Nokea
The adult son of a client with dementia asks the nurse how he should respond when his mother repeatedly says she has had a busy day at work. The mother has not worked in over 20 years. Which is the best guidance that the nurse could offer?
- A. Ask her to explain what she did at work today that kept her busy.
- B. Go along with her thought of it having been a busy day, but do not refer to her work.
- C. Reorient her that she is at home and did not go to work.
- D. Give her 5 to 10 minutes of rest, and she will have no memory of the incident.
Correct Answer: B
Rationale: Going along without reinforcing the delusion provides emotional reassurance and reduces distress.
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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.
The grown daughter of a woman with Alzheimer's disease reports to the nurse that she is trying to keep her mother's condition from worsening by asking her questions whenever they are together. Which will be accomplished by this intervention?
- A. Decrease environmental misinterpretation
- B. Improve memory retention
- C. Increase frustration
- D. Slow the progress of the disease
Correct Answer: C
Rationale: Questioning clients with Alzheimer's about tasks they cannot perform increases frustration due to their progressive cognitive decline.
Which statement made by the nurse would be most appropriate to an 89-year-old patient who is confused but has no history of dementia and is hospitalized for an acute urinary tract infection?
- A. You are likely to become progressively more confused now.
- B. This should be just a temporary situation.
- C. Don't worry about it, everyone is confused when they are in the hospital.
- D. I know things are upsetting and confusing right now, but your confusion should clear as you get better.
Correct Answer: D
Rationale: This response validates the patient's feelings while providing reassurance that delirium from the infection is typically temporary.
Which is believed to be a risk factor specific to the development of delirium?
- A. Increased severity of physical illness
- B. Older age
- C. Baseline cognitive impairment
- D. Gradual decline in functioning
Correct Answer: A
Rationale: Increased severity of physical illness is a primary trigger for delirium, unlike gradual decline, which is characteristic of dementia.