A client diagnosed with Alzheimer's Disorder has impairments of memory and judgement and is incapable of performing activities of daily living. Which nursing intervention should take priority?

Assist the client with bathing and toileting.

Design a bulletin board to represent the current season.

Present evidence of objective reality to improve cognition.

Label the door to the client's room with name and number.

Answer and Explanation

The Correct Answer is A

a. Assist the client with bathing and toileting. This intervention addresses the client's immediate and essential needs. Ensuring basic hygiene and toileting are crucial for maintaining the client's health, dignity, and comfort. Assisting with activities of daily living (ADLs) is a priority for clients who are unable to perform these tasks independently.
b. Design a bulletin board to represent the current season. While this can help with orientation and provide a sense of time and place, it is not as critical as addressing the client's basic physical needs.
c. Present evidence of objective reality to improve cognition. Reality orientation can be beneficial, but it is not a priority intervention compared to meeting the client's immediate physical needs.
d. Label the door to the client's room with name and number. This helps with orientation and independence but is less critical than ensuring the client’s hygiene and toileting needs are met.

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Correct Answer is A

Explanation

a. "You feel that your mother does not want you to come back home?" This response uses reflection, a therapeutic communication technique, to encourage the client to express and explore their feelings further.
b. "It's quite common for clients to feel that way after a lengthy hospitalization." While this normalizes the client's feelings, it might dismiss the client's unique emotional experience and does not invite further exploration.
c. "Why don't you talk to your mother? You may find out she doesn't feel that way." This response provides a solution but does not address the client's current emotional state or encourage them to express their feelings.
d. "Your mother seems like an understanding person. I'll help you approach her." This response makes an assumption about the mother and shifts the focus away from the client’s feelings.

A. The unit can be managed with fewer staff B. Clients are encouraged to communicate with others C. The reduced sensory input allows the client to regain control D. Clients are forced to be responsible for themselves

Correct Answer is C

Explanation

a. The unit can be managed with fewer staff. Seclusion requires close monitoring by staff.
b. Clients are encouraged to communicate with others. Seclusion is meant to be a temporary measure to prevent further harm, not necessarily to promote communication.
c. The reduced sensory input allows the client to regain control. Seclusion is a time-limited safety intervention used when a client poses a danger to themselves or others. It provides a safe space with reduced stimulation to allow the client to calm down and regain control.
d. Clients are forced to be responsible for themselves. Seclusion is not a punitive measure. The goal is to ensure safety and facilitate regaining control.

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A client diagnosed with Alzheimer's Disorder has impairments of memory and judgement and is incapable of performing activities of daily living. Which nursing intervention should take priority?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client tells the nurse, "I feel bad because my mother does not want me to return home after I leave the hospital." Which nursing response is therapeutic?

Correct Answer is A

Explanation

A new nurse orientee asks why a client admitted to the psychiatric unit is placed in seclusion. The nurse precepting the new nurse explains that which of the following is a benefit of seclusion?

Correct Answer is C

Explanation

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