A nurse is caring for a client with cognitive impairment.
Which of the following actions should the nurse take to enhance understanding?

Choice A rationale
A 5-year-old patient admitted yesterday with pneumonia may require frequent assessments and interventions that are within the scope of practice for an LPN. However, the complexity of care for a newly admitted patient with a potentially unstable condition may be better suited for an RN.
Choice B rationale
A 78-year-old female with osteoporosis who needs assistance performing range of motion exercises and ambulating with a walker can be managed by an LPN. These tasks are within the LPN’s scope of practice and do not require the higher level of assessment and decision-making skills of an RN.
Choice C rationale
A 78-year-old patient newly admitted with congestive heart failure requires complex assessments, monitoring, and interventions that are within the scope of practice for an RN. The RN’s advanced skills and knowledge are necessary to manage the patient’s condition effectively.
Choice D rationale
A 34-year-old patient post knee arthroscopy who requires reinforced crutch walking can be managed by an LPN. These tasks are within the LPN’s scope of practice and do not require the higher level of assessment and decision-making skills of an RN.

Choice A rationale
Avoiding eye contact to prevent confusion is incorrect. Eye contact is an important aspect of effective communication and helps to establish a connection with the client. Avoiding eye contact can make the client feel ignored or unimportant, which can hinder understanding and trust.
Choice B rationale
Speaking quickly to maintain the client’s attention is incorrect. Clients with cognitive impairment may have difficulty processing information quickly. Speaking slowly and clearly allows the client more time to understand and respond to the information being communicated.
Choice C rationale
Allowing the client extra time to respond is correct. Clients with cognitive impairment may need additional time to process information and formulate a response. Allowing extra time helps to ensure that the client fully understands the information and can respond appropriately.
Choice D rationale
Using complex sentences to stimulate cognitive function is incorrect. Simple and clear communication is more effective for clients with cognitive impairment. Complex sentences can be confusing and difficult for the client to understand, which can hinder effective communication.