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Alzheimer’s Disease Dementia NCLEX Quiz
Alzheimer’s disease nursing NCLEX quiz review for students!
Alzheimer’s disease (AD) is a type of dementia caused by the formation of beta-amyloid plaques and neurofibillary tangles in the brain. This causes the neurons to cease communication and eventually die. This disease is a chronic disease that progressively becomes worst over years. It tends to affect older adults greater than the age of 65 years.
This quiz will test your knowledge on the pathophysiology of Alzheimer’s disease, the nurse’s role, communication techniques, stages of Alzheimer’s Disease, medications, and more. Before taking this quiz, you might want to review our Alzheimer’s disease video , or our alzheimer’s disease NCLEX notes .
Alzheimer's Disease Dementia NCLEX Quiz
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Alzheimer’s Disease NCLEX Quiz Questions
1. Which statement below is INCORRECT about Alzheimer’s disease?
- A. It’s the 5th leading cause of death for adults over 65.
- B. Alzheimer’s disease is more likely to develop in men rather than women.
- C. Most patients typically start showing signs and symptoms of this disease after the age of 60.
- D. Hispanics and African Americans are at higher risk for developing Alzheimer’s disease.
The answer is B. Alzheimer’s disease is more likely to develop in WOMEN (not men) because they tend to live longer. All the other statements are true regarding AD.
2. The exact cause of Alzheimer’s disease is not fully understood. However, what two changes in the brain are found in a patient with this disease? Select all that apply:
- A. Destruction of the myelin sheath on the neuron
- B. Development of beta-amyloid plaques in between neurons
- C. Destruction of dopaminergic neurons
- D. Creation of neurofibrillary tangles within the neuron
The answers are B and D. Beta-amyloid plaques and neurofibrillary tangles are found in a patient with AD. Option A (destruction of the myelin sheath) happens in multiple sclerosis, and option C (destruction of dopaminergic neurons) occurs in Parkinson’s disease.
3. A neuron is made up of a cell body which contains the nucleus. In addition, it has dendrites. What is the function of the dendrite?
- A. Give structure to the cell body and help keep the neuron functioning
- B. To receive information for other nerves cells and take that information to the cell body
- C. Take information it receives away from the cell body and to other dendrites of neurons
- D. Release neurotransmitters at the synaptic junctions to relay messages
The answer is B. Dendrites receive information for other nerves cells and take that information to the cell body.
4. True or False: The axon of a neuron takes information it receives away from the cell body and to other dendrites of neurons.
The answer is true. This is the function of an axon.
5. Surrounding the neuron are cells that help protect its ability to function. Which cell type provides safety to the neuron by removing dangerous material that could damage the neuron?
- A. Microglia
- B. Ependymal cells
- C. Astrocytes
- D. Oligodendrocyte
The answer is A: microglia These cells play a role with inflammation that is found in Alzheimer’s Disease.
6. In Alzheimer’s disease, what protein is responsible for creating amyloid beta peptides which develop into plaques?
- A. Tau proteins
- B. Postsynaptic proteins (PSP)
- C. Amyloid precursor proteins (APP)
- D. Beta-synuclein
The answer is C: Amyloid precursor proteins (APP) are responsible for creating amyloid beta peptides. These small peptides form together and create plaques outside the neuron called beta-amyloid plaques (this impedes neuron communication and causes death of the neuron).
7. Neurofibrillary tangles found in Alzheimer’s disease are made up of a protein called ________. What is the role of these proteins?
- A. Beta-amyloid; delivers nutrients to the neuron
- B. Amyloid precursor protein; promotes neurotransmitter released at the synaptic junction
- C. Tau; provides structural strength to microtubules in the neuron
- D. Microglia; removes debris from outside the neuron
The answer is C: Neurofibrillary tangles found in Alzheimer’s disease are made up of a protein called Tau. Tau proteins provide structural strength to microtubules in the neuron.
8. In early stages of Alzheimer’s disease, the hippocampus is affected. This part of the brain is responsible for what function(s)? Select all that apply:
- A. Learning
- B. Navigation
- D. Language
- E. Planning
The answers are: A, B, and C. The hippocampus tends to be affected first in AD. This structure is important for being able to learn new things, recall memories (especially recent ones), and navigation (due to its function with spatial memory). This structure is affected early on, and this is why patients start to have memory problems and can get lost easily (losing function of spatial memory).
9. Alzheimer’s disease also affects the neurons found in the outside layer that surrounds the top of the cerebrum. This area is made up of different lobes such as the frontal, parietal, temporal, and occipital lobes. What is this area of the brain called?
- A. Corpus callosum
- B. Cerebral cortex
- C. Amygdala
- D. Cerebellum
The answer is B: cerebral cortex It’s important to note that in advance cases of AD, the cerebral cortex will shrink, leading to brain atrophy.
10. A patient with Alzheimer’s disease is having trouble performing the movements needed to use their toothbrush for mouth care. This is described as?
The answer is B: Apraxia
11. Which finding in a patient with Alzheimer’s disease best describes the term agnosia?
- A. The patient uses a fork to eat a bowl of soup.
- B. The patient makes up a word to recall the name of an object.
- C. The patient can’t recall their address.
- D. The patient is unable to perform the movements needed to use their hair brush.
The answer is A. Option b describes anomia, option c describes amnesia, option d describes apraxia.
12. You’re helping a patient with hygiene. The patient is having trouble asking you for a particular bathing item. The patient wants the soap bar but makes up a name for the item. This is known as what?
The answer is C: Anomia
13. A patient was recently diagnosed with Mild Alzheimer’s (Early-stage Alzheimer’s disease). What important educational topics should the nurse provide to this patient at this time? Select all that apply:
- A. Progression of the disease
- B. Future planning
- C. Surgical options
- D. Medications
The answers are A, B, and D. There are no surgical options for AD and no curative treatment at this time. During this early-stage the patient is still able to function and be independent, but this will not last too long (may be a couple of years…depends on the patient) until they will need constant help. This is the time the nurse needs to tell the patient about the progression of the disease (what to expect), medications available, and the need for future planning.
14. A patient is starting to experience memory changes that are subtle but doesn’t affect their ability to function. For example, they are forgetting recent commitments and new people they’ve met or recent conversations. The patient reports feeling like “something just isn’t right”. This describes what stage of Alzheimer’s disease?
- A. Preclinical Alzheimer’s Disease
- B. Mild Alzheimer’s Disease (early-stage)
- C. Mild Cognitive Impairment
- D. Moderate Alzheimer’s Disease (Middle Stage)
The answer is C: Mild Cognitive Impairment
15. Select all the correct options below that best describe the Moderate Alzheimer’s Disease (Middle Stage) of AD?
- A. Longest stage
- B. Patient is able to function (move around, talk etc.)
- C. Patient is confused to the point they need supervision
- D. Experiences mood swings
- E. May wander
- F. Stage last a couple of years
- G. When most patients are diagnosed
- H. Communication is minimal
- I. Caregiver fatigue is experienced
The answers are: A, B, C, D, E, I. This is the longest stage that is very hard for the caregivers (family members etc.). Many caregivers, at some point, will experience fatigue and stress during this stage. The discussion of respite care for the caregiver should be discussed (this will help provide a temporary break for the caregiver). The patient is very active during this stage, but has confusion and impaired judgement. They must be supervised. In addition, they may have episode of mood swings, hallucinations, and wander, which may lead them to get lost or injured.
16. The nurse is providing routine care for a patient with Severe Alzheimer’s disease (late stage). The patient has no motor activities or language communication abilities. What are some nursing interventions the nurse can implement to promote patient interaction and communication? Select all that apply.
- A. Limit interaction to verbal communication
- B. Use touch when appropriate
- C. Incorporate nonverbal communication
- D. Have music and imagery available during the day
- E. Identify yourself to the side of the patient rather than directly in front
The answers are B, C, and D. Communication and interaction is still very essential in the late-stage of Alzheimer’s disease. Even though the patient may not be able to speak or move around, communication and interaction are vitally important for providing quality patient care and a loving environment for the patient. The nurse should try to incorporate nonverbal communication as much as possible like facial expression and body gestures. This is because even though the patient may not understand the words spoken, they may understand the nonverbal communication. Touch should be used when needed to reassurance or let the patient know you care along with soft music and other tools to provide a calm, interactive environment.
17. During the evening hours you notice your patient with Moderate Alzheimer’s Disease (Middle Stage) begins to experience an increase in confusion, agitations, and hallucinations. What intervention below could the nurse implement to help decrease this occurrence?
- A. Provide the patient with coffee at bedtime
- B. Provide a relaxing and low noise environment in the evening
- C. Use stimulating distractions at night
- D. Limit patient’s contact with sunlight during the day
The answer is B: Provide a relaxing and low noise environment in the evening This phenomenon is known as Sundowner’s Syndrome. Patients with AD can experience this during the evening hours. It can be triggered by exhaustion, low lighting (not experiencing enough contact with sunlight during the day), sickness, and medications. The nurse should promote a calm, relaxing environment and avoid stimulating activities that could cause fatigue. Caffeine (coffee) can make Sundowning worst.
18. You’re providing education about testing for Alzheimer’s disease. Which tests below can a patient have to check for beta-amyloid proteins in the brain? Select all that apply:
- B. Spinal tap
- C. PET scan
- D. MRI scan
The answers are B and C. Currently, cerebrospinal fluid can be removed via a spinal tap to check for these proteins along with an amyloid PET scan. Recently, a new blood test has been created that can detected these proteins but may not be readily available for all patient at this time.
19. A patient is concerned about developing Alzheimer’s disease because their mother had the disease. What statement below could the nurse provide to the patient about genetic testing for Alzheimer’s disease? Select all that apply:
- A. Genetic testing is readily available at most doctor offices for this disease and should be discussed with the physician.
- B. A genetic test is available that assesses for ApoE-4 (Apolipoprotein E).
- C. Genetic testing is not routinely ordered but for research purposes.
- D. A positive genetic testing result means you will develop the disease.
The correct answers are B and C.
20. The nurse is helping a patient with Moderate Alzheimer’s disease (Middle Stage) participate in a task. When selecting a task for the patient, the nurse would want to make sure the task has?
- A. Multiple steps
- B. Clear simple directions
- C. Critical thinking
- D. Usage of multiple tools
The answer is B: clear simple directions. Patients with this stage of AD can follow directions that are simple and clear. It is best to avoid tasks that require multiple steps, critical thinking, and usage of multiple tools. This could confuse the patient and lead to outbursts of anger.
21. You’re providing education to a group of caregivers about wandering in Alzheimer’s disease. You ask the participants to verbalize signs a family member with this disease may be experiencing wandering. Which sign verbalized by a participant requires re-education?
- A. The family member takes longer than expected to return from a place.
- B. The family member repeatedly requests to visit an old acquaintance.
- C. The family member refuses to leave their bedroom.
- D. The family member has trouble finding rooms within the house.
The answer is C. Options A, B, D are all signs the patient is at risk for wandering. Wandering can lead the patient to become lost. Signs of wandering should be addressed and prevention measures should be taken to help protect the safety of the patient.
22. A family member who is the caregiver for a patient with Moderate Alzheimer’s disease (Middle Stage) asks for advice on safety measures that can be taken to keep the patient safe due to wandering. Which option below is NOT an appropriate safety measure for the caregiver to take?
- A. Display signs throughout the house to identify the rooms
- B. Consider a GPS tracking device system for the patient
- C. Encourage social interaction by taking the patient to a shopping mall
- D. Obscure assess to exit doors and windows
The answer is C: Encourage social interaction by taking the patient to shopping mall. Wandering is experienced by many patients with AD. It tends to become worst during the early evening. Triggers for wandering include being in stressful, crowded, unfamiliar areas (avoid a shopping mall…they tend to be busy and unfamiliar for the patient), needs a basic need met like a bathroom, trying to do a routine they have always done before, or restless from inactivity (the patient needs regular exercise).
23. The nurse is speaking to a patient with Moderate Alzheimer’s disease (Middle Stage). The patient is sitting in the bedside chair and is about to eat breakfast. Which action by the nurse demonstrates the nurse knows how to communicate with this patient correctly?
- A. The nurse approaches the patient from behind to initiate conversation.
- B. The nurse asks “Do you want orange juice with breakfast?”
- C. The nurse leaves the TV on while talking with the patient.
- D. The nurse stands over the patient while conversing with the patient.
The answer is B. This option is correct because the nurse is using a closed-ended question which requires a yes or no answer rather than an opened-ended like “what do you want to drink with breakfast?”. This type of question requires more thought and can confuse the patient. Option A is wrong because the nurse should approach the patient directly in the front rather than behind (this could scare the patient and lead to an emotional outburst). Option C is wrong because the nurse should eliminate outside noise so the patient can hear and concentrate on the conversation. Option D is wrong because the nurse should communicate on eye level rather than standing over the patient. The patient with AD may feel intimated by this.
24. A caregiver reports that their family member with Alzheimer’s disease does not have interest in eating. They request some advice on how to help their family member eat better. What intervention below would be incorrect for the nurse to give?
- A. Eat with the family member for meals
- B. Keep the eating environment free from outside noise and well lit
- C. Serve the family member a variety of food items on their plate
- D. Select healthy but tasty soft finger foods
The answer is C. A person with AD can become easily overwhelmed, especially by a full plate of food. Therefore, it’s important to not overwhelm the patient with options, but to serve them one food item at a time that they like.
25. A patient with Alzheimer’s disease is prescribed a cholinesterase inhibitor. Which of the following medications below is NOT this type of medication?
- A. Galantamine
- B. Rivastigmine
- C. Memantine
- D. Donepezil
The answer is C: Memantine This is a NMDA antagonist.
26. Select the statement below that best describes how Galantamine works to treat a patient with Alzheimer’s disease.
- A. “This medication decreases the amount of glutamate readily available at the receptor site.”
- B. “Galantamine prevents the breakdown of acetylcholine.”
- C. “This medication decreases the levels of acetylcholine in the brain.”
- D. “Galantamine decrease beta-amyloid plaques in the brain.”
The answer is B. Galantamine is a cholinesterase inhibitor and works to prevent the breakdown of acetylcholine by inhibiting the enzyme cholinesterase.
27. A patient taking a cholinesterase inhibitor is experiencing nausea and diarrhea. These side effects can be decreased by doing which of the following?
- A. Administering the medication on an empty stomach
- B. Administering the medication with meals
- C. Administering the medication two hours before a meal
- D. Administering the medication at bedtime
The answer is B. This medication group can lead to GI upset. If this occurs, administering the med with meals can help decrease this side effect.
28. A patient with Severe Alzheimer’s Disease is prescribed to take Memantine. Which statement best describes how this medication works to treat this disease?
- A. “It increases acetylcholine levels in the brain.”
- B. “It prevents the enzyme cholinesterase from working.”
- C. “It limits how glutamate can engage the NMDA receptor in the brain.”
- D. “It decreases beta amyloid plaques in the brain.”
The answer is C. Memantine is an NMDA receptor antagonist that limits how glutamate can engage the NMDA receptor in the brain.
29. What medication is relatively new that is given by IV infusion that can help decrease beta amyloid plaques in patients with Alzheimer’s disease?
- A. Memantine
- B. Galantamine
- C. Donepezil
- D. Aducanumab
The answer is D. Aducanumab. Before a patient takes this medication their doctor may order diagnostic testing to confirm plaques are present like spinal tap or amyloid PET scan. Side effects are a potential brain bleed or swelling and will need brain scans periodically to monitor the brain.
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