Chapter 24 prepU

Which client behavior should the nurse attempt to change when managing a client's tendency to wander and pace at night?

take a nap mid-afternoon and before dinner

An 80-year-old client with Alzheimer's disease is prescribed donepezil. Which teaching points should the nurse provide to the client's spouse about the new medication?

"The drug won't cure the client's Alzheimer's, but it has the potential to slow down the progression of the disease."

The nurse is caring for a client with dementia. The client's brain images show atrophy of cerebral neurons and enlargement of the third and fourth ventricles. What is the cause of dementia in this client?

Alzheimer's disease

When conducting a nursing assessment of a client experiencing moderate cognitive dysfunction, the nurse can best prepare for an effective interview by ensuring what?

Asking a family member to be present during the assessment

When giving tacrine to an elderly client, the nurse must be aware of what information?

Because the liver is most vulnerable to tacrine, liver function tests must be done periodically.

The spouse caregiver of a client with dementia tells the nurse that the client has been agitated lately. The spouse states, "I don't know how to handle this. The client was always such a gentle person!" Which interventions should the nurse suggest?

Distract the client with family photos and discuss the events pictured.

A client with Alzheimer's disease is admitted to an acute care facility for treatment of an infection. Assessment reveals that the client is anxious. When developing the client's plan of care, which would be least appropriate for a nurse to include?

Frequently provide reality orientation

A nurse is preparing a presentation for a group of staff nurses about neurocognitive disorders. When describing vascular neuorocognitive disorder, the nurse would identify which as posing the greatest risk for this disorder?

Hypertension

A client with dementia is having difficulty clearly communicating about physical needs. When teaching the caregiver about ways to assist the client in meeting physical needs, which instruction would the nurse most likely include?

Keep a record of bowel movements.

Which medication is not known to cause delirium?

Loop diuretics

Which of these is a N-methyl-D-aspartic acid (NMDA) receptor antagonist?

Memantine

The client has advanced Alzheimer's disease and becomes confused at mealtimes. The client has agnosia, apraxia, and disturbed executive functioning. Which is the most appropriate nursing intervention?

Provide the client with a tray, opening containers for the client.

The nurse is assessing a client who is diagnosed with delirium. Which presenting sign in the client indicates to the nurse that the client may have a diagnosis of dementia?

Remote memory loss

An older client transferred from a nursing home presents to the emergency department in an agitated state. The nurse is unable to obtain a coherent response to any questions posed. What is the best nursing action?

Review medication profile record.

A client is diagnosed with dementia related to Parkinson's disease. While at a clinic visit, a cholinesterase inhibitor is prescribed for the client. The nurse knows that this type of medication would be prescribed for the client to achieve which goal?

Slow deterioration of memory and function

The nurse is assessing a client with aphasia and notes the client may be exhibiting echolalia during their conversation. What signs does the nurse observe that leads to this conclusion?

The client may echo whatever is heard.

The nurse is interviewing a 50-year-old with a suspected cognitive disorder. The client has a long history of alcoholism. When the nurse asks if the client is employed, the client replies that the client is currently employed as a conductor on a national railway system. The client's spouse takes the nurse aside and informs the nurse that the client hasn't worked for several years and never worked for the railway. The nurse attributes the client's answer to which explanation?

The client may have Korsakoff's syndrome.

The nurse asks a client to pretend the client is brushing the client's teeth. The client is unable to perform the action. Upon examination, the nurse finds that the client possesses intact motor abilities. What can this problem be documented as?

The client may have apraxia.

A 65-year-old has been admitted to the intensive care unit following surgical resection of the bowel. The client has developed a fever. Which additional signs indicate the client has developed delirium?

The client removes the client's surgical bandage and begins picking at the sheets.

The diagnosis of delirium is supported when the nurse notes what about the client?

The client reports seeing "hundreds of bugs" and is not always oriented to time and place

Major goals for the nursing care of clients with dementia should include what?

The client will be safe, be physiologically stable, and have infrequent episodes of agitation.