Which statement by the nurse would be most appropriate to the family member who is the primary caregiver to a client with dementia?
- A. Most people seek help when they really need it.
- B. What is wrong with your family? Can't they see you need help?
- C. You should be grateful that you still have your family member around.
- D. Yes, it is important for you to spend some time relaxing and doing what you like to do. This will help you to be better prepared to manage the demands of the caregiver role.
Correct Answer: D
Rationale: Encouraging self-care supports the caregiver's well-being, enhancing their ability to manage caregiving demands.
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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 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.
The caregiver of a client with Alzheimer's disease reports to the nurse that often the client will suddenly become angry during meals and nothing seems to calm him down. The nurse teaches the caregiver to use distraction techniques. Which response would be best to teach as an example of this technique?
- A. Let's look at what is on television.
- B. If you stop yelling, I will get your dessert.
- C. Don't you want to finish your meal?
- D. I don't understand what you are saying.
Correct Answer: A
Rationale: Distraction, such as watching television, redirects the client's focus and helps de-escalate agitation.
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.
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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