Nokea
For several days, an elderly client becomes confused and agitated after supper. This is an example of which of the following?
- A. Sundown syndrome
- B. Dementia
- C. Age-associated memory impairment
- D. Delirium
Correct Answer: A
Rationale: Sundown syndrome is increased confusion and agitation in the evening, matching the pattern. Dementia is broader and not time-specific. Age-associated memory impairment is mild and doesn’t include agitation. Delirium is acute and not tied to a daily cycle.
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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.
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.
In developing a nursing care plan for an adult with a mental health disorder, the nurse knows the goals that are set must be:
- A. Important to the client
- B. Evaluated on a weekly basis
- C. Achievable by client discharge
- D. Approved by the physician
Correct Answer: A
Rationale: Client-important goals boost engagement. Weekly evaluation is useful but not mandatory. Discharge-tied goals may not fit long-term needs. Physician approval is secondary to client-centered planning.
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.
A nurse is caring for a group of older adult clients. Which of the following client findings indicates delirium?
- A. A client expresses dislike of orange juice after reporting earlier that it was a favorite juice.
- B. A client wants to know what type of poison the nurse placed in her medication.
- C. A client asks when family members will be arriving after visiting 1 hr earlier.
- D. A client requests extra blankets when the thermostat in the room indicates 80°F.
Correct Answer: C
Rationale: Changing preferences isn’t delirium-specific. Suspecting poison suggests delusion, not necessarily delirium. Confusion about recent events, like family visits, indicates delirium’s hallmark disorientation. Requesting blankets in a warm room may reflect sensory issues, not delirium directly.