Nokea
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.
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A client with dementia is starting pharmacotherapy to slow the progression of cognitive decline. The client has a history of moderate but steady alcohol use over the past 45 years. Which medication should the nurse question as least suitable for this client?
- A. Tacrine (Cognex)
- B. Memantine (Namenda)
- C. Donepezil (Aricept)
- D. Rivastigmine (Exelon)
Correct Answer: A
Rationale: Tacrine is less suitable due to its high risk of liver toxicity, particularly concerning given the client's history of alcohol use.
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.
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.
A client with moderate Alzheimer's disease is living with her grown daughter. Which statement by the daughter would indicate the need for intervention by the nurse?
- A. It's distressing when my mother forgets my name.
- B. I wish my sister would come to visit more often.
- C. Mother won't let anyone else do anything for her.
- D. Taking care of my mother is a big responsibility.
Correct Answer: C
Rationale: Refusing help from others increases caregiver strain, indicating a need for intervention to promote shared caregiving.
A client voluntarily admitted to the inpatient psychiatric unit is currently experiencing mild delirium. The client approaches the nurse and states, 'I'm going to take a walk outside. I'll be back in about 10 minutes.' Which is the most appropriate nursing action?
- A. Further assess the client's motives for wanting to walk.
- B. Give the client permission to go on a walk on the grounds.
- C. Tell the client the walk is not allowed and restrict him to the unit.
- D. Designate a staff member to accompany the client on the walk.
Correct Answer: D
Rationale: Accompanying the client ensures safety due to the risk of disorientation in delirium.