A nurse is evaluating the effectiveness of cognitive stimulation therapy for a client with mild dementia.

Which of the following outcomes indicates that the therapy is beneficial?

The correct answer is B.

Provide the client with a calendar and a clock to promote orientation.This intervention helps the client with Alzheimer’s disease to maintain a sense of reality and reduce confusion by providing cues for time and date.

Choice A is wrong because asking the client to repeat information several times to enhance retention may increase frustration and anxiety for the client, as he or she may not be able to recall the information due to impaired memory.

Choice C is wrong because avoiding using reminiscence therapy as it may increase confusion is not supported by evidence.Reminiscence therapy is a type of intervention that involves recalling and sharing past experiences with others, which can improve mood, cognition, and socialization for clients with Alzheimer’s disease.

Choice D is wrong because correcting the client’s mistakes or inaccuracies to improve memory may also cause frustration and agitation for the client, as he or she may not be aware of the errors or may feel criticized or embarrassed.

Normal ranges for cognitive function can be assessed using tools such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), which measure orientation, attention, memory, language, and executive function.

The MMSE has a maximum score of 30, with scores below 24 indicating cognitive impairment.The MoCA has a maximum score of 30, with scores below 26 indicating mild cognitive impairment.

A. Ask the client to repeat information several times to enhance retention.

B. Provide the client with a calendar and a clock to promote orientation.

C. Avoid using reminiscence therapy as it may increase confusion.

D. Correct the client’s mistakes or inaccuracies to improve memory.

The correct answer is B.

Provide positive reinforcement when the client behaves appropriately.This is because positive reinforcement can help increase the frequency of desired behaviors and reduce the occurrence of inappropriate behaviors in clients with frontotemporal dementia (FTD) who exhibit disinhibition.Disinhibition is a common symptom of behavioral variant FTD (bvFTD), which is characterized by a deterioration in cognition and social behavior.

Choice A is wrong because restricting the client’s social interactions to prevent embarrassment can lead to social isolation, depression, and loss of self-esteem.Clients with FTD need social support and stimulation to maintain their quality of life.

Choice C is wrong because using physical restraints when the client becomes agitated or aggressive can increase the risk of injury, infection, and psychological distress.Physical restraints should only be used as a last resort when other interventions have failed and the client poses a serious threat to themselves or others.

Choice D is wrong because administering antipsychotic medications to control the client’s impulses can have adverse effects such as sedation, extrapyramidal symptoms, metabolic syndrome, and increased mortality.Antipsychotic medications should be used with caution and only when non-pharmacological interventions are insufficient or contraindicated.

Normal ranges for vital signs, blood tests, and other parameters are not applicable in this question.

A. Restrict the client’s social interactions to prevent embarrassment.

B. Provide positive reinforcement when the client behaves appropriately.

C. Use physical restraints when the client becomes agitated or aggressive.

D. Administer antipsychotic medications to control the client’s impulses.