• Shuffle
    Toggle On
    Toggle Off
  • Alphabetize
    Toggle On
    Toggle Off
  • Front First
    Toggle On
    Toggle Off
  • Both Sides
    Toggle On
    Toggle Off
  • Read
    Toggle On
    Toggle Off

Card Range To Study



Play button


Play button




Click to flip

Use LEFT and RIGHT arrow keys to navigate between flashcards;

Use UP and DOWN arrow keys to flip the card;

H to show hint;

A reads text to speech;

26 Cards in this Set

  • Front
  • Back


Characterized by a disturbance in level of awareness and change in cognition or thought process.

Develops rapidly over a short period.

Neurocognitive Disorder

Impaired thinking, reasoning, memory, learning, speaking

Primary NCDs

Those in which the disorder itself is the major sign of some organic brain disease not directly related to any other organic illness (e.g. Alzheimer's)

Secondary NCDs

Caused by or related to another disease or condition (e.g. HIV disease or cerebral trauma

Symptoms of NCDs

-Impairment exists in abstract thinking, judgment, and impulse control

-Conventional rules of social conduct are disregarded

-Personal appearance and hygiene are neglected

-Language may or may not be affected

-Personality change is common

Causes of Reversible NCDs



-Side effects of medications

-Nutritional deficiencies

-Metabolic disorders

Progression of disease process of NCDs

-Aphasia: trouble expressing or comprehending thoughts/commands

-Apraxia: Unable to perform purposeful movement, muscles don't function right.

-Irritability and moodiness, with sudden outbursts over trivial issues

-Inability to care for personal needs independently

-Wandering away from the home


Stages of Alzheimer's Disease

Stage 1. No apparent symptoms

Stage 2. Forgetfulness

Stage 3. Mild cognitive decline

Stage 4. Mild-to-moderate cognitive decline

Stage 5. Moderate cognitive decline

Stage 6. Moderate-to-severe cognitive decline

Stage 7. Severe cognitive decline

1. Hospitalized and diagnosed in the 4th stage of NCD due to Alzheimer’s disease, a client, when asked about the previous evening, describes a wonderful evening spent on a cruise. Which symptom is the client exhibiting?

a) Aphasia

b) Confabulation

c) Delirium

d) Apraxia

Correct answer: B

Confabulation is a behavioral reaction to memory loss in which the client fills in memory gaps with information about events that have not occurred. During the 4th stage of Alzheimer’s dementia, a client will use confabulation in an effort to maintain self-esteem.

2. A client is newly diagnosed with second stage NCD due to Alzheimer’s disease. Which cognitive change would a nurse observe?

a) Memory disturbance

b) Confabulation

c) Apraxia

d) Inability to plan or organize

Correct answer: A

In the second stage of the illness, losses in short-term memory are common and the individual may begin to lose things or forget names of people. It’s at this stage that a diagnosis may be considered.

Vascular NCD

Occurs as a result of significant cerebrovascular disease

More abrupt onset than is seen in association with Alzheimer's disease and the course is more variable

Etiology: hypertension, cerebral emboli, cerebral thrombosis

Frontotemporal NCD

-Occurs as a result of shrinking of the frontal and temporal anterior lobes of the brain

-Previously called Pick’s disease

-Exact cause is unknown, but genetics appears to be a factor

NCD due to traumatic brain injury

-Amnesia is the most common neurobehavioral symptom following head trauma

-Repeated head trauma can result in dementia pugilistica with symptoms of

Emotional lability

Dysarthria: uncoordinated movement

Ataxia: unsteady gait/balance


NCD due to Lewy body disease

-Similar to Alzheimer’s disease, but progresses more rapidly

-Appearance of Lewy bodies in the cerebral cortex and brainstem

-Progressive and irreversible

-May account for 25 percent of all NCD cases

NCD due to Parkinson's disease

Caused by a loss of nerve cells located in the substantia nigra and a decrease in dopamine activity

Cerebral changes in NCD due to Parkinson’s disease sometimes resemble those of Alzheimer’s disease

NCD due to HIV infection

-Caused by brain infections with opportunistic organisms or by the HIV-1 virus directly

-Symptoms may range from barely perceptible changes to acute delirium to profound cognitive impairment

Substance-induced NCD

-Occurs as a result of reactions to, or the overuse or abuse of, substances such as



-Sedatives, hypnotics, and anxiolytics

-Medications that cause anticholinergic side effects

-Toxins, such as lead and mercury

NCD due to Huntington's Disease

-This disease is transmitted as a Mendelian dominant gene

-Damage occurs in the areas of the basal ganglia and the cerebral cortex

-The client usually declines into a profound state of dementia and ataxia

-Average course of the disease is based on age at onset, with juvenile-onset and late-onset having the shortest duration

NCD due to Prion disease

-The disorder is attributable to prion disease (e.g., Creutzfeldt-Jakob disease or bovine spongiform encephalopathy)

-Onset of symptoms typically occurs between ages 40 and 60 years; course is extremely rapid, with progression from diagnosis to death in less than 2 years

-Five to 15 percent of cases have a genetic component

3. Which statement is true about vascular dementia?

a) Vascular dementia is reversible.

b) Vascular dementia is characterized by plaques and tangles in the brain.

c) Vascular dementia involves a gradual, progressive cognitive deterioration.

d) Vascular dementia involves a variable pattern of cognitive functioning.

Correct answer: D

In vascular dementia, clients suffer the equivalent of small strokes that destroy many areas of the brain. The pattern of deficits is variable, depending on which regions of the brain have been affected.

Pharmaceutical agents for cognitive impairment

Donepezil (Aricept)

Pharmaceutical agents for agitation, aggression, hallucinations, thought disturbances, and wandering

Risperidone (Risperdal)

Olanzapine (Zyprexa)

Quetiapine (Seroquel)

Ziprasidone (Geodon)

Haloperidol (Haldol)

4. A client has recently been diagnosed with mild to moderate NCD due to Alzheimer’s disease. Which medication would the nurse expect the physician to order for this client’s cognitive impairment?

a) Nortriptyline (Pamelor): Antidepressant

b) Zaleplon (Sonata): Used for sleep

c) Donepezil (Aricept): Used for cognitive impairment

d) Quetiapine (Seroquel): Used for agitation

Correct answer: C

Donepezil is used to improve cognition in clients diagnosed with mild to moderate dementia associated with Alzheimer’s disease. Its action improves cholinergic function by inhibiting acetlycholinesterase.

Pharmaceutical agents for depression

-SSRIs: Often considered first-line due to favorable side effect profile

-Tricyclic antidepressants: Often avoided due to anticholinergic and cardiac side effects

-Trazodone (Desyrel): Good choice for clients with insomnia

-Dopaminergic agents: Helpful in treatment of severe apathy

Pharmaceutical agents for anxiety (should not be used routinely for prolonged periods)

Chlordiazepoxide (Librium)

Alprazolam (Xanax)

Lorazepam (Ativan)

Oxazepam (Serax)

Diazepam (Valium)

Pharmaceutical agents for sleep disturbances (for short-term therapy only)

Flurazepam (Dalmane)

Temazepam (Restoril)

Triazolam (Halcion)

Zolpidem (Ambien)

Zaleplon (Sonata)

Ramelteon (Rozerem)

Eszopiclone (Lunesta)

Trazodone (Desyrel)

Mirtazapine (Remeron)