Alzheimer’s Disease and Dementia: NCLEX Review
Definition:
Dementia: General term for decline in mental ability severe enough to
interfere with daily life.
Alzheimer’s Disease: Most common cause of dementia; progressive,
irreversible brain disorder causing memory loss and cognitive decline.
Common NCLEX Focus Points
Sundowning: Increased confusion/agitation in late afternoon or evening.
Delirium vs Dementia: Delirium is acute and reversible; dementia is
chronic and progressive.
🧠 NCLEX Practice Questions
Alzheimer’s Disease & Dementia: Overview + Therapeutic Communication
🔹 Overview (Q1–10)
1. Which brain area is primarily affected in Alzheimer’s disease?
A) Brainstem
B) Hippocampus
C) Cerebellum
D) Occipital lobe
✅ Answer: B) Hippocampus
Rationale: The hippocampus controls memory and is one of the first areas
affected.
2. What is the most common form of dementia?
A) Vascular dementia
B) Frontotemporal dementia
C) Alzheimer’s disease
D) Parkinson’s-related dementia
✅ Answer: C) Alzheimer’s disease
Rationale: Alzheimer’s accounts for 60–80% of all dementia cases.
3. Which is an early symptom of Alzheimer’s disease?
A) Delusions
B) Seizures
C) Getting lost in familiar places
D) Hallucinations
✅ Answer: C) Getting lost in familiar places
Rationale: Disorientation to place is an early sign.
4. What is the best way to monitor progression in a dementia client?
A) CT scan
B) Daily temperature log
C) Mental status exam and functional assessments
D) White blood cell count
✅ Answer: C) Mental status exam and functional assessments
Rationale: Tracking cognitive and functional decline helps gauge disease
progression.
5. Which of the following is NOT a reversible cause of cognitive
impairment?
A) Vitamin B12 deficiency
B) Hypothyroidism
C) Alzheimer’s disease
D) Depression
✅ Answer: C) Alzheimer’s disease
Rationale: Alzheimer’s is progressive and irreversible.
6. Which nursing diagnosis is most appropriate for a client with late-
stage Alzheimer’s?
A) Risk for loneliness
B) Risk for aspiration
C) Risk for situational low self-esteem
D) Risk for hyperactivity
✅ Answer: B) Risk for aspiration
Rationale: Late-stage clients often lose the ability to swallow effectively.
7. What is the most appropriate intervention to manage wandering in
dementia?
A) Use chemical restraints
B) Apply physical restraints
C) Ensure a secure, supervised environment
D) Confine the client to bed
✅ Answer: C) Ensure a secure, supervised environment
Rationale: Safety is key; physical and chemical restraints are last resorts.
8. What behavior is common in late-stage Alzheimer’s disease?
A) Ability to hold a conversation
B) Aggressive driving
C) Inability to recognize loved ones
D) Strong judgment
✅ Answer: C) Inability to recognize loved ones
Rationale: Late-stage disease includes severe memory loss and cognitive
decline.
9. Alzheimer’s disease is most accurately diagnosed through:
A) A blood test
B) MRI or PET scans + clinical evaluation
C) Complete blood count
D) EKG
✅ Answer: B) MRI or PET scans + clinical evaluation
Rationale: Imaging plus clinical evaluation confirms diagnosis.
10. In Alzheimer’s disease, what neurotransmitter is notably
decreased?
A) Dopamine
B) Acetylcholine
C) GABA
D) Serotonin
✅ Answer: B) Acetylcholine
Rationale: Acetylcholine deficiency contributes to memory and learning
impairment.
🔹 Therapeutic Communication (Q11–20)
11. A client with dementia is upset and saying, “I want my mom.”
Which response is best?
A) “You’re too old to have a living mother.”
B) “Your mother died years ago.”
C) “Tell me something about your mother.”
D) “You must be confused again.”
✅ Answer: C) “Tell me something about your mother.”
Rationale: Uses validation and reminiscence therapy.
12. Which communication technique is best when speaking to
someone with moderate Alzheimer’s?
A) Complex reasoning
B) Slow, clear, simple sentences
C) High-volume shouting
D) Open-ended philosophical questions
✅ Answer: B) Slow, clear, simple sentences
Rationale: Keep communication brief and clear to avoid confusion.
13. A client with dementia refuses to eat. The nurse should:
A) Force the food
B) Offer finger foods or something they enjoy
C) Skip the meal
D) Scold the client
✅ Answer: B) Offer finger foods or something they enjoy
Rationale: Encouraging independence and interest can improve nutrition.
14. A dementia client forgets their spouse has died and asks for
them. The nurse’s best response is:
A) “Let’s talk about your spouse—what do you remember most?”
B) “You keep forgetting things.”
C) “They’re dead, you just forgot again.”
D) “Don’t ask me that again.”
✅ Answer: A) “Let’s talk about your spouse—what do you remember
most?”
Rationale: Redirection with validation minimizes distress.
15. What is the best way to reduce anxiety in a client with
dementia?
A) Limit conversation
B) Ignore emotional outbursts
C) Maintain a calm and consistent routine
D) Use sarcasm to lighten the mood
✅ Answer: C) Maintain a calm and consistent routine
Rationale: Routine and predictability reduce agitation.
16. A dementia client is searching for “the train.” What should the
nurse do?
A) Correct them immediately
B) Say, “There is no train, you’re confused”
C) Redirect: “Let’s go look outside together.”
D) Laugh and walk away
✅ Answer: C) Redirect: “Let’s go look outside together.”
Rationale: Gentle redirection avoids confrontation.
17. The client becomes agitated and starts yelling. What is the
nurse’s best response?
A) Walk away
B) Speak calmly and offer to go to a quiet area
C) Restrain the client
D) Yell back to get their attention
✅ Answer: B) Speak calmly and offer to go to a quiet area
Rationale: Calm tone and a quiet setting help de-escalate behavior.
18. Which is an appropriate therapeutic communication goal for
dementia care?
A) Increase reality orientation
B) Correct all misstatements
C) Encourage arguments to improve cognition
D) Promote safety, dignity, and comfort
✅ Answer: D) Promote safety, dignity, and comfort
Rationale: These are the foundations of compassionate dementia care.
19. The nurse enters a dementia client’s room and they say, “Get
out! You’re stealing from me!” What’s the best initial action?
A) Argue and correct the client
B) Leave without saying anything
C) Calmly say, “I’m sorry you’re feeling that way—can I help you?”
D) Threaten to call security
✅ Answer: C) Calmly say, “I’m sorry you’re feeling that way—can I help
you?”
Rationale: Responding to feelings—not the content—builds trust.
20. What is the nurse’s priority in communicating with a dementia
client who doesn’t understand instructions?
A) Repeat the instructions using the same words
B) Leave and come back later
C) Use gestures and visual cues
D) Say it louder each time
✅ Answer: C) Use gestures and visual cues
Rationale: Non-verbal communication can support understanding when
words fail.
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🧠 NCLEX Practice: Alzheimer's & Dementia (Overview + Therapeutic
Communication)
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🟢 Overview (10 Questions)
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1. A client is diagnosed with early-stage Alzheimer’s disease. Which of the
following would the nurse expect to observe?
A) Inability to recognize family members
B) Short-term memory loss
C) Loss of ability to walk
D) Bowel and bladder incontinence
✅ Answer: B) Short-term memory loss
Rationale: Early-stage Alzheimer’s is typically marked by forgetfulness,
especially of recent events.
---
2. Which client is at highest risk for developing Alzheimer’s disease?
A) A 70-year-old with a family history of dementia
B) A 45-year-old with mild depression
C) A 30-year-old with Type 1 diabetes
D) A 50-year-old who recently had surgery
✅ Answer: A) A 70-year-old with a family history of dementia
Rationale: Age and genetics are primary risk factors for Alzheimer’s
disease.
---
3. What is the primary pathophysiological characteristic of Alzheimer’s
disease?
A) Autoimmune destruction of neurons
B) Beta-amyloid plaque and neurofibrillary tangles
C) Excess dopamine in the brain
D) Decreased serotonin levels
✅ Answer: B) Beta-amyloid plaque and neurofibrillary tangles
Rationale: These are hallmark pathological findings in Alzheimer’s disease.
---
4. Which of the following best describes dementia?
A) A sudden, reversible decline in mental status
B) A progressive, irreversible loss of cognitive function
C) A temporary loss of orientation and attention
D) A result of acute head trauma only
✅ Answer: B) A progressive, irreversible loss of cognitive function
Rationale: Dementia gradually impairs memory, language, and judgment
over time.
---
5. What is the main focus of nursing care for a client with Alzheimer’s
disease?
A) Curing the disease
B) Reorienting the client constantly
C) Maintaining safety and supporting independence
D) Limiting family involvement
✅ Answer: C) Maintaining safety and supporting independence
Rationale: Alzheimer’s cannot be cured; nursing care focuses on
preserving function and preventing injury.
---
6. In a client with moderate Alzheimer’s, which symptom is most likely?
A) Complete mutism
B) Total physical immobility
C) Wandering and confusion
D) Normal cognitive function
✅ Answer: C) Wandering and confusion
Rationale: Moderate stages are often marked by agitation, confusion, and
safety risks.
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7. Which is a distinguishing feature of delirium versus dementia?
A) Dementia has a sudden onset
B) Delirium is usually permanent
C) Delirium has a rapid onset and fluctuating course
D) Dementia is reversible with treatment
✅ Answer: C) Delirium has a rapid onset and fluctuating course
Rationale: Unlike dementia, delirium develops quickly and may be
reversible.
---
8. What is a late sign of Alzheimer’s disease?
A) Disorientation to time
B) Inability to perform ADLs
C) Short-term memory loss
D) Mood swings
✅ Answer: B) Inability to perform ADLs
Rationale: Functional decline and dependence occur in the late stages.
---
9. The primary goal of medications like donepezil and memantine in
Alzheimer’s disease is:
A) Cure the disease
B) Improve muscle strength
C) Delay cognitive decline
D) Treat depression
✅ Answer: C) Delay cognitive decline
Rationale: These medications slow progression of symptoms but do not
cure the disease.
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10. Which safety intervention is most important for a client with moderate
to severe dementia?
A) Encourage unsupervised outdoor walks
B) Install locks on doors and remove clutter
C) Avoid routine to keep things stimulating
D) Provide detailed instructions for activities
✅ Answer: B) Install locks on doors and remove clutter
Rationale: Clients may wander or fall; a safe environment is critical.
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🔵 Therapeutic Communication (10 Questions)
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11. A client with dementia says, “I need to pick up my kids from school,”
even though they are elderly. What’s the best response?
A) “You don’t have children anymore.”
B) “You're confused—stay calm.”
C) “Tell me about your children.”
D) “Let’s not talk about that right now.”
✅ Answer: C) “Tell me about your children.”
Rationale: This uses validation therapy, which is more comforting than
correcting.
---
12. A confused client becomes anxious and starts crying. What is the best
initial nursing action?
A) Leave the client alone to calm down
B) Use a firm tone and command attention
C) Sit with the client and offer comfort
D) Restrain the client
✅ Answer: C) Sit with the client and offer comfort
Rationale: Therapeutic presence reduces anxiety and prevents escalation.
---
13. A client with Alzheimer’s keeps asking, “Where am I?” How should the
nurse respond?
A) “I told you already.”
B) “You're in the hospital. I'm here with you.”
C) “Just try to remember.”
D) “Stop asking that.”
✅ Answer: B) “You're in the hospital. I'm here with you.”
Rationale: Brief, supportive, reality-based reassurance is appropriate.
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14. A client with moderate dementia is frightened during bathing. What
should the nurse do?
A) Proceed quickly to finish
B) Scold the client for resisting
C) Speak calmly and explain each step
D) Skip the bath for the day
✅ Answer: C) Speak calmly and explain each step
Rationale: Calm explanations reduce fear and support cooperation.
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15. Which communication technique is most effective with a client with
dementia?
A) Use long sentences
B) Speak fast to avoid confusion
C) Use short, simple phrases
D) Ask open-ended questions
✅ Answer: C) Use short, simple phrases
Rationale: Clients process information better when it's clear and direct.
---
16. A client with dementia shouts “I want to go home!” repeatedly. What is
the nurse's best response?
A) “You are home.”
B) “Let’s walk together and talk about your home.”
C) “Be quiet, please.”
D) “Don’t act like that.”
✅ Answer: B) “Let’s walk together and talk about your home.”
Rationale: Validation with distraction helps calm emotional distress.
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17. A family member asks why their father with dementia keeps repeating
himself. The nurse’s best reply is:
A) “He’s probably trying to be annoying.”
B) “That’s how dementia affects the brain.”
C) “He’s doing it for attention.”
D) “Ignore him when he does that.”
✅ Answer: B) “That’s how dementia affects the brain.”
Rationale: Educating the family promotes understanding and
compassionate care.
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18. Which approach is best when a dementia client becomes verbally
aggressive?
A) Confront the client
B) Leave the room silently
C) Speak calmly and redirect the client
D) Raise your voice to assert control
✅ Answer: C) Speak calmly and redirect the client
Rationale: Redirection and calm tone de-escalate the situation.
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19. A client says, “I want to go to work,” but they are retired. What is the
best nurse response?
A) “You’re retired. Don’t you remember?”
B) “Why are you saying that?”
C) “What did you do at work?”
D) “You're too old to work.”
✅ Answer: C) “What did you do at work?”
Rationale: Using validation therapy fosters connection and reduces
anxiety.
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20. The nurse is caring for a dementia client who refuses to take
medications. What’s the priority action?
A) Document the refusal and try again later
B) Force the client to take the meds
C) Hide the meds in food without consent
D) Skip the dose permanently
✅ Answer: A) Document the refusal and try again later
Rationale: Respect autonomy while reattempting with better timing or
technique.
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Practice NCLEX Questions
1. A client with Alzheimer’s disease is exhibiting sundowning behavior.
Which nursing intervention is most appropriate?
A) Restrict visitors in the evening
B) Dim the lights and reduce noise in the evening
C) Encourage frequent naps during the day
D) Limit fluid intake in the afternoon
Answer: B) Dim the lights and reduce noise in the evening
Rationale: Reducing stimuli helps lessen agitation and confusion.
2. The nurse is teaching the family of a client newly diagnosed with
Alzheimer’s disease. Which statement indicates a correct
understanding?
A) “The disease will improve with medication.”
B) “Memory loss is temporary and will return.”
C) “The disease will worsen over time.”
D) “The client will regain full independence soon.”
Answer: C) “The disease will worsen over time.”
Rationale: Alzheimer’s is progressive and irreversible.
3. Which assessment finding is an early sign of Alzheimer’s disease?
A) Loss of ability to recognize family members
B) Difficulty recalling recent events
C) Inability to perform basic ADLs
D) Total disorientation to time and place
Answer: B) Difficulty recalling recent events
Rationale: Early Alzheimer’s typically affects short-term memory first.
4. Which medication is commonly prescribed to slow the progression of
Alzheimer’s disease?
A) Diazepam
B) Donepezil
C) Haloperidol
D) Levodopa
Answer: B) Donepezil
Rationale: Donepezil is a cholinesterase inhibitor that improves cognitive
function.
20 NCLEX Practice Questions with Answers & Rationales
1. Which nursing intervention is most important to prevent injury in a
client with Alzheimer’s disease?
A) Keep the client on bed rest
B) Ensure the environment is free from hazards
C) Allow the client to roam freely
D) Use physical restraints frequently
Answer: B) Ensure the environment is free from hazards**
Rationale: Clients with Alzheimer’s are at high risk for falls and injury.
Removing hazards and ensuring a safe environment helps prevent
accidents.
2. A client with dementia is having difficulty communicating. What is
the best approach for the nurse?
A) Use complex sentences to challenge the client
B) Speak slowly, clearly, and use simple words
C) Ignore attempts at communication
D) Use medical terminology
Answer: B) Speak slowly, clearly, and use simple words**
Rationale: Simplified communication helps clients with dementia
understand and respond better.
3. Which of the following medications is commonly prescribed to slow
cognitive decline in Alzheimer’s disease?
A) Donepezil
B) Diazepam
C) Metoprolol
D) Lithium
Answer: A) Donepezil**
Rationale: Donepezil is a cholinesterase inhibitor that improves cognitive
function by increasing acetylcholine.
4. The nurse notices a client with dementia becomes agitated and
restless around dusk. What should the nurse do first?
A) Restrain the client
B) Provide a quiet environment and minimize stimulation
C) Increase lighting in the room suddenly
D) Give a sedative immediately
Answer: B) Provide a quiet environment and minimize stimulation**
Rationale: Sundowning behavior worsens with increased stimuli. Reducing
noise and light helps calm the client.
5. Which statement by a family member shows understanding about
Alzheimer’s disease?
A) “This disease can be cured with medication.”
B) “Memory loss will improve over time.”
C) “Safety precautions are important at all times.”
D) “The client will regain all previous abilities.”
Answer: C) “Safety precautions are important at all times.”**
Rationale: Alzheimer’s is progressive and irreversible; safety measures are
crucial.
6. What is an early symptom of Alzheimer’s disease?
A) Loss of ability to recognize family
B) Forgetting recent events or conversations
C) Incontinence
D) Total disorientation
Answer: B) Forgetting recent events or conversations**
Rationale: Early Alzheimer’s typically affects short-term memory first.
7. A client with Alzheimer’s refuses to eat lunch. What should the
nurse do?
A) Force the client to eat
B) Offer favorite foods and try again later
C) Ignore and withhold food
D) Only give liquids
Answer: B) Offer favorite foods and try again later**
Rationale: Offering preferred foods and trying later can increase intake
without causing distress.
8. Which lab test is useful to rule out other causes of dementia-like
symptoms?
A) Complete blood count (CBC)
B) Thyroid function tests
C) Blood glucose
D) Urinalysis
Answer: B) Thyroid function tests**
Rationale: Hypothyroidism can cause cognitive impairment and mimic
dementia.
9. What is the nurse’s best response when a client with dementia
repeatedly asks the same question?
A) Answer calmly and patiently each time
B) Tell the client to stop asking
C) Ignore the question
D) Redirect to another topic immediately
Answer: A) Answer calmly and patiently each time**
Rationale: Repetition is common in dementia; patience reassures the
client.
10. Which intervention helps reduce agitation in a client with
dementia?
A) Isolate the client in a dark room
B) Maintain a consistent daily routine
C) Overstimulate with loud music
D) Change caregivers frequently
Answer: B) Maintain a consistent daily routine**
Rationale: Predictable routines reduce confusion and agitation.
11. The nurse observes the client with dementia attempting to
leave the facility at night. What should the nurse do?
A) Physically restrain the client
B) Escort the client back to their room and ensure safety
C) Ignore the behavior
D) Call security to detain the client
Answer: B) Escort the client back to their room and ensure safety**
Rationale: Redirecting and ensuring safety prevents harm while
maintaining dignity.
12. Which of the following is a common side effect of donepezil?
A) Hypertension
B) Nausea and diarrhea
C) Dry mouth
D) Insomnia
Answer: B) Nausea and diarrhea**
Rationale: GI upset is a common side effect of cholinesterase inhibitors.
13. Which action helps improve nutrition in a client with
dementia?
A) Offer finger foods and assist with feeding
B) Restrict fluids to prevent incontinence
C) Serve meals in a noisy environment
D) Feed the client rapidly to finish meals faster
Answer: A) Offer finger foods and assist with feeding**
Rationale: Finger foods are easier to handle; assistance improves intake.
14. Which of the following is a priority for a client with Alzheimer’s
disease?
A) Promote independence while ensuring safety
B) Allow unlimited unsupervised activities
C) Discourage family involvement
D) Focus only on physical health
Answer: A) Promote independence while ensuring safety**
Rationale: Encouraging independence supports dignity but safety is
essential.
15. The nurse teaches a family about sundowning syndrome.
Which statement is correct?
A) “It happens in the morning.”
B) “Symptoms worsen in the late afternoon or evening.”
C) “It is caused by infection.”
D) “It only occurs in hospital settings.”
Answer: B) “Symptoms worsen in the late afternoon or evening.”**
Rationale: Sundowning refers to increased confusion and agitation in late
day.
16. What is the nurse’s priority when a client with dementia is
wandering?
A) Restrain the client to prevent harm
B) Assess for triggers and provide a safe environment
C) Punish wandering behavior
D) Ignore the behavior
Answer: B) Assess for triggers and provide a safe environment**
Rationale: Understanding causes and safety measures prevents injury.
17. Which communication technique is best when caring for a
client with dementia?
A) Use yes/no questions
B) Speak quickly and loudly
C) Use abstract concepts
D) Avoid eye contact
Answer: A) Use yes/no questions**
Rationale: Yes/no questions are easier for clients with cognitive
impairment.
18. Which is the best way to manage agitation in a client with
dementia?
A) Use physical restraints immediately
B) Identify and remove triggers
C) Ignore the behavior
D) Isolate the client in a dark room
Answer: B) Identify and remove triggers**
Rationale: Removing triggers helps reduce agitation effectively.
19. Which symptom is NOT typical of Alzheimer’s disease?
A) Gradual memory loss
B) Sudden onset confusion
C) Difficulty with problem-solving
D) Language difficulties
Answer: B) Sudden onset confusion**
Rationale: Sudden confusion is more typical of delirium, not Alzheimer’s.
20. A client with Alzheimer’s has been prescribed memantine.
What is the purpose of this medication?
A) Treat depression
B) Manage agitation
C) Protect brain cells from excess glutamate
D) Cure Alzheimer’s disease
Answer: C) Protect brain cells from excess glutamate**
Rationale: Memantine blocks NMDA receptors to reduce glutamate
toxicity, helping slow progression.
🧠 Pharmacology & Therapeutic Communication: Alzheimer’s/Dementia
PHARMACOLOGY (Questions 1–8)
1. Which medication is prescribed to improve memory and cognitive
function in mild to moderate Alzheimer’s disease?
A) Haloperidol
B) Donepezil
C) Risperidone
D) Lorazepam
Answer: B) Donepezil
Rationale: Donepezil is a cholinesterase inhibitor that increases
acetylcholine levels in the brain to improve memory.
2. Which is a common side effect of donepezil (Aricept)?
A) Constipation
B) Bradycardia
C) Urinary retention
D) Hypertension
Answer: B) Bradycardia
Rationale: Donepezil can cause vagotonic effects, leading to slowed heart
rate.
3. A client with Alzheimer’s is prescribed memantine. The nurse
explains that this drug works by:
A) Increasing serotonin
B) Blocking NMDA receptors
C) Stimulating dopamine release
D) Decreasing GABA
Answer: B) Blocking NMDA receptors
Rationale: Memantine blocks excessive glutamate activity at NMDA
receptors, which can reduce neurodegeneration.
4. Which lab result should the nurse monitor before administering
rivastigmine?
A) Potassium
B) Liver enzymes
C) Hemoglobin A1C
D) White blood cell count
Answer: B) Liver enzymes
Rationale: Rivastigmine is metabolized in the liver; hepatic function should
be monitored.
5. Which medication is most appropriate for managing moderate
agitation in a dementia client with behavioral disturbances?
A) Diazepam
B) Haloperidol
C) Risperidone
D) Phenytoin
Answer: C) Risperidone
Rationale: Atypical antipsychotics like risperidone are used cautiously for
agitation in dementia when non-pharmacological methods fail.
6. The nurse teaches a family that medications for Alzheimer’s
disease:
A) Reverse the disease entirely
B) Cure the underlying cause
C) Slow progression and reduce symptoms
D) Eliminate the need for caregiving
Answer: C) Slow progression and reduce symptoms
Rationale: Medications like donepezil or memantine can delay symptom
progression but do not cure the disease.
7. A client on donepezil reports dizziness and blacking out. What is the
nurse’s priority?
A) Encourage more fluid intake
B) Assess for bradycardia and fall risk
C) Reassure that this is normal
D) Recommend a sedative
Answer: B) Assess for bradycardia and fall risk
Rationale: Donepezil may cause bradycardia and syncope, increasing fall
risk.
8. What teaching should the nurse give when starting memantine?
A) “You may feel drowsy, avoid driving.”
B) “Take this medication with antacids.”
C) “This drug will cure your Alzheimer’s.”
D) “Stop taking it if you feel better.”
Answer: A) “You may feel drowsy, avoid driving.”
Rationale: CNS effects like dizziness or drowsiness are common with
memantine.
THERAPEUTIC COMMUNICATION (Questions 9–15)
9. A client with Alzheimer’s is looking for their deceased wife. What is
the most therapeutic response?
A) “Your wife died years ago.”
B) “She’s not here right now. Tell me about her.”
C) “Please stop asking about her.”
D) “Let’s go back to your room.”
Answer: B) “She’s not here right now. Tell me about her.”
Rationale: This uses validation therapy—redirects gently while validating
feelings.
10. A confused client becomes agitated when told it’s time for a
bath. What should the nurse say?
A) “You’re being difficult, please cooperate.”
B) “Don’t you remember you need a bath now?”
C) “Let’s go get cleaned up so you feel refreshed.”
D) “You have to do what I say.”
Answer: C) “Let’s go get cleaned up so you feel refreshed.”
Rationale: Positive, respectful phrasing promotes cooperation.
11. A client with dementia asks, “Where is my mother?” (who died
long ago). Best response?
A) “She’s gone. Don’t you remember?”
B) “I told you before, stop asking.”
C) “Tell me something you used to do with your mother.”
D) “You’re confused again.”
Answer: C) “Tell me something you used to do with your mother.”
Rationale: Encourages reminiscing, validation, and avoids causing
distress.
12. What is the best approach when a client with dementia
becomes combative during ADLs?
A) Call security
B) Give the client space and return later
C) Argue to gain compliance
D) Force the care quickly
Answer: B) Give the client space and return later
Rationale: Avoid escalation by pausing and returning when the client is
calm.
13. Which statement demonstrates therapeutic communication
with a dementia client?
A) “Try harder to remember.”
B) “You’ve asked that three times already.”
C) “You seem upset. Can you show me what you need?”
D) “You need to stop wandering around.”
Answer: C) “You seem upset. Can you show me what you need?”
Rationale: Acknowledges emotion and uses supportive, clear language.
14. A dementia client repeatedly packs to “go home.” What is the
best nursing action?
A) Correct them and say they are home
B) Redirect and engage in an activity
C) Call the doctor for medication
D) Lock the door to prevent leaving
Answer: B) Redirect and engage in an activity**
Rationale: Gentle redirection reduces distress and prevents escalation.
15. Which strategy improves cooperation during medication
administration for dementia clients?
A) Insist they take it immediately
B) Give the medication covertly in food
C) Offer simple explanations and praise cooperation
D) Say nothing and wait for compliance
Answer: C) Offer simple explanations and praise cooperation
Rationale: Clear instructions and positive reinforcement help improve
cooperation.
