Nokea
A client with dementia is starting pharmacotherapy to slow the progression of cognitive decline. The client has a history of moderate but steady alcohol use over the past 45 years. Which medication should the nurse question as least suitable for this client?
- A. Tacrine (Cognex)
- B. Memantine (Namenda)
- C. Donepezil (Aricept)
- D. Rivastigmine (Exelon)
Correct Answer: A
Rationale: Tacrine is less suitable due to its high risk of liver toxicity, particularly concerning given the client's history of alcohol use.
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Which client would have an increased risk for delirium?
- A. An elderly woman with abdominal pain
- B. A 3-year-old child with a temperature of 103.2 F
- C. A middle-aged woman newly diagnosed with multiple sclerosis
- D. A young adult male with gastroenteritis and dehydration
Correct Answer: B
Rationale: High fever in young children significantly increases the risk of delirium, more so than the other conditions listed.
The nurse is assessing a client with early signs of dementia. What is the nurse trying to determine when the nurse asks the client what he ate for breakfast that morning?
- A. Orientation
- B. Food preferences
- C. Recent memory
- D. Remote memory
Correct Answer: C
Rationale: Asking about breakfast assesses recent memory, which is typically impaired early in dementia.
The nurse is encouraging a group of clients with dementia to join in upper body range of motion exercises using light dumbbells. Which technique will most likely result in the greatest amount of participation?
- A. Show an instructional video just prior to the activity.
- B. Describe the exercise immediately before performing it.
- C. Demonstrate the exercises while clients simultaneously perform them.
- D. Perform the same routine daily to avoid the need for repeated instruction.
Correct Answer: C
Rationale: Demonstrating exercises simultaneously encourages participation by providing clear, immediate guidance.
The caregiver of a client with Alzheimer's disease reports to the nurse that often the client will suddenly become angry during meals and nothing seems to calm him down. The nurse teaches the caregiver to use distraction techniques. Which response would be best to teach as an example of this technique?
- A. Let's look at what is on television.
- B. If you stop yelling, I will get your dessert.
- C. Don't you want to finish your meal?
- D. I don't understand what you are saying.
Correct Answer: A
Rationale: Distraction, such as watching television, redirects the client's focus and helps de-escalate agitation.
Which are possible sources of frustrations for nurses caring for persons with dementia? Select all that apply.
- A. The clients do not retain explanations or instructions, so the nurse must repeat the same things continually.
- B. The nurse may get little or no positive response or feedback from clients with dementia.
- C. It can be difficult to remain positive and supportive to clients and family because the outcome is so bleak.
- D. It can be helpful for the nurse to talk to colleagues or even a counselor about personal feelings of depression and grief as the dementia progresses.
- E. The clients may seem not to hear or respond to anything the nurse does.
Correct Answer: A,B,C,E
Rationale: Repetition, lack of response, bleak outcomes, and non-responsiveness contribute to nurse frustration, while discussing feelings is a coping strategy, not a source of frustration.