A nurse is caring for a client who has moderate Alzheimer's disease. During weekly home visits, the nurse notices that the client's caregiver is tired, irritable, and impatient with the client. Which of the following actions should the nurse recommend to the caregiver?
Consider respite care services.
Contact hospice services for end-of-life care.
Pursue local protective services.
Take a nonprescription sleeping medication.
The Correct Answer is A
A. Respite care services provide temporary relief for caregivers, allowing them to take breaks and avoid burnout. This recommendation addresses the caregiver's fatigue and stress, helping to prevent caregiver exhaustion and improve their well-being.
B. Hospice services are appropriate for end-of-life care, but the client with moderate Alzheimer's disease is not at the end of life, so this is not the most appropriate recommendation at this stage.
C. Pursuing local protective services is necessary if there is evidence of abuse or neglect. However, the issue here seems to be caregiver stress, not abuse, so this action is not warranted.
D. Taking a nonprescription sleeping medication might address some symptoms of fatigue but does not address the underlying issue of caregiver burnout. Respite care is a more effective solution for the caregiver's needs.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. While checking the client’s vital signs is important, it is not the first action the nurse should take. The priority is to stop the transfusion immediately to prevent further harm.
B. Administering oxygen may be necessary if the client’s condition worsens, but stopping the transfusion is the first step in addressing the potential transfusion reaction.
C. Collecting a urine sample may be important if hemolysis is suspected, but the first priority is to stop the transfusion to prevent further damage.
D. The symptoms of chills, back pain, and nausea are indicative of a potential transfusion reaction, such as hemolytic reaction. The nurse’s first action is to stop the transfusion to prevent further complications. After stopping the infusion, the nurse should notify the provider, monitor the client’s vital signs, and assess for additional symptoms.
Correct Answer is B
Explanation
A. Checking potassium levels is important in the management of DKA, but it is not the priority intervention. Potassium levels should be monitored closely, as insulin therapy can lower potassium levels, but the first step in treatment is fluid resuscitation.
B. Administering 0.9% sodium chloride (normal saline) is the priority intervention in DKA. This helps to correct dehydration and restore circulatory volume, which is critical in stabilizing the client. Fluid replacement is the first step in managing DKA before insulin is administered.
C. Beginning bicarbonate continuous IV infusion is typically not recommended unless the pH is extremely low (below 6.9). The primary treatment in DKA is fluid and insulin therapy, and bicarbonate is used only in severe cases of acidosis.
D. Initiating a continuous IV insulin infusion is essential in treating DKA, but it should be done after initial fluid resuscitation. Insulin therapy lowers blood glucose and helps to resolve ketosis, but fluid replacement is the first priority to stabilize the client.
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