Nokea
The daughter of a client with dementia has been the primary caregiver for 5 months. The daughter expresses to the nurse, 'At times it is so overwhelming! I feel I do not have a life anymore!' Which is the most helpful response by the nurse?
- A. Are you saying you don't want to care for your mother anymore?
- B. I know it is really hard. It takes a lot of work and you are doing such a good job.
- C. Your mother really appreciates what you do for her. You are the best one to care for her.
- D. Here is the number of a caregivers' support group. How do you think you would feel talking with others in the same situation?
Correct Answer: D
Rationale: Offering a support group provides practical help and emotional validation for the caregiver's stress.
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The nurse is caring for a client with Alzheimer's disease. The nurse observes that the client's pacing and mumbling to himself increase at mealtime and shift change. Which intervention should the nurse implement first?
- A. Administer an antianxiety drug such as lorazepam (Ativan) at these times.
- B. Explain the unit routine and the reasons for increased activity to the client.
- C. Keep unit activity to a minimum.
- D. Move the client to a quieter area during these times.
Correct Answer: D
Rationale: Moving the client to a quieter area reduces overstimulation, addressing the immediate cause of agitation.
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.
A nurse is educating a group of elderly community members about cognitive disorders. Which would the nurse include as a measure most likely to prevent Alzheimer's disease and other dementias?
- A. Crafts
- B. Cooking
- C. Watching television
- D. Reading
Correct Answer: D
Rationale: Reading and other brain-stimulating activities are associated with a reduced risk of Alzheimer's disease.
Which patient is most likely suffering from dementia?
- A. A 90-year-old male who has experienced progressive mental decline that started with forgetfulness
- B. An 80-year-old female who has been in excellent health until she was admitted through the emergency department with a severe urinary tract infection and is now very anxious and is threatening staff
- C. A 6-year-old child who has just been administered conscious sedation for a closed reduction of a fractured wrist and says that her parents have three sets of eyes
- D. A 22-year-old male who was involved in a motorcycle crash without wearing a helmet now unable to remember where he is
Correct Answer: A
Rationale: Dementia involves progressive memory impairment starting with forgetfulness, unlike delirium or amnestic disorders seen in the other cases.
During the change of shift report in the intensive care unit, the nurse learns that a client has developed signs of delirium over the past 8 hours. Which behavior documented in the nursing notes would be consistent with delirium?
- A. Unable to identify a water pitcher
- B. Unable to transfer to sitting position
- C. Difficulty with verbal expression
- D. Disoriented to person
Correct Answer: D
Rationale: Delirium is characterized by sudden onset and disorientation, such as to person, unlike dementia, which involves agnosia, apraxia, or aphasia.