Snoring and obesity are not conditions noted to result in impaired cognitive functioning.
D) Any change or deviation from normal in an individual’s cognitive function should be evaluated. Nutritional deficiencies, medication reactions, and stroke are conditions that can result in impaired cognitive ability. Snoring and obesity are not conditions noted to result in impaired cognitive functioning.
E) Any change or deviation from normal in an individual’s cognitive function should be evaluated. Nutritional deficiencies, medication reactions, and stroke are conditions that can result in impaired cognitive ability. Snoring and obesity are not conditions noted to result in impaired cognitive functioning.
Page Ref: 1578
Cognitive Level: Analyzing
Client Need: Psychosocial Integrity
Nursing Process: Assessment
Learning Outcome: 1. Summarize the physiology of the neurological system in relationship to cognition.

2) An older client with no history of cognitive impairment is showing signs of increased confusion. Which health problem should the nurse suspect is causing this client’s confusion?
A) Cataracts
B) Hypertension
C) Urinary tract infection
D) Lower back strain
Answer: C
Explanation: A) A new disorder such as an infection can increase confusion in the older client. Hypertension, lower back strain, and cataracts are not conditions that are known to cause signs of confusion in older adults.
B) A new disorder such as an infection can increase confusion in the older client. Hypertension, lower back strain, and cataracts are not conditions that are known to cause signs of confusion in older adults.
C) A new disorder such as an infection can increase confusion in the older client. Hypertension, lower back strain, and cataracts are not conditions that are known to cause signs of confusion in older adults.
D) A new disorder such as an infection can increase confusion in the older client. Hypertension, lower back strain, and cataracts are not conditions that are known to cause signs of confusion in older adults.
Page Ref: 1578
Cognitive Level: Analyzing
Client Need: Physiological Integrity
Nursing Process: Assessment
Learning Outcome: 1. Summarize the physiology of the neurological system in relationship to cognition.

3) An older client complains of periods of confusion and forgetfulness, but reports clear thought process at most times of the day. What is the an appropriate response of the nurse?
A) “Are you having trouble hearing?”
B) “You probably have nothing to worry about. It’s most likely stress-related.”
C) “Everybody has a few problems with memory as they get older.”
D) “You should probably have an MRI of your brain.”
Answer: A
Explanation: A) People who cannot hear or see well often appear confused. The nurse should assess whether the client is having difficulty with these prior to moving on in the assessment process. A nurse should never discount the client’s concerns, and memory loss with confusion and forgetfulness is not part of the normal aging process. The nurse needs to explore further before an expensive diagnostic study is considered. It would be beyond the scope of practice for the nurse to recommend this testing.
B) People who cannot hear or see well often appear confused. The nurse should assess whether the client is having difficulty with these prior to moving on in the assessment process. A nurse should never discount the client’s concerns, and memory loss with confusion and forgetfulness is not part of the normal aging process. The nurse needs to explore further before an expensive diagnostic study is considered. It would be beyond the scope of practice for the nurse to recommend this testing.
C) People who cannot hear or see well often appear confused. The nurse should assess whether the client is having difficulty with these prior to moving on in the assessment process. A nurse should never discount the client’s concerns, and memory loss with confusion and forgetfulness is not part of the normal aging process. The nurse needs to explore further before an expensive diagnostic study is considered. It would be beyond the scope of practice for the nurse to recommend this testing.
D) People who cannot hear or see well often appear confused. The nurse should assess whether the client is having difficulty with these prior to moving on in the assessment process. A nurse should never discount the client’s concerns, and memory loss with confusion and forgetfulness is not part of the normal aging process. The nurse needs to explore further before an expensive diagnostic study is considered. It would be beyond the scope of practice for the nurse to recommend this testing.
Page Ref: 1578
Cognitive Level: Applying
Client Need: Physiological Integrity
Nursing Process: Assessment
Learning Outcome: 2. Examine the relationship between cognition and other concepts/systems.

4) The nurse is working with a group of parents of children with intellectual disabilities. What should the nurse recommend to support environmental safety for these children?
Select all that apply.
A) Have parents maintain a regular schedule for activities.
B) Teach emotional safety.
C) Use medications to decrease agitation.
D) Provide aids to assist with orientation.
E) Turn the temperature down on the hot water heater.
Answer: B, E
Explanation: A) Turning the temperature down on the hot water heater will help to prevent accidental burns when bathing or washing dishes. Teaching emotional safety can decrease the risk of physical or sexual abuse. Using therapeutic measures to decrease agitation is recommended for clients with high risk for other-directed violence. Although a routine daily schedule and orientation aids will structure the client’s environment to promote optimal orientation, they will not necessarily improve environmental safety.
B) Turning the temperature down on the hot water heater will help to prevent accidental burns when bathing or washing dishes. Teaching emotional safety can decrease the risk of physical or sexual abuse. Using therapeutic measures to decrease agitation is recommended for clients with high risk for other-directed violence. Although a routine daily schedule and orientation aids will structure the client’s environment to promote optimal orientation, they will not necessarily improve environmental safety.
C) Turning the temperature down on the hot water heater will help to prevent accidental burns when bathing or washing dishes. Teaching emotional safety can decrease the risk of physical or sexual abuse. Using therapeutic measures to decrease agitation is recommended for clients with high risk for other-directed violence. Although a routine daily schedule and orientation aids will structure the client’s environment to promote optimal orientation, they will not necessarily improve environmental safety.
D) Turning the temperature down on the hot water heater will help to prevent accidental burns when bathing or washing dishes. Teaching emotional safety can decrease the risk of physical or sexual abuse. Using therapeutic measures to decrease agitation is recommended for clients with high risk for other-directed violence. Although a routine daily schedule and orientation aids will structure the client’s environment to promote optimal orientation, they will not necessarily improve environmental safety.
E) Turning the temperature down on the hot water heater will help to prevent accidental burns when bathing or washing dishes. Teaching emotional safety can decrease the risk of physical or sexual abuse. Using therapeutic measures to decrease agitation is recommended for clients with high risk for other-directed violence. Although a routine daily schedule and orientation aids will structure the client’s environment to promote optimal orientation, they will not necessarily improve environmental safety.
Page Ref: 1575
Cognitive Level: Applying
Client Need: Safe and Effective Care Environment
Nursing Process: Implementation
Learning Outcome: 3. Identify commonly occurring alterations in cognition and their related therapies.