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A new nurse has been working with clients with Alzheimer's disease for almost 6 months. During a staff meeting, the nurse expresses frustration because the same instructions have to be given to clients on a daily basis. The nurse states, 'I feel like all my work doesn't do them any good.' Which should the nurse's supervisor encourage the nurse to do?
- A. Cease giving instructions because the clients will not remember them anyway.
- B. Try to stay supportive and meet the clients' needs at the current moment.
- C. Seek counseling if personal feelings get in the way of client care.
- D. Consider transferring to a different client care specialty area.
Correct Answer: B
Rationale: Remaining supportive and focusing on current needs helps manage frustration and maintains client-centered care.
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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.
The nurse is working with a client who has hallucinations and delusions. The client tells the nurse she cannot take a shower because she is waiting for her husband to take her home. Which response by the nurse is best in this situation?
- A. It would be best if you just took your shower now.
- B. You seem anxious and upset.
- C. You have plenty of time to shower before it's time to go home.
- D. Why are you thinking you're going home?
Correct Answer: C
Rationale: Going along with the delusion without reinforcing it allows the client to proceed with activities calmly.
The nurse is developing interventions to promote socialization in a client with moderate dementia. Which would provide a safe and secure environment for the client?
- A. A card game with other clients
- B. An activity with the nurse
- C. Decorating a bulletin board with the group
- D. Morning stretch group with music
Correct Answer: B
Rationale: One-on-one activities with the nurse minimize overstimulation and provide a predictable, safe environment.
The daughter of a woman with dementia asks the nurse if her mother will ever be able to live independently again. Which would be the most appropriate response?
- A. You sound like you aren't ready for her to be dependent on caregivers.
- B. Her confusion is a temporary complication of her physical illness and should subside when the illness gets better.
- C. Symptoms of dementia gradually get worse. Unfortunately she will not be independent again.
- D. With early treatment, mild dementia can be reversed. It may be possible.
Correct Answer: C
Rationale: Dementia is progressive, leading to increasing dependence, unlike delirium, which may be reversible.
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.