A patient complains of periods of confusion and forgetfulness at times, and reports clear thought process at most times of the day. The symptoms have been gradually worsening. What should the nurse say in response to this patient?
1. "Have you started any new medications since the symptoms began?"
2. "You probably have nothing to worry about; it's most likely stress-related."
3. "Everybody has a few problems with memory as they get older."
4. "You should probably have an MRI of your brain."
Correct Answer: 1
The diagnosis of Alzheimer disease requires the documented presence of dementia, onset between 40 and 90 years, no loss of consciousness, and absence of systemic or brain disorders that could cause mental changes. Side effects of medication should also be ruled out as a possible cause of the symptoms. A nurse should never discount the patient's concerns and memory loss with confusion, and forgetfulness is not part of the normal aging process. The nurse needs to explore further before an expensive diagnostic study is considered. It would be beyond the scope of practice for the nurse to recommend this testing.
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