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A client with Alzheimer's disease has lost all sense of time and place and has developed visual agnosia. The client is in which of the following stages of Alzheimer's disease?
- A. Intermediate stage
- B. Severe stage
- C. End stage
- D. Early stage
Correct Answer: B
Rationale: The intermediate stage might involve moderate memory loss and some disorientation, but not typically severe symptoms like complete loss of time and place or visual agnosia. In the severe stage, clients exhibit major confusion, losing all sense of time and place, and may develop visual agnosia (inability to recognize objects), aligning with the client’s condition. The end stage involves near-total dependence and loss of physical abilities, often beyond the cognitive symptoms described. Early-stage symptoms are mild, like forgetfulness, and don’t include such advanced disorientation.
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A nurse in an acute care facility is assisting with the admission of an older adult client who has late stage Alzheimer's disease. The nurse notes that the client's partner appears exhausted. He states that he is finding it more and more difficult to care for his partner. Which of the following actions should the nurse take first?
- A. Suggest that the client's partner see a counselor to help him cope with his exhaustion.
- B. Encourage the client's partner to call a family meeting to ask for help.
- C. Ask the partner to talk about his difficulties in caring for the client.
- D. Recommend that the client's partner place the client in a long-term care facility.
Correct Answer: C
Rationale: Counseling helps later, not first. Family meetings follow understanding needs. Asking about difficulties assesses the situation, guiding support. Recommending placement is premature without discussion.
A client is given the diagnosis of generalized anxiety disorder and is prescribed a benzodiazepine. The client should be instructed on which of the following?
- A. Monthly laboratory tests are needed to monitor drug level.
- B. Foods that contain tyramine should be avoided
- C. Benzodiazepines do not cause physical dependence.
- D. Benzodiazepines and alcohol can be dangerous
Correct Answer: D
Rationale: Lab tests aren’t routine for benzodiazepines. Tyramine avoidance applies to MAOIs, not benzodiazepines. Benzodiazepines can cause dependence, so that’s false. Combining benzodiazepines with alcohol increases CNS depression, posing risks like respiratory failure, making it critical to instruct the client on this danger.
A nurse is conducting a home health visit for an older adult client who lives with family members. The nurse notices that the client has multiple unusual bruises, and, based on several other factors, the nurse suspects that the client has been physically abused. Which of the following actions should the nurse take first?
- A. Check the bruises at the next visit to the client's home.
- B. Institute more frequent visits to the client's home.
- C. Follow the agency's guidelines for reporting suspected abuse.
- D. Arrange referral for family therapy to deal with home stressors.
Correct Answer: C
Rationale: Delaying action by checking bruises later doesn’t address immediate safety. More frequent visits monitor but don’t act on the suspicion promptly. Following agency guidelines for reporting suspected abuse ensures the client’s safety first, as it’s the nurse’s legal and ethical duty. Therapy may help later but isn’t the first step without ensuring safety.
A young adult moves to a new town and is unable to establish relationships because of geographical distance to other towns and a sparsely populated community. This young adult is at greatest risk for which of the following?
- A. Mental illness
- B. Social isolation
- C. Substance abuse
- D. Depression
Correct Answer: B
Rationale: Mental illness is broad and less immediate. Geographical and sparse population factors directly lead to social isolation, the primary risk here. Substance abuse or depression could follow, but isolation is the most direct consequence of the situation.
Which of the following is a physical clinical finding of depression in older adults?
- A. Increased anxiety
- B. Slowed memory
- C. Slowed intellect
- D. Headache
Correct Answer: D
Rationale: Increased anxiety is a psychological symptom, not a physical finding, though it may accompany depression. Slowed memory and intellect are cognitive symptoms related to depression’s impact on thinking, not physical manifestations. Physical symptoms of depression can include changes in sleep, appetite, or pain, such as headaches, which are commonly reported in older adults as a somatic expression of the disorder.