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How to Try This: Delirium Superimposed on Dementia

AJN, American Journal of Nursing: January 2008 - Volume 108 - Issue 1 - p 61
doi: 10.1097/01.NAJ.0000305130.56712.c3
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1. According to Fick and colleagues, the prevalence rate of delirium in people with dementia in the community is

a. 22%.

b. 44%.

c. 66%.

d. 88%.

2. Which statement about delirium is correct?

a. It is rare in older adults.

b. It is potentially life threatening.

c. It is characterized by gradual changes in attention.

d. It rarely affects cognition.

3. All of the following laboratory values suggest infection or dehydration except

a. white blood cell count of 20 × 103/mm3.

b. blood urea nitrogen level of 45 mg/dL.

c. serum creatinine level of 2 mg/dL.

d. fasting blood sugar level of 70 mg/dL

4. Inouye and colleagues found that

a. up to 65% of older adults are hospitalized with delirium.

b. up to 56% of older adults develop delirium during hospitalization.

c. about 23% of all adults 85 years and older have dementia.

d. more men than women develop delirium with dementia when they are hospitalized.

5. According to Fick and colleagues, about how many nurses recognize cases of hypoactive delirium?

a. 1%

b. 21%

c. 41%

d. 61%

6. The primary tool for identifying the presence of delirium is the

a. Confusion Assessment Method (CAM).

b. Folstein Mini-Mental State Examination.

c. Geriatric Depression Scale.

d. Short Portable Mental Status questionnaire.

7. Which of these can be considered a normal finding in people with dementia?

a. inattention

b. altered level of consciousness

c. fluctuating mental status

d. disorganized thinking

8. Which class of drugs is especially associated with delirium?

a. anticholinergics

b. nonsteroidal antiinflammatory drugs

c. tricyclic antidepressants

d. aminoglycosides

9. All of the following are recommended to decrease the risk of delirium in hospitalized patientsexcept

a. using sedatives to promote sleep.

b. providing passive range of motion exercises.

c. having a family member stay with the patient.

d. providing sensory aides.

10. According to the article, the biggest challenge of delirium superimposed on dementia is

a. preventing its occurrence.

b. treating the condition.

c. explaining the condition to the family.

d. recognizing the condition in the first place.

11. Which statement about the CAM is correct?

a. The specificity ranges from 65% to 85%.

b. It has established reliability and validity in people with dementia.

c. The sensitivity ranges from 25% to 50%.

d. It is equally effective when used by nurses not trained and nurses trained in its use.

12. The CAM identifies delirium if which of the following is (are) present?

a. mental status altered from baseline and inattention

b. mental status altered from baseline or inattention

c. disorganized thinking and altered level of consciousness

d. a change in the patient's ability to perform activities of daily living

13. A plan of care addressing the cause of delirium might include

a. withdrawing medication.

b. beginning physical therapy.

c. administering sedatives.

d. increasing environmental stimuli.

14. Delirium increases vulnerability to

a. insomnia.

b. restless legs syndrome.

c. respiratory depression.

d. skin breakdown.

© 2008 Lippincott Williams & Wilkins, Inc.