Nokea
You are running a caregiver support group for those who are caring for a person with impaired cognition related to Alzheimer's disease. You are planning a session on the stages of Alzheimer's disease, its progression and some useful helpful tips for these participating care givers. Which of the following elements should you include in this session?
- A. According to the Global Deterioration Scale, clients in the first stage of Alzheimer's disease tend to cover up their failing abilities
- B. According to the Reisberg Scale, clients in the first stage of Alzheimer's disease tend to cover up their failing abilities
- C. According to the Global Deterioration Scale, clients in the third stage of Alzheimer's disease tend to cover up their failing abilities
- D. According to the Reisberg Scale, clients in the fourth stage of Alzheimer's disease tend to cover up their failing abilities
Correct Answer: B
Rationale: The Reisberg Scale (Global Deterioration Scale) indicates that in the first stage, individuals with Alzheimer's may cover up their failing abilities, which is an important point to include for caregivers to understand early disease behaviors.
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An 80-year-old client with severe kidney damage is placed on life support and dialysis. Care decisions are being made by his wife, who is showing signs of early Alzheimer's disease. The client's daughter arrives from out of town with a copy of the client's living will, which states that the client did not want to be on life support. The nurse should:
- A. Immediately inform the physician about the living will.
- B. Suggest to the daughter that she discuss her father's wishes with her mother.
- C. Prepare to remove the client from life support.
- D. Make a copy of the living will and give it to the client's wife.
Correct Answer: A
Rationale: Informing the physician about the living will ensures that the client's wishes are addressed promptly.
A client with a history of gout is admitted with joint swelling. The nurse should include which of the following in the plan of care?
- A. Apply warm compresses to affected joints.
- B. Encourage a high-purine diet.
- C. Administer indomethacin as prescribed.
- D. Restrict fluid intake.
Correct Answer: C
Rationale: Indomethacin reduces inflammation and pain in acute gout attacks.
The nurse is assessing a client with a suspected myocardial infarction. Which of the following findings is most indicative of this condition?
- A. Chest pain radiating to the left arm.
- B. Bilateral leg swelling.
- C. Fever.
- D. Dry cough.
Correct Answer: A
Rationale: Chest pain radiating to the left arm is a classic symptom of myocardial infarction due to cardiac ischemia.
The nurse monitors the serum electrolyte levels of a client who is taking digoxin (Lanoxin). Which of the following electrolyte imbalances is a common cause of digoxin toxicity?
- A. Hyponatremia.
- B. Hypomagnesemia.
- C. Hypocalcemia.
- D. Hypokalemia.
Correct Answer: D
Rationale: Hypokalemia enhances digoxin's effect on the heart, increasing toxicity risk by altering cardiac membrane potential.
The nurse instructs a female client about collecting a midstream urine sample for culture and sensitivity. Which should the nurse include in client teaching?
- A. Bathe before collecting the specimen.
- B. Cleanse the perineum from front to back.
- C. Label specimen with the provider's name.
- D. Collect urine at the beginning of urination.
Correct Answer: B
Rationale: To prepare properly for collection of a sterile urine specimen, the client cleanses the perineum from front to back using antiseptic swabs. Bathing before a midstream urine collection is unnecessary; however, proper specimen handling is critically important because improper specimen handling can yield inaccurate test results. The specimen should be labeled with the client's name, date, time, and medical record number in addition to the provider's name. The client should begin the flow of urine and collect the sample after starting the flow of urine, and then send the specimen to the laboratory as soon as possible.