Question

A nurse is contributing to the plan of care for a client who has dementia. Which of the following actions should the nurse include in the plan of care?

Answer 1

Correct Answers:

Provide a consistent daily routine.

Rationale :

🟡 Clients with dementia benefit greatly from a consistent daily routine because it helps reduce confusion, anxiety, and agitation by providing a predictable environment. Familiar patterns enhance the client’s sense of security and stability.

🟡 Dementia impairs memory and cognitive function, making it difficult for clients to adapt to frequent changes. A structured routine supports orientation and helps maintain functional abilities for as long as possible.

🟡 Posting a written schedule may be ineffective if the client has significant memory or visual processing deficits, and allowing too many choices can lead to frustration and overstimulation.

🟡 Using loudspeakers can increase disorientation and agitation, as dementia patients are sensitive to excessive noise and stimulation.

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Answer 2

Correct Answers:

Drink adequate amounts of fluid to prevent constipation

Rationale :

🔵 Buspirone (BuSpar) is an anxiolytic used for generalized anxiety disorder (GAD) that has minimal sedative effects compared to benzodiazepines. One of its common side effects is gastrointestinal upset, including constipation, so maintaining adequate fluid intake helps prevent this complication.

🔵 Unlike sedative medications, buspirone does not cause significant CNS depression or sedation, making it a preferred choice for long-term management of anxiety.

🔵 It does not typically cause visual disturbances, and there is no associated risk of cardiac arrest when used as prescribed.

🔵 Teaching clients about maintaining hydration and fiber intake helps improve adherence and prevents discomfort, supporting overall therapeutic success.

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Answer 3

Correct Answers:

Posttraumatic stress disorder

Rationale :

⭐ Posttraumatic stress disorder (PTSD) develops after exposure to a traumatic event involving actual or threatened death or serious injury. Flashbacks, where the individual relives the traumatic experience, are a hallmark symptom of PTSD.

⭐ The client’s description of reliving the car crash and witnessing his best friend’s death aligns with the intrusive re-experiencing symptoms of PTSD, which also include nightmares, hypervigilance, and avoidance behaviors.

⭐ Panic disorder involves sudden episodes of intense fear but is not triggered by a specific traumatic memory. Obsessive-compulsive disorder is characterized by repetitive thoughts and compulsions, while agoraphobia involves fear of open or crowded spaces, not re-experiencing trauma.

⭐ Recognizing PTSD early is essential to provide trauma-focused therapy and prevent worsening of anxiety and functional impairment.

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Answer 4

Correct Answers:

Selective serotonin reuptake inhibitors (SSRIs)

Rationale :

🌼 Selective serotonin reuptake inhibitors (SSRIs) are considered the first-line treatment for depression in older adults because they are generally well-tolerated and have a safer side-effect profile compared to other antidepressants. They effectively increase serotonin levels, improving mood and cognitive functioning.

🌼 SSRIs such as sertraline and citalopram have minimal anticholinergic and cardiovascular side effects, which is crucial for older adults who are often more sensitive to medication effects and at higher risk for orthostatic hypotension and cardiac complications.

🌼 Benzodiazepines and hypnotics are not appropriate for depression as they primarily treat anxiety and insomnia and can increase the risk of sedation, falls, and dependence in older adults.

🌼 Monoamine oxidase inhibitors (MAOIs) are rarely used in older adults due to serious dietary restrictions and potential for hypertensive crisis, making SSRIs the safest and most effective option.

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Answer 5

Correct Answers:

severe stage

Rationale :

🟢 In the severe stage of Alzheimer's disease, clients experience profound cognitive decline, including loss of orientation to time and place and severe agnosia (inability to recognize familiar objects or people despite intact sensory function). Visual agnosia is a hallmark of this advanced cognitive impairment.

🟢 Clients at this stage often show marked disorientation, confusion, and inability to perform activities of daily living independently, requiring extensive caregiving support.

🟢 The early stage typically involves mild memory loss and difficulty with complex tasks, while the intermediate stage includes progressive confusion but not complete disorientation or severe agnosia.

🟢 The end stage is characterized by profound physical deterioration, including loss of motor abilities, dysphagia, and total dependence, rather than just advanced cognitive impairment as seen in the severe stage.

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Answer 6

Correct Answers:

Headache

Rationale :

🟠 Physical clinical findings of depression in older adults often manifest as somatic complaints, including headaches, generalized pain, fatigue, and gastrointestinal disturbances. Older adults may express depression through physical symptoms rather than overt emotional complaints, making recognition more challenging.

🟠 While anxiety, slowed memory, and slowed intellect can occur in depression, they are considered cognitive or psychological symptoms, not primary physical findings.

🟠 Recognizing somatic symptoms is crucial in geriatric populations because depression is frequently underdiagnosed due to misattribution of these physical complaints to aging or medical illnesses.

🟠 Proper identification of physical manifestations allows for timely diagnosis and treatment, improving quality of life and functional ability in older adults.

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Answer 7

Correct Answers:

Donepezil (Aricept)

Rationale :

🟩 Donepezil (Aricept) is a cholinesterase inhibitor approved for the treatment of mild to moderate stages of Alzheimer’s disease. It works by inhibiting the breakdown of acetylcholine, thereby improving cognitive function, memory, and daily activity performance.

🟩 Early to moderate Alzheimer’s management focuses on slowing cognitive decline, and donepezil is one of the first-line medications recommended for this purpose.

🟩 Risperidone and haloperidol are antipsychotics, used only for severe behavioral disturbances such as aggression, and not as primary treatment for cognitive symptoms.

🟩 Alprazolam is a benzodiazepine used for anxiety, which may worsen confusion and sedation in Alzheimer’s patients, making it inappropriate for routine dementia management.

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Answer 8

Correct Answers:

vascular dementia

Rationale :

🔷 Vascular dementia results from impaired blood flow to the brain, often due to conditions like severe cardiovascular disease, strokes, or multiple small infarcts. The presence of significant cardiovascular disease strongly suggests this type of dementia because of the link between vascular insufficiency and cognitive decline.

🔷 Clinical features often include a stepwise progression of symptoms, with abrupt changes in cognitive function corresponding to ischemic events.

🔷 Alzheimer’s disease is the most common dementia but is primarily associated with amyloid plaques and neurofibrillary tangles, not cardiovascular pathology.

🔷 Lewy body dementia is associated with visual hallucinations and parkinsonian features, and frontal dementia (frontotemporal dementia) is linked to behavioral and language changes, making them less likely in this scenario.

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Answer 9

Correct Answers:

hallucinations

Rationale :

🟣 Hallucinations are sensory perceptions without external stimuli, meaning the person sees, hears, or feels things that are not actually present. In this case, the client sees snakes on the walls, which is a visual hallucination.

🟣 Delirium refers to an acute confusional state often caused by medical illness or medication, but it is a condition, not the actual symptom; hallucinations may occur during delirium but are not the definition of it.

🟣 Delusions are fixed false beliefs (e.g., thinking one is being poisoned) rather than sensory misperceptions.

🟣 Psychosis is a broader term describing a loss of contact with reality, which can include hallucinations or delusions, but the specific symptom described here is clearly a hallucination.

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Answer 10

Correct Answers:

Follow the agency's guidelines for reporting suspected abuse.

Rationale :

🟥 The nurse’s first priority when suspecting elder abuse is to ensure the client’s safety by immediately reporting the suspicion according to legal and agency guidelines. Reporting is a mandatory duty for healthcare professionals and must occur as soon as abuse is suspected, even before confirmation.

🟥 Delaying action, such as waiting until the next visit or only increasing home visits, may place the client at continued risk of harm. Timely reporting allows for protective services to intervene and assess the client’s situation.

🟥 Family therapy may help address home stressors later, but it is not appropriate as the first action when abuse is suspected, as it does not immediately address the client’s safety needs.

🟥 Early and proper reporting is crucial to prevent further physical injury or neglect, which is the nurse’s ethical and legal obligation in suspected abuse cases.

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QLexNursing

1 :
A nurse is contributing to the plan of care for a client who has dementia. Which of the following actions should the nurse include in the plan of care?

2 :
A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). Which information regarding side effects should be given to the client?

3 :
A client describes flashbacks of a terrifying car crash in which he saw his best friend die. Which disorder should the nurse suspect in this situation?

4 :
An older adult is given the diagnosis of depression and is started on medication. Which group of medications would be appropriate for the depressed older adult?

5 :
A client with Alzheimer's disease has lost all sense of time and place and has developed visual agnosia. The client is in which of the following stages of Alzheimer's disease?

6 :
Which of the following is a physical clinical finding of depression in older adults?

7 :
Which medication would the nurse expect to be prescribed for a client with moderate stages of Alzheimer's disease?

8 :
An elderly client with severe cardiovascular disease is given the diagnosis of dementia. Which type of dementia does the client most likely have?

9 :
A hospitalized client sees snakes on the walls of the hospital room and becomes anxious. This is an example of which of the following?

QLexNursing

1 : A nurse is contributing to the plan of care for a client who has dementia. Which of the following actions should the nurse include in the plan of care?

2 : A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). Which information regarding side effects should be given to the client?

3 : A client describes flashbacks of a terrifying car crash in which he saw his best friend die. Which disorder should the nurse suspect in this situation?

4 : An older adult is given the diagnosis of depression and is started on medication. Which group of medications would be appropriate for the depressed older adult?

5 : A client with Alzheimer's disease has lost all sense of time and place and has developed visual agnosia. The client is in which of the following stages of Alzheimer's disease?

6 : Which of the following is a physical clinical finding of depression in older adults?

7 : Which medication would the nurse expect to be prescribed for a client with moderate stages of Alzheimer's disease?

8 : An elderly client with severe cardiovascular disease is given the diagnosis of dementia. Which type of dementia does the client most likely have?

9 : A hospitalized client sees snakes on the walls of the hospital room and becomes anxious. This is an example of which of the following?

1 :
A nurse is contributing to the plan of care for a client who has dementia. Which of the following actions should the nurse include in the plan of care?

2 :
A client with generalized anxiety disorder (GAD) is prescribed buspirone (BuSpar). Which information regarding side effects should be given to the client?

3 :
A client describes flashbacks of a terrifying car crash in which he saw his best friend die. Which disorder should the nurse suspect in this situation?

4 :
An older adult is given the diagnosis of depression and is started on medication. Which group of medications would be appropriate for the depressed older adult?

5 :
A client with Alzheimer's disease has lost all sense of time and place and has developed visual agnosia. The client is in which of the following stages of Alzheimer's disease?

6 :
Which of the following is a physical clinical finding of depression in older adults?

7 :
Which medication would the nurse expect to be prescribed for a client with moderate stages of Alzheimer's disease?

8 :
An elderly client with severe cardiovascular disease is given the diagnosis of dementia. Which type of dementia does the client most likely have?

9 :
A hospitalized client sees snakes on the walls of the hospital room and becomes anxious. This is an example of which of the following?