A nurse in an assisted-living facility is caring for a client who is in early stages of dementia. The client has been oriented to name and place and is usually cooperative. Which of the following nursing actions is appropriate if the client refuses to take morning medications?
Notify the charge nurse of the need for evaluation of the client's level of competence.
Ask the client to express her reasons for refusing the morning medications and document the event.
Crush the pills, if not contraindicated, and hide them the client's in applesauce.
Try to talk the client into adherence by telling her the possible implications of missing a dose.
The Correct Answer is B
A: While assessing competence might eventually be necessary, it should come after understanding the client's reasons for refusal.
B: This action respects the client’s autonomy and provides insights into her thinking or possible misconceptions that can be addressed.
C: Crushing pills without consent and hiding them in food is unethical and could be dangerous, as some medications are not meant to be crushed.
D: Trying to convince the client might be seen as coercive. Understanding her reasons first is a more patient-centered approach.
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Related Questions
Correct Answer is A
Explanation
A: Providing reassurance of presence can help stabilize the client's emotional state by ensuring safety and support.
B: While taking the client to a quiet room can be helpful, the first action should be to reassure her of your presence and support.
C: Inquiring about the cause of anxiety can be useful, but it should not be the first step when the client is actively hyperventilating.
D: Medication might be necessary, but initial reassurance and creating a safe environment take precedence.
Correct Answer is D
Explanation
A: Quizzing the client might be part of an assessment but not the initial action.
B: Allowing independent function is important, but assessing cognitive function to tailor support is essential first.
C: Preparing for discharge might be premature without assessing readiness and stability.
D: Assessing awareness and cognitive function helps guide appropriate support and independence levels.
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