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Hands-on Clinic => Nursing and Clinical => Topic started by: tth on Jun 25, 2018

Title: A 78-year-old female comes to the clinic for a physical examination. She is accompanied by her ...
Post by: tth on Jun 25, 2018

A 78-year-old female comes to the clinic for a physical examination. She is accompanied by her daughter and looks to her daughter to answer questions during the interview.
 
  She was diagnosed with early Alzheimer's disease 2 years ago, and her daughter would like her current mental status evaluated.
  You ask the patient her daughter's name, and she answers correctly. You ask her the date and time, and she answers incorrectly. You hand the patient a pencil and ask her if she knows what it is. She replies with, Is it a stick? You ask the patient to put on a patient gown, and she does not know how to perform the task. These are examples of disorientation to time and:
  A. Agnosia and apraxia
  B. Anomia and aphasia
  C. Agnosia and ataxia
  D. Apathy and ataxia

Question 2

You are an emergency room clinician that assisted with CPR on a 20-year-old trauma patient. The CPR was unsuccessful, the patient expired, and you need to explain this to the family in the waiting room.
 
  Upon telling the mother about the death of her son, she becomes dizzy and faints. What is the most likely cause for the woman fainting?
  A. Cardiogenic shock
  B. Vasovagal response
  C. Syncope due to hypoxia
  D. Dizziness and vertigo

Title: A 78-year-old female comes to the clinic for a physical examination. She is accompanied by her ...
Post by: Bsand8 on Jun 25, 2018

Answer to Question 1

ANS: A
Most organic dementias develop over months to years. There are typically no physical motor or sensory alterations until the condition is advanced. Memory impairment is the predominant symptom. There may be impairment in another area of cognitive functioning, such as with aphasia (producing language as well as understanding it), agnosia (perceptual impairment of environment), apraxia (inability to perform complex motor acts), and impairment in executive functioning (inability to plan, organize, sequence, and think abstractly). Ataxia is not a symptom of dementiait is a problem with gait usually due to cerebellar dysfunction.

Answer to Question 2

ANS: B
Neurocardiogenic syncope, also called vasovagal syncope, is a common cause of dizziness and fainting. It is due to a sudden decrease in blood pressure and heart rate after prolonged standing, with stress, or from dehydration. It is a result of sympathetic sensitivity, causing a reflexive response that suddenly causes bradycardia and venous dilation. Hypotension and dizziness result.