A nurse in a long-term care facility is assessing a client who has dementia. Which of the following findings should the nurse identify as a risk for this client?

Hallways are long distances

The room has an area rug

The bed is in a low position

Outside doors have locks

Answer and Explanation

The Correct Answer is A

A. Hallways are long distances:
Long hallways can be challenging for individuals with dementia due to their potential mobility issues, disorientation, and decreased ability to navigate. Dementia often affects spatial awareness and can lead to confusion, making it difficult for patients to find their way back to their rooms or common areas. Long distances increase the risk of falls and disorientation.

B. The room has an area rug:
Area rugs can present tripping hazards for anyone, especially for individuals with mobility issues, balance problems, or cognitive impairments like dementia. Patients might trip on the edges of the rug, leading to falls and injuries.

C. The bed is in the low position:
Having the bed in a low position is generally considered a safety measure, especially for patients at risk of falls. However, for a patient with dementia, it might be important to strike a balance. Beds that are too low can be difficult for individuals with dementia to get in and out of, potentially leading to falls. It's important to assess the patient's ability to safely get in and out of bed.

D. Outside doors have locks:
Locks on outside doors are essential for the safety of individuals with dementia. Dementia patients are prone to wandering, which can lead them to dangerous situations if they leave the facility unsupervised. Locks on outside doors help prevent wandering, ensuring the patients stay within the secure confines of the facility.

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Correct Answer is A

Explanation

A. "Since injuring my knee, I've decided to become the team manager."
Option A represents an adaptive use of the ego defense mechanism known as sublimation. Sublimation is a process in which a person channels potentially negative or harmful impulses or feelings into more socially acceptable and constructive activities. In this case, the adolescent with the injured knee is using the opportunity to become the team manager, which is a positive and constructive way to stay engaged with the team despite the setback of the injury.

B. "Since my mom died, I focus all my attention on my grades."
This is an example of reaction formation, a defense mechanism where someone overemphasizes the opposite of their true feelings. In this case, the individual might be hiding or avoiding their grief by focusing on grades.

C. "I didn't tell the teacher about the bullying because it wouldn't have changed anything."
This is an example of rationalization, where the individual provides a logical-sounding but potentially inaccurate explanation for their actions. It can be a defense mechanism to justify or make more acceptable one's choices.

D. "I'm not even going to think about writing that thesis paper until after prom."
This is an example of procrastination or avoidance, which is not an ego defense mechanism but a coping or time-management strategy. It doesn't represent an adaptive use of a defense mechanism in this context.

A. Buprenorphine B. Naltrexone C. Disulfiram D. Bupropion

Correct Answer is B

Explanation

A. Buprenorphine:
Buprenorphine is a medication used in the treatment of opioid dependence. It acts on the same receptors in the brain as opioids, helping to reduce cravings and withdrawal symptoms in individuals recovering from opioid addiction. It is not typically used for alcohol withdrawal.

B. Naltrexone:
Naltrexone is an opioid receptor antagonist used in the treatment of alcohol dependence. It works by blocking the effects of endorphins, the body's natural opioids. In the context of alcohol dependence, it reduces the rewarding effects of alcohol and decreases the craving for alcohol. Naltrexone can be prescribed for individuals experiencing acute manifestations of alcohol withdrawal as part of a comprehensive treatment plan.

C. Disulfiram:
Disulfiram is a medication that causes unpleasant symptoms (such as nausea, vomiting, and flushing) when alcohol is consumed. It works as a deterrent, discouraging individuals from drinking alcohol by creating a negative reaction. Disulfiram is used as a part of comprehensive alcohol treatment programs to help maintain abstinence. It is not typically used for acute alcohol withdrawal symptoms.

D. Bupropion:
Bupropion is an antidepressant medication that is also used to aid smoking cessation. It helps reduce withdrawal symptoms and the urge to smoke. While it is not used specifically for alcohol withdrawal, individuals with alcohol dependence often have higher rates of tobacco use. Bupropion might be prescribed to address both smoking cessation and depressive symptoms in individuals with alcohol dependence, but it does not directly address alcohol withdrawal.

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