A nurse is planning care for an older adult client who has moderate Alzheimer's disease. Which of the following interventions should the nurse implement in the client's plan of care?

Maintain scheduled daily routines for the client.

Use long sentences when speaking with the client.

Provide the client with increased environmental stimuli.

Ensure all siderails are up on the client's bed when they are sleeping.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Maintain scheduled daily routines for the client: A consistent daily routine helps reduce confusion and anxiety in clients with Alzheimer’s disease by providing structure and familiarity. Predictability supports cognitive function and enhances a sense of security.

B. Use long sentences when speaking with the client: Long or complex sentences can overwhelm clients with moderate Alzheimer’s disease. Simple, short sentences with clear instructions are more effective for promoting understanding and cooperation.

C. Provide the client with increased environmental stimuli: Too much environmental stimulation can lead to agitation, confusion, or sensory overload in individuals with Alzheimer’s disease. A calm, quiet environment is more appropriate to help maintain focus and comfort.

D. Ensure all siderails are up on the client's bed when they are sleeping: Raising all side rails can pose a safety risk by increasing the likelihood of injury from attempts to climb over them. Alternatives like using a low bed and ensuring supervision are safer and more appropriate.

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Correct Answer is ["A","C","E","F"]

Explanation

Rationale:

A. Administer oxygen: The client is experiencing labored respirations and increasing distress. Although their oxygen saturation is currently within normal range, supplemental oxygen is a priority to support oxygenation during this acute episode, especially with signs of anxiety and shortness of breath.

B. Obtain prescription for amiodarone: Amiodarone is used for certain ventricular arrhythmias. The client’s heart rhythm is described as regular, though tachycardic, not indicating a need for amiodarone. This is not an immediate priority without evidence of a specific arrhythmia like ventricular tachycardia.

C. Place client in semi-Fowler's position: Elevating the head of the bed helps reduce the work of breathing and improves lung expansion. This position supports respiratory function, especially when the client is experiencing shortness of breath.

D. Monitor blood pressure every 30 minutes: Blood pressure monitoring is important, but this action is not immediate in the face of worsening symptoms. The client needs more urgent interventions first, including respiratory and cardiac stabilization.

E. Obtain prescription for a beta blocker: The client’s heart rate increased significantly to 170/min and they have a history of poorly controlled hypertension. A beta blocker may be needed to reduce sympathetic overactivity and heart rate, helping to lower blood pressure and myocardial oxygen demand.

F. Monitor for neurologic complications: With a blood pressure of 185/100 mmHg and a worsening severe headache, the client is at risk for neurologic complications such as hypertensive encephalopathy or stroke. Close neurologic monitoring is essential to detect early signs of deterioration.

A. Remain 0.3 m (1 ft) away from children. B. Limit the time spent around women who are pregnant to 10 min daily. C. Use disposable utensils for meals. D. Use an absorbent pad if incontinent.

Correct Answer is C

Explanation

Rationale:
A. Remain 0.3 m (1 ft) away from children: Clients receiving radioactive iodine therapy are advised to maintain a greater distance—typically 1 to 2 meters (3 to 6 feet)—from children and pregnant women for several days to limit radiation exposure.

B. Limit the time spent around women who are pregnant to 10 min daily: Clients should actually avoid close contact with pregnant women entirely for several days post-treatment, not merely limit contact time, to prevent radiation exposure to the fetus.

C. Use disposable utensils for meals: After radioactive iodine therapy, clients may excrete small amounts of radiation in saliva and other bodily fluids. Using disposable utensils helps prevent contaminating shared household items and protects others from exposure.

D. Use an absorbent pad if incontinent: While using precautions to manage bodily fluids is important, this instruction is relevant only if the client is incontinent. It is not a universal teaching point for all clients undergoing radioactive iodine therapy.

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A nurse is planning care for an older adult client who has moderate Alzheimer's disease. Which of the following interventions should the nurse implement in the client's plan of care?

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