Nokea
The nurse is providing community education regarding Alzheimer disease. Which client scenario is best for the client with progressing Alzheimer symptoms?
- A. Transfer the client to a behavioral health unit.
- B. Place the client in a personal care home.
- C. Place the client in a long-term care dementia unit.
- D. Maintain the client in the home and bring assistance to the care provider.
Correct Answer: D
Rationale: The best client scenario allows the client to remain in the familiar environment of the client's home while maintaining safety. Home health nurses and nurse aides can aid families in managing client care. Transferring clients to the behavioral health unit, to a personal care home, or a dementia unit all take the client from the home setting, which can be confusing.
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The nurse is caring for a 24-year-old client newly diagnosed with schizophrenia. The client asks: 'How could this be happening? What is wrong with my brain?' The nurse is most correct to identify which neurotransmitter as having the highest imbalance?
- A. Acetylcholine
- B. Dopamine
- C. Serotonin
- D. Gamma-aminobutyric acid
Correct Answer: B
Rationale: Schizophrenia is characterized as a psychobiologic disease because of findings in brain and neurotransmitter chemistry. Dopamine excess is believed to be the major cause of symptoms, with imbalance of norepinephrine, serotonin, and gamma-aminobutyric acid also playing a role.
The nurse is instructing the parents of a 21-year-old with schizophrenia who hears voices. Which response by the parent to the child validates that the parent understands the discharge teaching?
- A. The parent states 'Does the person speaking have a name?'
- B. The parent states 'The person speaking to you is bad, but you are good.'
- C. The parent states 'The voice is not real. We have talked about this before.'
- D. The parent states 'I do not hear the voices, but what are they telling you?'
Correct Answer: D
Rationale: The parent is most correct to state not hearing the voices but then asking the client to share what the voices are saying. By identifying the content of the hallucinations, the parent can determine the safety of the client or if others are in jeopardy. Also, the parent is correct to call the auditory hallucinations by the term 'the voices.'
Which family-centered nursing diagnosis is a priority for Alzheimer disease clients who have a spouse providing care?
- A. Altered Health Maintenance
- B. Fatigue
- C. Caregiver Fatigue
- D. Grief
Correct Answer: C
Rationale: A priority family-centered nursing diagnosis related to a spouse who is providing care is Caregiver Fatigue. The nurse determines family-specific interventions that can assist the spouse or family in care for themselves while caring for the client. Altered Health Maintenance is a client diagnosis. Fatigue and Grief are also potential diagnoses but not as high a priority as Caregiver Fatigue.
The nurse is caring for a client in the mild cognitive impairment stage of Alzheimer disease. When reviewing the client's medication regimen, which medication does the nurse identify as having a neuroprotective property?
- A. Namenda
- B. Vitamin B2
- C. Celebrex
- D. Neurontin
Correct Answer: A
Rationale: The neuroprotective drugs are the newest medications on the market. The newest drug, Namenda, contains memantine, which is a neuroprotective. The other medications are not Alzheimer medications that diminish dementia.
During a multidisciplinary meeting, the group discussed potential signs of tardive dyskinesia noted sporadically in a client. Following the meeting, symptoms progressed for the client. Which medical order does the nurse anticipate?
- A. Reduce the medication dose.
- B. Discontinue the medication.
- C. Provide an adjunct medication.
- D. Begin alternate treatments.
Correct Answer: B
Rationale: Nurses and the multidisciplinary team consistently assess the client taking antipsychotic medications to check for tardive dyskinesia. When symptoms progress, the nurse should report the symptoms immediately because the drug must be discontinued. Reducing the dose, adjunct medications, and alternative treatments would not be the medical orders issued.