A home health nurse is assisting a family member with planning care for a client who has Alzheimer's disease. Which of the following instructions should the nurse include?

Remove clutter from rooms and hallways.

Place a monthly calendar in the client's room.

Use confrontation to manage the client's behavior.

Review the daily schedule with the client every morning.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Remove clutter from rooms and hallways: Keeping the environment free of clutter helps reduce confusion, prevents falls, and promotes safety for clients with Alzheimer’s disease, who often have impaired spatial awareness and judgment.

B. Place a monthly calendar in the client's room: A monthly calendar may be too complex and difficult for a client with Alzheimer's to interpret. Simpler tools, like a daily schedule or clock with the day and date, are more appropriate for supporting orientation.

C. Use confrontation to manage the client's behavior: Confrontation can increase agitation and confusion in clients with Alzheimer’s disease. A calm, supportive, and redirecting approach is more effective for managing difficult behaviors.

D. Review the daily schedule with the client every morning: While routine is beneficial, clients with moderate to severe Alzheimer’s may not retain or comprehend daily plans. Short, simple reminders throughout the day are often more effective than once-daily reviews.

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Correct Answer is C

Explanation

Rationale:
A. Fasting blood glucose 65 mg/dL (70 to 110 mg/dL): While slightly below the normal range, this mild hypoglycemia is not a typical adverse effect of cyclosporine. Cyclosporine is more commonly associated with nephrotoxicity, hypertension, and increased infection risk rather than altering glucose levels significantly.

B. RBC count 6.3/μL (4.7 to 6.1/μL): This value is slightly elevated but not clinically concerning and is not a known adverse effect of cyclosporine. The medication typically affects white blood cells and kidney function more than red cell production.

C. BUN 24 mg/dL (10 to 20 mg/dL): An elevated BUN level may indicate reduced kidney function, which is a common adverse effect of cyclosporine. This immunosuppressant is nephrotoxic and requires close monitoring of renal function through BUN and creatinine levels.

D. Alkaline Phosphatase (ALP) 25 units/L (30 to 120 units/L): This ALP level is slightly below normal but not typically associated with cyclosporine use. Cyclosporine does not usually cause significant changes in ALP unless there is liver involvement, which is less common than kidney-related complications.

A. Fever B. Atrial fibrillation C. Paradoxical pulse D. Pericardial friction rub

Correct Answer is C

Explanation

Rationale:
A. Fever: While fever may occur in pericarditis due to inflammation or infection, it is not specific to cardiac tamponade. It reflects a systemic inflammatory response rather than a mechanical complication like fluid accumulation compressing the heart.

B. Atrial fibrillation: Atrial fibrillation may develop in some cardiac conditions, including pericarditis, but it is not a hallmark feature of cardiac tamponade. It does not directly reflect the hemodynamic compromise seen with tamponade.

C. Paradoxical pulse: Paradoxical pulse (pulsus paradoxus) is a key sign of cardiac tamponade. It refers to an exaggerated decrease in systolic blood pressure during inspiration, caused by restricted ventricular filling from fluid accumulation in the pericardial sac, leading to reduced cardiac output.

D. Pericardial friction rub: A pericardial friction rub is a classic finding in acute pericarditis due to inflamed pericardial surfaces rubbing together, but it is not typically heard in cardiac tamponade, where fluid accumulation muffles heart sounds.

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A home health nurse is assisting a family member with planning care for a client who has Alzheimer's disease. Which of the following instructions should the nurse include?

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