A, B, D, and E. Show
Therapeutic communication techniques include listening, maintaining silence, maintaining neutral responses, using broad openings and open-ended questions, focusing and refocusing, restating, clarifying and validating, sharing perceptions, reflecting, providing acknowledgment and feedback, giving information, presenting reality, encouraging formulation of a plan of action, providing nonverbal encouragement, and summarizing 1. Which of the following is a priority nursing intervention for the management of delirium? A) Giving the client low-dose oxygenation and maintaining his or her fluid and electrolyte balance B) Reducing noise and placing familiar objects in the client's environment C) Giving the client a clock, a watch, and calendars to provide the client with temporal orientation D) Providing psychological support through cognitive and social stimulation Ans: A Priority questions address physiologic integrity. The client needs to be stabilized before the other interventions can be implemented 2. A nurse is conducting a class at a senior citizens' center on factors that protect against dementia. Which of the following statements by an older adult in the class indicates a need for further teaching by the nurse? A) "No healthy lifestyle is going to ward off dementia." B) "Eating food high in omega-3 fatty acids will help preserve my thinking processes." C) "Engaging in social activities will help prevent dementia." D) "Engaging in an organized exercise program will help prevent symptoms of dementia." Ans: A Engaging in regular exercise has a positive effect on preventing cognitive decline. Omega-3 fatty acids are nutritional interventions that help preserve cognition. There is evidence that engaging in stimulating and meaningful activities also has a positive effect on preventing cognitive decline. Adopting a healthy lifestyle may help ward off dementia just as it does other diseases 3. A nurse teaches a client and care partner about cholinesterase inhibitors. Which of the following statements should the nurse include in the teaching? A) "Rivastigmine (Exelon) has a high chance of interacting with other medications." B) "Nausea, vomiting, diarrhea, and loss of appetite can be prevented or reduced by starting with a low dose." C) "Rivastigmine is only for treatment of mild Alzheimer's disease and will be discontinued as the disease progresses." D) "You should have a 'drug holiday' monthly to improve the medication's functioning." Ans: B When administering medications to older adults, it is imperative to start with lower doses and increase the doses slowly. Exelon is less likely to interact with other drugs and may be safer and better tolerated in people. It will continue and other medications may be added. The effectiveness of cholinesterase inhibitors is diminished significantly if it is stopped and then restarted 4. Which of the following are examples of appropriate communication techniques for dealing effectively with people with dementia? A) Ask open-ended questions so the person feels he or she can make choices. B) For people in the later stages of Alzheimer disease, talk as you would to a child. C) Maintain good eye contact and use a relaxed and smiling approach. D) When the person forgets something, remind him or her not to forget next time Ans: C To facilitate communication with people who have dementia, the nurse uses a relaxed and smiling approach. The nurse should avoid infantilization of the older adult and not emphasize the person's memory or cognitive deficits 5. A nurse develops a plan to addressing dementia-related behaviors in an older adult with dementia. Which of the following interventions should be included in this plan? (Select all that apply.) A) Maintain a clutter-free environment. B) Implement regular rest periods. C) Place pictures of familiar people in very visible places. D) Lay out clothing in the order in which the items are to be donned. E) Test the client's memory with each conversation Ans: A, B, C, D Implement regular rest periods to compensate for fatigue and loss of reserve energy. Use simple pictures and place pictures of familiar individuals in visible areas. Keep the environment free of clutter and place dangerous substances in an inaccessible area. Avoid persistent testing of memory 6. An 80-year-old client was referred to a neurologist after several months of worsening cognitive deficits and has subsequently been diagnosed with Alzheimer disease. Which statement by the nurse to the client's family demonstrates appropriate use of terminology? A) "It's very difficult and stressful when a loved one becomes senile." B) "Even though your parent is demented, we will do all we can to promote his quality of life." C) "This form of organic brain syndrome is a common health problem in the ninth decade of life." D) "We always try our best to foster wellness in persons who have dementia." Ans: D Nurses can use phrases such as "a person with dementia" or a "person with a dementing illness" to accurately refer to the medical syndrome of impaired cognitive function while avoiding pejorative connotations associated with describing older adults as "demented." The terms "senile" and "organic brain syndrome" are no longer in use. 7. A client was diagnosed 3 years ago with a cognitive impairment, a condition that worsened over the next several months and which culminated in his recent death. An autopsy revealed numerous infarcted brain regions resulting from vessel occlusions. This client most likely suffered from which type of dementia? A) Alzheimer disease Ans: B While the four major types of dementia are not discrete or mutually exclusive, vascular dementia is characterized by pathophysiologic processes including infarctions from occlusion of blood vessels. This pathophysiology is not characteristic of Alzheimer disease, Lewy body dementia, or frontotemporal lobe dementia 8. A long-time resident of an assisted living facility has just been diagnosed with Alzheimer disease. A nurse who provides care at the facility has remarked to a colleague, "It's a real shame, but at least she'll never know what's happening to her." What fact should underlie the colleague's response? A) Older adults with Alzheimer disease and other dementias rarely have insight into their cognitive deficits. B) Many persons with dementia are acutely aware of the fact that they are experiencing a cognitive deficit. C) Certain types of dementia are occasionally marked by older adults' awareness of their disease. D) An awareness of dementia is an indication that the condition is either latent or resolving Ans: B One of the myths associated with dementia is that people with dementia deny their symptoms or have no awareness of their deficits. In recent years, this perception of a high prevalence of socalled denial in people with dementia has diminished, and gerontologists are researching insight and self-awareness through all stages of dementia 9. A gerontological nurse has been providing ongoing care for an older adult who has a diagnosis of dementia. What goal should the nurse prioritize when conducting ongoing assessment of this client? A) Identifying strategies that can be used to cure the client's dementia B) Identifying genetic or lifestyle factors that may have contributed to the client's dementia C) Determining whether the client has Alzheimer disease, Lewy body dementia, or frontotemporal lobe dementia D) Identifying factors affecting the client's functioning and quality of life Ans: D A major goal of ongoing assessment of clients with dementia is to identify factors that interfere with the person's level of functioning or quality of life so that interventions can be initiated to alleviate these contributing factors. Medical diagnosis is not a nursing action and causative factors are not a priority after diagnosis. Dementia is not curable. 10. A nursing home is in the planning stages of building a new wing that will be specifically designed for the needs of older adults who have dementia. What design characteristic should be included in this new facility? A) Monochromatic walls and floors that are a neutral color B) Pictures, signs, and color codes for identifying places C) Bright, glossy floors that can provide sensory stimulation D) Bright lighting during the day and total darkness at night Ans: B Pictures, signs, and color codes can help to orient persons with dementia. Floors and walls do not need to be one color, and glossy floors and total darkness at night are safety hazards for this population 11. A nurse prepares to administer scheduled medications to a new resident with mild nonAlzheimer-type dementia. Which of the following type of medication should the nurse administer without concern of worsening delirium? A) An anticholinergic Ans: D Cholinesterase inhibitors are standard treatment for mild-to-moderate Alzheimer disease. Anticholinergics, including benzodiazepines, as well as atypical antipsychotics can all lead to delirium 12. A 74-year-old client is diagnosed with mild Alzheimer disease. He has no other noted health issues. When speaking with the nurse, he expresses concern regarding the progression of his disease. Which statement by the nurse is most appropriate? A) As you have no other health issues, the progression is usually gradual. B) The medications stop the progression of the disease. C) We never know how fast Alzheimer disease will progress. D) Yes, progression is usually fairly fast, you might want to start making plans. Ans: A Alzheimer disease is very gradual; it has accelerated decline with concomitant conditions. Medications slow the progression, but don't stop it 13. A intensive care nurse cares for an 83-year-old with sepsis. The client exhibits illogical thinking and agitation. Which intervention should the nurse implement? (Select all that apply.) A) Administer a benzodiazepine. Ans: B, C, D, E Older clients with infection and those in the ICU are at great risk for delirium. Sleep, rest, pain control, and familiar items are interventions to minimize delirium. The client is a greater risk for falls so a fall prevention program should be initiated. Benzodiazepines should be avoided 14. A nurse councils a care partner of a client with dementia. The care partner states "He fights me when I try and bath him; he hasn't had a shower in 2 months!" Which response by the nurse is most appropriate? A) "I hear your frustration." B) "He wants to feel he has a choice. How do you get him to shower?" C) "I would just put him in there, he needs to be clean." D) "Whatever worked before should work now." E) "What other ways have you tried to assure he is clean?" Ans: E There are multiple ways to stay clean, if showering is a trigger, then avoid it. What has worked in the past does not mean it will work again. Forcing a shower is unsafe. They don't get him to shower, it's been months 15. A nurse observes an aide asking a client what he wants for breakfast, lunch, and dinner while assisting him to toilet. Which action by the nurse is most appropriate? A) Direct the aide to present only one idea at a time. B) Encourage this small talk. C) No action is required. D) Tell the aide to avoid conversations while the client is toileting. Ans: A Multiple events/ideas are occurring at once; this increases the risk of overloading the client. Teach the aide to present one idea at a time (e.g., do you like oatmeal?). Directed small talk is appropriate, when the client is dressed and not in a compromised situation Which techniques should the nurse use when communicating with someone who has cognitive deficits?The nurse must use simple, concrete terms when speaking to psychiatric patients with cognitive deficits because these patients may be unable to follow language that is elaborate.
Which communication techniques should the nurse use with a patient who has been identified as having difficulty expressing thoughts and feelings?Which communication techniques should the nurse use with a client who has been identified as having difficulty expressing thoughts and feelings? Open-ended questions give the client the widest possible latitude in answering.
Which measure would the nurse take when communicating with a visually impaired patient quizlet?Do not rely on gestures or nonverbal communication while communicating with visually impaired patients. Make sure that the patient is using glasses or contact lenses. The nurse should communicate in a normal tone of voice.
Which of the following are examples of appropriate communication techniques for dealing effectively with people with dementia?It can help to:. speak clearly and slowly, using short sentences.. make eye contact with the person when they're talking or asking questions.. give them time to respond, because they may feel pressured if you try to speed up their answers.. encourage them to join in conversations with others, where possible.. |
Which of the following techniques would the nurse use when communicating with someone who has cognitive deficits quizlet?
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