Alzheimer’s Delirium and Dementia Q 5
A family member expresses concern to a nurse about behavioral changes in an elderly aunt. Which would cause the nurse to suspect a cognitive impairment disorder?
A. Decreased interest in activities that she once enjoyed.
B. Fearfulness of being alone at night.
C. Increased complaints of physical ailments.
D. Problems with preparing a meal or balancing her checkbook.
Correct Answer: D. Problems with preparing a meal or balancing her checkbook.
Making a meal and balancing a checkbook are higher-level cognitive functions that, when unable to be performed, may signal onset of a cognitive disorder. Dementia is a disorder that is characterized by cognitive decline involving memory and at least 1 of the other domains, including personality, praxis, abstract thinking, language, executive functioning, complex attention, social and visuospatial skills. In addition to the noted decline, the severity must be significant enough to interfere with daily functionality. It is often a progressive disorder, and individuals often do not have insight into their deficits.
Option A: Depression causes feelings of sadness and/or a loss of interest in activities once enjoyed. It can lead to a variety of emotional and physical problems and can decrease the ability to function at work and at home. Depression affects an estimated one in 15 adults (6.7%) in any given year. And one in six people (16.6%) will experience depression at some time in their life. Depression can occur at any time, but on average, first appears during the late teens to mid-20s.
Option B: Autophobia is considered a situational phobia. This means that the situation of being alone or loneliness causes extreme distress. To be diagnosed with autophobia, the fear of being alone causes you so much anxiety that it interferes with daily routine.
Option C: Somatic symptom disorder is characterized by an extreme focus on physical symptoms — such as pain or fatigue — that cause major emotional distress and problems functioning. The client may or may not have another diagnosed medical condition associated with these symptoms, but the reaction to the symptoms is not normal.