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A nurse is contributing to the plan of care for a client who has dementia. Which of the following actions should the nurse include in the plan of care?
- A. Use an overhead loudspeaker to announce events.
- B. Post a written schedule of daily activities.
- C. Allow the client to choose free-time activities
- D. Provide a consistent daily routine.
Correct Answer: D
Rationale: Using an overhead loudspeaker can be disorienting or frightening for clients with dementia due to their sensitivity to loud noises and potential for confusion. A written schedule may not be helpful if the client has difficulty reading or understanding due to cognitive decline, which is common in dementia. While allowing choices is generally good, it can be overwhelming for someone with dementia depending on their cognitive ability, potentially leading to frustration or anxiety. A consistent daily routine helps provide structure and predictability, which can reduce confusion and anxiety in clients with dementia by creating a stable environment they can rely on.
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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 reviewing the plan of care for a client who has depression. Which of the following actions should the nurse plan to take?
- A. Reinforce how to use assertive communication techniques.
- B. Schedule the client's daily self-care activities.
- C. Discourage the client from expressing anger.
- D. Set short-term and long-term goals for the client.
Correct Answer: D
Rationale: Assertiveness is secondary to overall planning. Scheduling self-care helps but isn’t comprehensive. Suppressing anger hinders emotional health. Goal setting provides direction and motivation, key to depression management.
A nurse is caring for a client who has an anxiety disorder. Which of the following findings should the nurse recognize as a manifestation of mild anxiety?
- A. Incoherent speech
- B. Irritability
- C. Insomnia
- D. Chest pain
Correct Answer: B
Rationale: Incoherent speech indicates severe anxiety. Irritability is a mild anxiety sign, with maintained function. Insomnia suggests chronic anxiety. Chest pain aligns with severe anxiety or panic.
An elderly client with severe cardiovascular disease is given the diagnosis of dementia. Which type of dementia does the client most likely have?
- A. Frontal
- B. Lewy body
- C. Alzheimer's
- D. Vascular dementia
Correct Answer: D
Rationale: Frontal (frontotemporal) dementia affects personality and behavior, not directly tied to cardiovascular issues. Lewy body dementia involves protein deposits and symptoms like hallucinations, not primarily cardiovascular-related. Alzheimer’s is common but linked to neurodegenerative changes, not specifically cardiovascular disease. Vascular dementia results from impaired blood flow to the brain, often due to cardiovascular conditions, making it the most likely here.
A client with Alzheimer's disease has difficulty with bathing and dressing activities. This is an example of which type of loss?
- A. Physical loss
- B. Functional loss
- C. Affective loss
- D. Conative loss
Correct Answer: B
Rationale: Physical loss involves losing a body part or function, not the ability to perform tasks. Functional loss is the reduced ability to perform daily activities like bathing and dressing, common in Alzheimer’s due to cognitive and motor decline. Affective loss is emotional, and conative loss relates to motivation, neither fitting this scenario.