Nokea
Which distinguishes delirium from dementia?
- A. Delirium has an acute onset and is progressive in course.
- B. Delirium has a gradual onset and can be resolved.
- C. Dementia has a gradual onset and is progressive in course.
- D. Dementia has an acute onset and can be resolved.
Correct Answer: C
Rationale: Dementia is characterized by a gradual onset and progressive course, while delirium has a sudden onset and is often reversible.
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The nurse is working with a client who has hallucinations and delusions. The client tells the nurse she cannot take a shower because she is waiting for her husband to take her home. Which response by the nurse is best in this situation?
- A. It would be best if you just took your shower now.
- B. You seem anxious and upset.
- C. You have plenty of time to shower before it's time to go home.
- D. Why are you thinking you're going home?
Correct Answer: C
Rationale: Going along with the delusion without reinforcing it allows the client to proceed with activities calmly.
A client with dementia gets angry and begins to yell at the nurse during mealtime. The nurse leaves the client's side for 5 to 10 minutes and then returns. Which of the following best explains the nurse's behavior?
- A. The nurse was unsure of how to calm the client.
- B. The nurse was frustrated and needed to take a time-out.
- C. The nurse gave the client a chance to calm down before resuming the meal.
- D. The nurse stepped away to verify the safety of other clients.
Correct Answer: C
Rationale: Leaving briefly allows the client to calm down, leveraging their short memory to resume interaction calmly.
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.
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.
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.