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 C
Explanation
A: Checking the bruises at the next visit does not address the immediate safety concerns of the client.
B: Instituting more frequent visits might help in monitoring but doesn't address the immediate issue of suspected abuse.
C: Reporting suspected abuse as per agency guidelines is the most immediate and appropriate action to ensure the client’s safety.
D: Family therapy might be helpful later but does not immediately address or confirm the suspected abuse.
Correct Answer is B
Explanation
A: Personality disorders are generally lifelong patterns that do not necessarily emerge in older adulthood.
B: Depression is common among older adults due to various transitions, health declines, and social isolation factors.
C: Somatoform disorders involve the presentation of physical symptoms without a medical cause, not particularly more common in older adults.
D: Schizophrenia typically has an onset in late adolescence or early adulthood; it's less common for new cases to originate in later life.
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