A nurse in an acute care facility is providing teaching for the adult child of an older adult client who is admitted with a urinary tract infection and delirium. The client has been living independently at home. Which of the following statements by the adult child demonstrates the teaching has been effective?

"I should look into the possibility of long-term care for my father when he is discharged."

"I would like information about respite care for when my father is discharged."

"I expect that my father will no longer be confused when he is discharged."

"I will obtain a permanent identification bracelet for my father when he is discharged."

Answer and Explanation

The Correct Answer is C

Choice A reason: This statement reflects a misunderstanding of the situation. Delirium is an acute, reversible condition often triggered by infections such as urinary tract infections. Long-term care placement is not automatically indicated once delirium resolves, especially since the client was living independently prior to hospitalization. Planning for long-term care prematurely assumes permanent cognitive decline, which is not consistent with delirium’s clinical course.

Choice B reason: Respite care is designed to provide temporary relief for caregivers of individuals with chronic conditions or long-term care needs. Since the client was living independently before admission and delirium is expected to resolve after treatment of the infection, respite care is not necessary at this point. This statement suggests the adult child believes ongoing caregiver support will be required, which is inaccurate for this clinical scenario.

Choice C reason: This statement demonstrates accurate understanding. Delirium is characterized by acute onset of confusion, disorientation, and fluctuating mental status, often secondary to an underlying medical condition such as infection. Once the infection is treated and the acute illness resolves, the delirium typically subsides, and the client’s baseline cognitive function returns. Recognizing that the confusion is temporary and reversible shows that the teaching has been effective.

Choice D reason: Obtaining a permanent identification bracelet is more appropriate for clients with chronic, progressive cognitive disorders such as dementia or Alzheimer’s disease, where confusion and wandering are persistent risks. Since delirium is reversible and not a permanent condition, this intervention is unnecessary. This statement reflects a misunderstanding of the difference between delirium and dementia.

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Correct Answer is B

Explanation

Choice A reason: Systematic desensitization is a behavioral therapy technique used to reduce phobias or anxiety by gradually exposing the client to the feared stimulus while teaching relaxation strategies. It does not involve acting out scenarios or practicing new behaviors in a group setting.

Choice B reason: Role playing is the correct answer because it involves acting out scenarios and practicing new behaviors in a safe environment. This technique allows clients to rehearse adaptive responses, gain confidence, and receive feedback. It is widely used in behavioral therapy and group education to promote skill acquisition and behavioral change.

Choice C reason: Biofeedback involves using monitoring devices to provide clients with information about physiological processes such as heart rate or muscle tension. Clients learn to control these processes voluntarily. While effective for stress reduction, it does not involve acting out scenarios or practicing interpersonal behaviors.

Choice D reason: Cognitive restructuring is a cognitive-behavioral technique focused on identifying and challenging distorted thoughts. It helps clients replace maladaptive thinking patterns with healthier ones. While important in therapy, it does not involve role enactment or practicing behaviors in scenarios.

A. Sit with the client during mealtimes. B. Turn on the television for the client to watch. C. Remove sharp objects from the client’s room. D. Observe the client every 15 min. E. Provide the client with a low-protein diet. F. Offer the client physical activities. G. Offer the client physical activities.

Correct Answer is ["A","C","D","F"]

Explanation

Choice A reason: Sitting with the client during mealtimes is an essential intervention because clients with bipolar disorder, especially during manic episodes, often have poor appetite and difficulty focusing long enough to eat. Direct support ensures nutritional intake, prevents further weight loss, and provides structure. It also reduces the risk of malnutrition and dehydration, which are common complications in manic states.

Choice B reason: Turning on the television for the client is not therapeutic. Clients in manic episodes are easily overstimulated, and television can increase agitation, distractibility, and hyperactivity. Instead of calming the client, it may worsen confusion and disorientation. Therefore, this intervention is inappropriate.

Choice C reason: Removing sharp objects from the client’s room is a critical safety measure. Clients with bipolar disorder experiencing mania may act impulsively, and the risk of self-harm or accidental injury is high. Ensuring the environment is free of dangerous objects reduces the likelihood of harm and supports safe management of the client’s agitation.

Choice D reason: Observing the client every 15 minutes is necessary for safety monitoring. The client is hyperactive, confused, and disoriented, which increases the risk of injury, aggression, or unpredictable behavior. Frequent observation allows early detection of escalating agitation and ensures timely intervention. This is a standard safety protocol in acute psychiatric care.

Choice E reason: Providing a low-protein diet is not indicated. Clients with bipolar disorder do not require protein restriction; in fact, adequate protein intake is important for maintaining energy and nutritional balance. Restricting protein could worsen malnutrition and weight loss. This intervention is inappropriate.

Choice F reason: Offering the client physical activities is beneficial because it provides a safe outlet for excess energy during manic episodes. Structured physical activity helps reduce agitation, channel hyperactivity, and promote better sleep. It also decreases restlessness and supports overall emotional regulation. Activities should be simple, noncompetitive, and safe to avoid overstimulation.

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Naxlex Comprehensive Predictor Exams

A nurse is planning to teach a group of clients about techniques to change unwanted behaviors. Which of the following techniques is the nurse using when they act out different scenarios and has clients respond by practicing new behaviors?

Correct Answer is B

Explanation

A nurse is caring for a client who has bipolar disorder. The nurse is planning care for the client. Select the 4 interventions the nurse should include in the client’s care.

Correct Answer is ["A","C","D","F"]

Explanation

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