INSTRUCTIONS Cognitive assessment in primary care: Practical recommendations
TEST INSTRUCTIONS
* Read the article. The test for this CE activity is to be taken online at http://www.nursingcenter.com/CE/NP. Tests can no longer be mailed or faxed.
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* Registration deadline is June 5, 2026.
PROVIDER ACCREDITATION
Lippincott Professional Development will award 2.5 contact hours for this continuing nursing education activity.
Lippincott Professional Development is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.
This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 2.5 contact hours. Lippincott Professional Development is also an approved provider of continuing nursing education by the District of Columbia, Georgia, West Virginia, New Mexico, South Carolina, and Florida, CE Broker #50-1223. Your certificate is valid in all states.
Payment: The registration fee for this test is $24.95.
Cognitive assessment in primary care: Practical recommendations
Learning Outcomes: Seventy-five percent of participants will be able to demonstrate competency in clinical reasoning for practical recommendations for cognitive assessment in primary care by achieving a posttest score of 70% or greater.
Learning Objectives: After reading the article and completing the posttest, the participant will be able to:
1. Describe the possible causes, signs, and symptoms of dementia.
2. Identify assessment tools to use to screen for dementia.
3. Apply strategies to assist patients, family members, and care partners with managing dementia.
Posttest: Case Scenario
Case Scenario: Mr. X arrives at your practice, a primary care office, today for an annual exam with his wife. You are the NP providing care for Mr. X. Mr. X's wife explains that due to Mr. X's decreasing attention span and poor vision, he no longer drives. His wife also states that he has become increasingly confused and irritable over the past 6 months. He also has been having trouble sleeping. Mr. X's wife states that she is concerned that he may have dementia.
1. You are aware that the symptoms Mr. X is experiencing must be carefully assessed because
a. they include confusion and irritability, which are a normal part of aging.
b. a delayed dementia diagnosis contributes to lost opportunities for treatment.
c. Medicare will not cover the cost of an additional cognitive assessment visit.
2. Mr. X's wife asks you what causes dementia. You explain to her that
a. dementia can only be diagnosed after death with an autopsy.
b. various neurodegenerative diseases can underlie dementia.
c. Mr. X's inability to sleep and polypharmacy are not associated with an increased likelihood of dementia.
3. To further evaluate Mr. X's cognition and executive function, you ask him to draw a clock and remember three words. This test is known as the
a. Mini-Cog.
b. Montreal Cognitive Assessment.
c. Saint Louis University Mental Status examination.
4. You explain that, based on Mr. X's progressively worsening symptoms and his score on the test evaluating cognition and executive function which indicated likely dementia syndrome, he could possibly have the most common cause of dementia syndrome, which is
a. frontotemporal dementia.
b. anosognosia.
c. Alzheimer disease.
5. You order testing for Mr. X that includes an FDA-approved serum test to measure for accumulation of amyloid-beta in the brain, to evaluate for supporting evidence for a diagnosis of
a. frontotemporal dementia.
b. anosognosia.
c. Alzheimer disease.
6. Mr. X's medical history shows that he takes multiple medications. Vital signs reveal that he has bradycardia, normal BP, and is afebrile. If on history/exam you find that Mr. X has tremors, rigidity, hallucinations, and rapid eye movement sleep behavior disorder, Mr. X's probable diagnosis would be
a. dementia with Lewy bodies.
b. vascular dementia.
c. frontotemporal dementia.
7. You complete Mr. X's history, exam, and tests. You find that he has amnesia, depression, and apathy. You refer Mr. X for biomarker tests to be done at a specialty center to check for amyloid-beta and phosphorylated tau (p-tau) by
a. lumbar puncture for cerebrospinal fluid analysis.
b. MRI of the brain.
c. a comprehensive metabolic panel.
8. Testing confirms presence of amyloid-beta and p-tau. At a follow-up visit with Mr. X and his wife, you explain that his diagnosis is Alzheimer disease using the SPIKES framework to guide the conversation. SPIKES stands for Setting-Perception-Invitation-Knowledge-Empathy-
a. Situation.
b. Standard.
c. Summary.
9. You have a conversation with Mr. X's wife to assess her for comfort with and ability to fulfill the role of care partner by evaluating her perception of burden with a 22-item tool called the
a. Pearlin Mastery scale.
b. Zarit Burden Interview.
c. Modified Caregiver Strain Index.
10. Mr. X's wife asks about medical treatment for her husband's Alzheimer disease diagnosis. Your best response is
a. "There are currently no available disease-modifying treatments, with a bleak future outlook."
b. "The first disease-modifying treatments have arrived on the market in limited availability."
c. "There are currently many available disease-modifying treatments that are very effective in reversing the symptoms."