A nurse is assisting with reminiscence therapy for a group of older adult clients. Which of the following strategies should the nurse implement?

Encouraging thought-stopping to block undesirable thoughts

Making a unit calendar to promote orientation

Playing board games with other clients to enhance cognition

Discussing childhood memories during group therapy

Answer and Explanation

The Correct Answer is D

A.   Thought-stopping is a cognitive behavioral technique used to interrupt and replace negative or distressing thoughts. However, it is not directly related to reminiscence therapy. Reminiscence therapy focuses on stimulating memories and promoting positive reflections on past experiences rather than blocking thoughts.
B.   Creating a unit calendar can be a helpful strategy to promote orientation to time and events for older adults, especially those who may have memory impairments. While this is a valuable activity for maintaining orientation, it is not specifically reminiscence therapy. Reminiscence therapy involves recalling and discussing personal memories rather than focusing on current events.

C.   Playing board games can indeed enhance cognition by stimulating various cognitive functions such as problem-solving, memory, and social interaction. However, it is not considered reminiscence therapy. Reminiscence therapy involves specific guided discussions or activities that evoke memories from the past, which can promote emotional well-being and socialization through shared experiences.
D.   This is the most appropriate strategy for reminiscence therapy. Discussing childhood memories encourages older adults to recall and share past experiences, fostering a sense of identity, meaning, and connection. It can also enhance self-esteem and provide opportunities for social interaction within a therapeutic context.

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Correct Answer is B

Explanation

A. Obsessive behaviors, such as repetitive actions or fixations on specific thoughts or tasks, can be indicative of delirium. Delirium often manifests with altered behavior patterns that are unusual for the individual, including obsessive or compulsive-like behaviors that are not typical of their baseline mental status. However, this is not specific to delirium.
B. Fluctuating orientation, where the client is sometimes alert and oriented and at other times confused or disoriented, is a hallmark of delirium. Unlike dementia, which typically presents with a more steady decline in cognitive function, delirium is characterized by rapid changes in mental status over hours to days. This fluctuation is important to note as it strongly suggests delirium rather than other chronic cognitive impairments.
C. Gradual memory loss reported by family members is more suggestive of chronic conditions such as dementia rather than delirium. Delirium, in contrast, is characterized by acute onset and fluctuating course rather than a gradual decline in cognitive abilities over time.
D. Depression can coexist with delirium, but a consistent state of depression without acute changes in mental status is less indicative of delirium. Delirium is characterized by rapid changes in cognition and behavior rather than a persistent mood disorder. Therefore, while depression should be assessed and managed appropriately, it is not typically a sign of delirium unless there are acute changes in mental status accompanying it.

A. Administer an antianxiety medication. B. Calculate the client's score on the Hamilton Rating Scale for Anxiety. C. Discuss the benefits of relaxation exercises with the client. D. Explain the use of response prevention to the client.

Correct Answer is D

Explanation

A. While medications like SSRIs (Selective Serotonin Reuptake Inhibitors) or benzodiazepines may eventually be part of the treatment plan for OCD, administering medication should not be the first action unless the client is in acute distress or experiencing severe anxiety symptoms that require immediate pharmacological intervention.
B. This option involves assessing the severity of anxiety symptoms, which is important for understanding the client's baseline anxiety level. However, calculating this score is not the first action. It can be done later as part of the comprehensive assessment to guide ongoing treatment planning.
C. Relaxation exercises, such as deep breathing or progressive muscle relaxation, can help manage anxiety symptoms in clients with OCD. However, before initiating specific interventions like relaxation exercises, the nurse should first establish rapport, assess the client's current level of distress, and gather information about the client's symptoms and coping mechanisms.
D. Response prevention is a cognitive-behavioral therapy technique used in the treatment of OCD, where clients are prevented from engaging in compulsive behaviors. This should follow after thorough assessment of the actual psychological state of the client.

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A nurse is assisting with reminiscence therapy for a group of older adult clients. Which of the following strategies should the nurse implement?

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