N128 Week 4 - Alzheimer's Disease (Early Onset)

Section 6 Question 13 of 27 Which laboratory test should be scheduled? Serum BUN and creatinine. Serum liver enzymes. Urinalysis. White blood count.

Serum liver enzymes. Serum BUN and creatinine. Renal function is not significantly affected by acetylcholinesterase inhibitors. Serum liver enzymes. Liver toxicity is a significant side effect of acetylcholinesterase inhibitors, so liver function tests should be monitored regularly. Skidmore-Roth, L. (2021). Mosby's 2021 Nursing Drug Reference. (34th edition). St. Louis, Missouri. Elsevier. Pg. 418. Urinalysis. Donepezil may cause nocturia or urinary incontinence, but urine will not be affected by the medication. White blood count. Infection and immunosuppression are not significant side effects of acetylcholinesterase inhibitors.

Question 11 of 27 How does donepezil reduce the symptoms for clients with mild to moderate Alzheimer's disease? Enhancing acetylcholine function. Inhibiting serotonin uptake. Anti-oxidating free radical. Reducing GABA action.

Enhancing acetylcholine function. Enhancing acetylcholine function. Donepezil prevents an enzyme known as acetylcholinesterase from breaking down acetylcholine in the brain. Increased concentrations of acetylcholine lead to increased communication between the nerve cells that use acetylcholine as a chemical messenger, which may temporarily improve or stabilize the symptoms of Alzheimer's disease. Skidmore-Roth, L. (2021). Mosby's 2021 Nursing Drug Reference. (34th edition). St. Louis, Missouri. Elsevier. Pg. 418. Keltner, N., Steele, D. (2019). Psychiatric Nursing (8th edition). St. Louis, Missouri. Elsevier. Pg. 195. Inhibiting serotonin uptake. This is not the mechanism of action for donepezil. Anti-oxidating free radical. This is not the mechanism of action for donepezil. Reducing GABA action. This is not the mechanism of action for donepezil.

Question 23 of 27 What initial action should the nurse take? Evaluate the clietn's vital signs before transferring him to his bed. Monitor the client's blood glucose level after he is back in his bed. Assist with transferring the client to his bed and turn on a night light. Advise the UAP to turn off the room light and let the client rest in the chair.

Evaluate the clietn's vital signs before transferring him to his bed. Evaluate the clietn's vital signs before transferring him to his bed. The client may be experiencing an adverse effect of the medication, and he should be assessed before further action is initiated. Skidmore-Roth, L. (2021). Mosby's 2021 Nursing Drug Reference. (34th edition). St. Louis, Missouri. Elsevier. Pg. 957. Monitor the client's blood glucose level after he is back in his bed. There is no reason to anticipate a change in his blood glucose level. Assist with transferring the client to his bed and turn on a night light. The client is exhibiting signs of a physiological problem. Nursing assessment is warranted. Advise the UAP to turn off the room light and let the client rest in the chair. He is exhibiting signs of a physiological problem. Nursing assessment is warranted.

Question 2 of 27 Which of the following are risk factors for Alzheimer's Disease: (Select all that apply. One, some, or all options may be correct.) Select all that apply Genetic predisposition. History of head trauma. Male gender. High cholesterol levels. Cooking with teflon coated pans.

Genetic predisposition. History of head trauma. High cholesterol levels. Genetic predisposition. Genetic predisposition increases risk by 60-70 %. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 436. History of head trauma. Brain injury is associated with a greater risk. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 436. Male gender. Alzheimer's disease may affect women more post menopause. High cholesterol levels. Lifestyles associated with cardiovascular disease such as high cholesterol, diabetes, and obesity increase the risk. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 436. Cooking with teflon coated pans. There is no documented evidence that teflon causes Alzheimer's disease.

Question 7 of 27 What is the goal of nursing care for a client with a neurocognitive disorder due to Alzheimer's disease? Individualizing care. Improving cognition. Maintaining optimum function. Promoting self-confidence and self-esteem.

Maintaining optimum function. Individualizing care. This is the approach, not the desired outcome. Improving cognition. Chronic illness with a slow decline. Maintaining optimum function. There is not a cure for Alzheimer's disease, but support can help the client and the client's family live at a maximum functional level. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 439. Promoting self-confidence and self-esteem. This is the approach, not the desired outcome.

Question 10 of 27 What should the nurse advise the client's daughter to do? (Select all that apply. One, some, or all options may be correct.) Select all that apply Ignore the behavior. Tell her father that the man is a friend. Make sure her father's room has sufficient light. Tell her father that he does not see anyone and that it is in his imagination. Divert her father's attention with food or drink.

Make sure her father's room has sufficient light. Divert her father's attention with food or drink. Ignore the behavior. The client is anxious and needs assistance. Tell her father that the man is a friend. A false reality should not be supported. Make sure her father's room has sufficient light. Shadows can increase confusion and support delusions. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 434. Tell her father that he does not see anyone and that it is in his imagination. Dismissing the client's experience will not lower his anxiety. Divert her father's attention with food or drink. Night time confusion can be reduced by diverting the client to something familiar and soothing. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 434.

Question 22 of 27 What action should the nurse implement first? Redirect the client's attention to a familiar object from his home. Quietly leave the room until he calms down. Assign a UAP to remain with the client. Apply a soft vest restraint and bed alarm.

Redirect the client's attention to a familiar object from his home. Redirect the client's attention to a familiar object from his home. The nurse should first attempt to calm the client by redirecting his attention or distracting him from the source of the anxiety. Keltner, N., Steele, D. (2019). Psychiatric Nursing (8th edition). St. Louis, Missouri. Elsevier. Pg. 337. Quietly leave the room until he calms down. Although it may be useful to leave the room if the client is not likely to harm himself, this is not the first action that the nurse should implement. Assign a UAP to remain with the client. This may be useful, but it is not the first action that the nurse should implement. Apply a soft vest restraint and bed alarm. From an ethical-legal perspective, the use of a physical restraint is always the last choice, and it should be considered only if all other interventions fail to ensure client safety.

Question 1 of 27 Which is the best response by the nurse to the client's statement? Tell the client that there is nothing to worry about. Emphasize to the client that anxiety is common when people have problems remembering things and that he will be fine. State how worried the client looks and ask the how to make them more comfortable. Remind the client that he has Alzheimer's disease and has become more forgetful lately.

State how worried the client looks and ask the how to make them more comfortable. Tell the client that there is nothing to worry about. This response belittles the client's feelings and does not address his anxiety. Emphasize to the client that anxiety is common when people have problems remembering things and that he will be fine. Although it is common for clients to be anxious when they are confused secondary to memory loss, pointing this out may make him defensive and more anxious. State how worried the client looks and ask the how to make them more comfortable. This response acknowledges the clients feelings and the word "worried" is generally neutral. Cooper, K., Gosnell, K. (2019). Foundations of Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 68. Remind the client that he has Alzheimer's disease and has become more forgetful lately. The nurse does not know what the client understands about his diagnosis, and being too direct may make the client defensive and more anxious.

Question 18 of 27 Which are common components of an advance directive for healthcare? (Select all that apply. One, some, or all options may be correct Select all that apply Appointment of another person to make healthcare decisions if the client is unable. Specific or general instructions about physical healthcare treatment. The naming of individuals to whom personal possessions will be given in the event of a death. Specific or general instructions about mental or psychological healthcare treatment. A section explaining the document is legal and cannot be changed by the client once signed.

Appointment of another person to make healthcare decisions if the client is unable. Specific or general instructions about physical healthcare treatment. Specific or general instructions about mental or psychological healthcare treatment. Appointment of another person to make healthcare decisions if the client is unable. Also known as a durable power of attorney, this can be part of an advance directive for healthcare. It names another person to make healthcare decisions if the individual is mentally or physically unable. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 574. Specific or general instructions about physical healthcare treatment. Decisions or preferences about physical healthcare treatment such as the use or nonuse of a ventilator can be outlined in an advance directive for healthcare. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 574. The naming of individuals to whom personal possessions will be given in the event of a death. This is not a component of an advance directive for healthcare. Specific or general instructions about mental or psychological healthcare treatment. Decisions or preferences about mental or psychological healthcare treatment such as the use or nonuse of electrical shock treatment can be outlined in an advance directive for healthcare. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 574. A section explaining the document is legal and cannot be changed by the client once signed. An individual may change their advance directive for healthcare if the individual has the mental capacity to do so and is acting freely without pressure from another person or agency.

Question 24 of 27 After assisting the client to the bed, which nursing action has the highest priority? Administer oxygen per nasal cannula. Notify the HCP of the vital signs. Provide several warm blankets. Elevate the client's feet fifteen degrees.

Elevate the client's feet fifteen degrees. Administer oxygen per nasal cannula. The client's O2 saturation is within normal limits (WNL); therefore, administration of oxygen is not warranted. Notify the HCP of the vital signs. Immediate action should be taken before contacting the HCP. Provide several warm blankets. This is an important intervention since the client's temperature is low, but it is not the highest priority. A temperature below 96.8°F (35.5°C) is considered hypothermia. Elevate the client's feet fifteen degrees. The client is experiencing hypotension secondary to his initial dose of the antipsychotic medication. The priority nursing action is to restore his blood pressure. Potter, P., Perry, A., Stockert, P., Hall, A. (2019). Essentials for Nursing Practice. (9th edition). St. Louis, Missouri. Elsevier. Pg. 308.

Question 26 of 27 What information is most important to find out from the client's daughter before developing the plan of care to address caregiver role strain? Ask how is the rest of the family coping with their father's illness. Identify what the daughter feels is most stressful in her daily life. Find out if the daughter has attended a caregiver support group. Evaluate how much time do the daughter spends taking care of herself.

Identify what the daughter feels is most stressful in her daily life. Ask how is the rest of the family coping with their father's illness. This will provide useful information, but does not address the daughter's stress. Identify what the daughter feels is most stressful in her daily life. This question will focus the caregiver on the daughter's needs. Ignatavicus, D. (2018). Medical-Surgical Nursing: Patient Centered Collaborative Care. (9th edition). St. Louis, Missouri. Elsevier. Pg. 865. Find out if the daughter has attended a caregiver support group. This will provide useful information, and may help in the long term but a short term goal needs to be identified. Evaluate how much time do the daughter spends taking care of herself. This will provide useful information, but may make the daughter feel as if she is not totally devoted to her father.

Question 27 of 27 What is the best response by the nurse? Empathize with the daughter and agree that they would feel guilty for thinking that, too. Ask the daughter why she feels her father would be better off. Suggest that the daughter is just too tired to think clearly. Asknowledge that the daughter has many conflicting emotions right now.

Asknowledge that the daughter has many conflicting emotions right now. Empathize with the daughter and agree that they would feel guilty for thinking that, too. This response is judgmental and blocks further communication. Ask the daughter why she feels her father would be better off. The use of "why" is often perceived as challenging, and it should not be used by the nurse when seeking to maintain therapeutic communication. Suggest that the daughter is just too tired to think clearly. This response trivializes her feelings and blocks further communication. Asknowledge that the daughter has many conflicting emotions right now. This response restates the daughter's feelings and provides the opportunity for her to continue to share concerns. Ignatavicus, D. (2018). Medical-Surgical Nursing: Patient Centered Collaborative Care. (9th edition). St. Louis, Missouri. Elsevier. Pg. 866.

Question 20 of 27 What is the best response by the nurse? Insist that the daughter correct the client's inaccurate statements to promote reality orientation. Encourage the daughter and let her know that she is right to balance the client's feelings with the need to promote reality. Tell the daughter that her dad is attempting to manipulate her and make sure he gets his own way. Say to the daughter that there is no reason to attempt to correct her father because he will not understand.

Encourage the daughter and let her know that she is right to balance the client's feelings with the need to promote reality. Insist that the daughter correct the client's inaccurate statements to promote reality orientation. Reality orientation is an important tool for the client with Alzheimer's disease, but it is also important to recognize and respect the client's feelings. Encourage the daughter and let her know that she is right to balance the client's feelings with the need to promote reality. Reality orientation is an important tool for the client with Alzheimer's disease, unfortunately, as the disease progresses, it often causes the client to become agitated. It is important to recognize the feelings and emotions of the client with Alzheimer's disease. Keltner, N., Steele, D. (2019). Psychiatric Nursing (8th edition). St. Louis, Missouri. Elsevier. Pg. 333. Tell the daughter that her dad is attempting to manipulate her and make sure he gets his own way. This statement is judgmental and uncaring. Say to the daughter that there is no reason to attempt to correct her father because he will not understand. Reality orientation is an important tool for the client with mild to moderate Alzheimer's disease, and it should be included in the client's care whenever possible.

Question 8 of 27 What is the nurse's best response? Tell the daughter that her father is in the middle stage of this disease and he will stabilize at this level of functioning for some time. Explain that everyone responds differently to this disease, but it is likely that his health and daily functioning will continue to decline. Let the daughter know that it is evident that she is worried about her father, but there is nothing that you can do. Ask the daughter if she has a friend or a family member who can help her.

Explain that everyone responds differently to this disease, but it is likely that his health and daily functioning will continue to decline. Tell the daughter that her father is in the middle stage of this disease and he will stabilize at this level of functioning for some time. The nurse does not know the course of this illness for this client. Explain that everyone responds differently to this disease, but it is likely that his health and daily functioning will continue to decline. This is the most accurate description of this disease, and it allows the client's daughter to participate in her father's plan of care. Keltner, N., Steele, D. (2019). Psychiatric Nursing (8th edition). St. Louis, Missouri. Elsevier. Pg. 333. Let the daughter know that it is evident that she is worried about her father, but there is nothing that you can do. This statement is not accurate and it may make the client's daughter feel hopeless and helpless when she needs support. Ask the daughter if she has a friend or a family member who can help her. This is avoiding the question, and it does not give the information that the client's daughter needs to plan for the future.

Question 6 of 27 Which of the following memory issues/deficits are related to Mild Neurocognitive Disorder due to Alzheimer's disease? (Select all that apply. One, some, or all options may be correct. Select all that apply Temporarily misplaces keys and purse. Forgets the purpose or use of an item. Cooks a meal and forgets to serve it. Momentarily forgets an acquaintance's name. Becomes lost on the client's own street.

Forgets the purpose or use of an item. Cooks a meal and forgets to serve it. Temporarily misplaces keys and purse. The temporary misplacement of items is typically associated with "normal forgetfulness." Key word is temporary. Forgets the purpose or use of an item. This type of memory loss is associated with mild Alzheimer's disease. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 438. Cooks a meal and forgets to serve it. This type of memory loss is associated with mild Alzheimer's disease. They have troupble with planning or organizing. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 438. Momentarily forgets an acquaintance's name. Occasional or momentary lapse in memory is typically associated with "normal forgetfulness." Becomes lost on the client's own street. This type of memory loss is associated with moderate Alzheimer's disease.

Question 19 of 27 Which response by the nurse is most therapeutic? Tell the daughter that this may be traumatic so it is best for her to wait outside the room. Have the daughter pull up a chair so that she may sit on the left side of the bed and hold her dad's hand. Ask the client if he wants the daughter to stay in the room for the procedure. Explain how clients generally follow staff requests if family members are not present.

Have the daughter pull up a chair so that she may sit on the left side of the bed and hold her dad's hand. Tell the daughter that this may be traumatic so it is best for her to wait outside the room. This should not be the nurse's decision and is not the most therapeutic response. Have the daughter pull up a chair so that she may sit on the left side of the bed and hold her dad's hand. The client's daughter's presence may make the procedure safer and less traumatic. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 125. Ask the client if he wants the daughter to stay in the room for the procedure. The client is confused, afraid, and disoriented. Asking his permission may worsen his symptoms. Explain how clients generally follow staff requests if family members are not present. The client is confused, and he needs a familiar face to help him feel safe.

Question 25 of 27 Which behaviors are commonly associated with caregiver role strain? (Select all that apply. One, some, or all options may be correct. Select all that apply Reports of physical symptoms such as frequent headaches. Feels a sadness that will not go away. Allows other family members to provide care one day per week. Frequently forgets to change care recipient's soiled linens. Withdraws from family and friends.

Reports of physical symptoms such as frequent headaches. Feels a sadness that will not go away. Frequently forgets to change care recipient's soiled linens. Withdraws from family and friends. Reports of physical symptoms such as frequent headaches. Reports of frequent physical symptoms are a sign of caregiver stress. Harding, M. (2020). Lewis's Medical-Surgical Nursing. (11th edition). St. Louis, Missouri. Elsevier. Pg. 65. Feels a sadness that will not go away. Mental health issues, including depression, are prevalent among caregivers of clients with chronic illnesses such as Alzheimer's disease. Harding, M. (2020). Lewis's Medical-Surgical Nursing. (11th edition). St. Louis, Missouri. Elsevier. Pg. 65. Allows other family members to provide care one day per week. Allowing other family members to provide care is a therapeutic response to caregiving and does not indicate increased stress or burden. Frequently forgets to change care recipient's soiled linens. Abuse or neglect is sometimes associated with increased caregiver stress or burden. Harding, M. (2020). Lewis's Medical-Surgical Nursing. (11th edition). St. Louis, Missouri. Elsevier. Pg. 65. Withdraws from family and friends. Caregivers who are experiencing stress often withdraw from family, friends, and social activities. Harding, M. (2020). Lewis's Medical-Surgical Nursing. (11th edition). St. Louis, Missouri. Elsevier. Pg. 65.

Question 3 of 27 What is the best initial response by the nurse? Tell the daughter that changes in behavior and personality often occur as Alzheimer's disease progresses. Explain to the daughter that behavior changes may indicate that he has already progressed to a later stage of the disease. Assure the daughter that behavior changes are probably the result of his effort to cope with his altered mental function. Help the daughter understand that behavior changes usually indicate that the person is feeling depressed about the situation.

Tell the daughter that changes in behavior and personality often occur as Alzheimer's disease progresses. Tell the daughter that changes in behavior and personality often occur as Alzheimer's disease progresses. Subtle changes in behavior and personality, which would easily be recognized by a loved one, occur even in early Alzheimer's disease. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 438. Explain to the daughter that behavior changes may indicate that he has already progressed to a later stage of the disease. These changes do not occur only at a late stage of Alzheimer's disease. Assure the daughter that behavior changes are probably the result of his effort to cope with his altered mental function. Although this may be a contributing factor, it is not the most accurate information about behavioral changes in Alzheimer's disease. Help the daughter understand that behavior changes usually indicate that the person is feeling depressed about the situation. Although this may be a contributing factor, it is not the most accurate information about behavioral changes in Alzheimer's disease.

Question 15 of 27 Which finding by the nurse is most concerning? The client sloshes milk from the side of the glass when he sets it down. The client watches his daughter eat and mimics her as she takes a bite. The client reaches for the plastic fruit used in the table's centerpiece. The client's eyes water and face becomes red each time he swallows a bite of meat or bread.

The client's eyes water and face becomes red each time he swallows a bite of meat or bread. The client sloshes milk from the side of the glass when he sets it down. It is not uncommon for an individual with Alzheimer's disease to lose dexterity. Adapted serving dishes and utensils are available to make eating easier. This is not the most critical piece of information. The client watches his daughter eat and mimics her as she takes a bite. The "watch me" technique is often used to encourage nutritional intake and to help the individual with Alzheimer's disease understand how to eat; therefore, this is not the most critical piece of information. The client reaches for the plastic fruit used in the table's centerpiece. Confusion and distraction are not uncommon; therefore, this is not the most critical information. The nurse should tell the client's daughter to avoid placing other items on the table. The client's eyes water and face becomes red each time he swallows a bite of meat or bread. Watering eyes during swallowing could indicate silent aspiration or choking, and it requires immediate medical evaluation. During the late stages of Alzheimer's disease, individuals can lose the mechanical ability to swallow, and they are at increased risk for aspiration. Williams, P. (2020). Basic Geriatric Nursing. (7th edition). St. Louis, Missouri. Elsevier. Pg. 128, 129.

Question 17 of 27 Which finding is most important for the PN to report to the team leader? The client's skin becoming dry and flaky. How long it is not taking for the client to finish a meal. The weak and thready quaility of the client's pulse. How the client rejects foods that he previously liked.

The weak and thready quaility of the client's pulse. The client's skin becoming dry and flaky. Dry and flaky skin may indicate dehydration and should be reported, but this is not the most critical finding. How long it is not taking for the client to finish a meal. It is not uncommon for individuals with Alzheimer's disease to become distracted while eating. The nurse can provide tips to increase nutrition, but this is not the most critical finding. The weak and thready quaility of the client's pulse. A weak and thready pulse may indicate severe vascular dehydration and should be reported immediately. Potter, P., Perry, A., Stockert, P., Hall, A. (2019). Essentials for Nursing Practice. (9th edition). St. Louis, Missouri. Elsevier. Pg. 484. How the client rejects foods that he previously liked. This is common among individuals with Alzheimer's disease and can affect nutrition, but it is not the most critical finding.

Question 12 of 27 Which side effect of donepezil is most important for the client's daughter to report to the HCP? Tarry stool. Fatigue. Loss of appetite. Insomnia.

Tarry stool. Tarry stool. A bloody, black or tarry stool may indicate GI bleeding, a serious side effect of the medication. Skidmore-Roth, L. (2021). Mosby's 2021 Nursing Drug Reference. (34th edition). St. Louis, Missouri. Elsevier. Pg. 419. Fatigue. Fatigue is a common side effect of donepezil, but it is not the most critical side effect. Loss of appetite. Loss of appetite is concerning, but this is not the most critical side effect. Insomnia. Insomnia is a common side effect of donepezil, but it is not the most critical side effect.

Question 9 of 27 What does the nurse suspect that the client is experiencing? Delirium. Dementia. Schizophrenia. Delirium tremens.

Delirium. Delirium. Recent onset along with visual hallucinations indicates a possible delirium. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 441. Dementia. Dementia has a slow onset. Schizophrenia. Initial symptoms are usually seen in young adulthood. Delirium tremens. The client does not have a history of substance abuse and his vital signs do not indicate delirium tremens.

Question 21 of 27 Which action should the nurse take? Encourage increased physical activity 1 hour before bedtime. Keep the room well lit during the evening hours. Provide a mild stimulant such as coffee during the day to reduce afternoon napping. Contact the HCP and request a sedative for nighttime use to promote sleep.

Keep the room well lit during the evening hours. Encourage increased physical activity 1 hour before bedtime. Activity during the day may help symptoms of sundowning; however, it should not be encouraged within 4 hours of bedtime or it may interfere with sleep. Keep the room well lit during the evening hours. Adequate lighting can decrease agitation that occurs when surroundings are unfamiliar or dark. Reduced lighting and increased shadows can cause the client with Alzheimer's disease to misinterpret what they see. Harding, M. (2020). Lewis's Medical-Surgical Nursing. (11th edition). St. Louis, Missouri. Elsevier. Pg. 1395. Provide a mild stimulant such as coffee during the day to reduce afternoon napping. Stimulants such as nicotine, alcohol, caffeine, and sweets should not be consumed after morning hours or they may interfere with sleep. Contact the HCP and request a sedative for nighttime use to promote sleep. Nonpharmacalogical measures work best for clients with Alzheimer's disease who are experiencing symptoms of sundowning.

Question 5 of 27 What is the best response by the nurse to address the client? Tell the client to hang in there and the assessment will be done soon. Have the client take a break and offer him a cup of water. Let the client know that his cooperation is appreciated and have the client say what he think is the problem. Remind the client how worried his daughter is about him.

Let the client know that his cooperation is appreciated and have the client say what he think is the problem. Tell the client to hang in there and the assessment will be done soon. This does not address the client's concerns, and using jargon is not appropriate. Have the client take a break and offer him a cup of water. This does not address the client's concerns. Let the client know that his cooperation is appreciated and have the client say what he think is the problem. This acknowledges the client's concerns and engages him in his own care as much as possible. Giving the client some control may decrease his anxiety. Halter, M. (2018). Varcarolis' Foundations of Psychiatric Mental Health Nursing. (8th edition). St. Louis, Missouri. Elsevier. Pg. 142. Remind the cient how worried his daughter is about him. This may be true, but it does not address the client's feelings.

Question 16 of 27 Which information would support the daughter's statement about trazodone? The client sleeps through the night. The client is able to control his bladder at times. The client wanders around the house. The client denies feeling any pain.

The client sleeps through the night. The client sleeps through the night. Trazodone is an antidepressant often used to improve sleep in the client with Alzheimer's disease. Skidmore-Roth, L. (2021). Mosby's 2021 Nursing Drug Reference. (34th edition). St. Louis, Missouri. Elsevier. Pg. 1259. The client is able to control his bladder at times. Trazodone has no effect on bladder control. The client wanders around the house. Wandering behavior is not an indication of stabilized cognitive functioning. The client denies feeling any pain. Trazodone is not an analgesic.

Question 14 of 27 What is the goal for the care of a client with mild-to-moderate Alzheimer's disease who takes donepezil? The client will maintain the highest level of cognitive ability. The client will demonstrate improved cognitive ability within one month. The client will engage in abstract thinking within one month. The client will communicate clearly within one month.

The client will maintain the highest level of cognitive ability. The client will maintain the highest level of cognitive ability. Donepezil slows cell destruction. Keltner, N., Steele, D. (2019). Psychiatric Nursing (8th edition). St. Louis, Missouri. Elsevier. Pg. 344. The client will demonstrate improved cognitive ability within one month. Donepezil only slows cell destruction. The client will engage in abstract thinking within one month. Due to cell destruction of executive functioning, this is not possible. The client will communicate clearly within one month. While taking donepezil, the client will maintain communication patterns for limited periods; however, the medication will not improve the client's disease process.

Question 4 of 27 Which question gives the nurse the most information about the client's judgment? "Are you in good spirits most of the time?" "If you smelled smoke in a movie theater, what would you do?" "Who is the current President of the United States?" "What was the name of your favorite childhood pet"

"If you smelled smoke in a movie theater, what would you do?" "Are you in good spirits most of the time?" This question is part of a geriatric depression assessment scale and does not adequately assess judgment. "If you smelled smoke in a movie theater, what would you do?" This question elicits the most information about judgment. The client must know what a fire is and describe how he would react. Keltner, N., Steele, D. (2019). Psychiatric Nursing (8th edition). St. Louis, Missouri. Elsevier. Pg. 333. "Who is the current President of the United States?" This question elicits information about short-term memory and does not adequately assess judgment. "What was the name of your favorite childhood pet" This question elicits information about long-term memory and does not adequately assess judgment.