A nurse is assisting with the care of a client who has dementia.
Which of the following actions should the nurse take?

Provide the client with a dark environment for sleeping.

Repeat orientation asks until the client gives a correct response.

Give the client a list of foods to choose from for dinner.

Make a personal introduction to the client at each interaction.

Answer and Explanation

The Correct Answer is D

Choice A rationale

Providing the client with a dark environment for sleeping can aid in better rest and sleep quality, which is particularly important for clients with dementia who may have disrupted sleep patterns. However, it's essential to ensure that the environment is safe to prevent any accidents due to poor visibility.

Choice B rationale

Repeating orientation tasks until the client gives a correct response can help reinforce their memory and cognitive function. This practice is known as reality orientation, which is a therapeutic technique used to improve awareness of time, place, and person in clients with dementia.

Choice C rationale

Giving the client a list of foods to choose from for dinner provides autonomy and encourages decision-making. It helps in maintaining cognitive function and personal preferences, which can positively impact their mental health and quality of life.

Choice D rationale

Making a personal introduction to the client at each interaction helps in establishing a connection and reducing confusion. Clients with dementia often have short-term memory loss, so frequent reintroduction can provide reassurance and familiarity, contributing to their sense of security. .

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Correct Answer is A

Explanation

Choice A rationale

Diarrhea is a common symptom of opioid withdrawal due to increased gastrointestinal motility.

Choice B rationale

Hypokinesis, or decreased movement, is not associated with opioid withdrawal. Withdrawal symptoms include restlessness and agitation.

Choice C rationale

Bradycardia, or slow heart rate, is not a typical manifestation of opioid withdrawal. Tachycardia (increased heart rate) is more common.

Choice D rationale

Meiosis, or pupil constriction, occurs with opioid use. During withdrawal, mydriasis (dilated pupils) is more common.

A. Request a consult with recreational therapy. B. Lower the window shade in the client's room. C. Place the client in a room close to the nurses' station. D. Obtain a PRN prescription for a vest restraint.

Correct Answer is C

Explanation

Choice A rationale

Recreational therapy may be beneficial, but it is not the primary intervention to reduce the risk of falls.

Choice B rationale

Lowering the window shade could help with sensory overload, but it does not directly address fall prevention.

Choice C rationale

Placing the client near the nurses' station allows for closer monitoring and quicker intervention, which can help prevent falls.

Choice D rationale

Vest restraints should only be used as a last resort after other less restrictive measures have been tried and found ineffective.

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A nurse is assisting with the care of a client who has dementia.Which of the following actions should the nurse take?

Nursing Test Bank

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A nurse is assisting with the care of a client who has dementia.
Which of the following actions should the nurse take?