A nurse is providing teaching to the caretakers of a client who has Alzheimer’s disease with mild cognitive decline. The client is beginning to experience sleep disturbances. Which of the following instructions should the nurse include?

Give the client a cup of hot black tea before bed.

Wake the client at the same time each morning.

Take the client for a walk 2 hours before bedtime each night.

Allow the client to take a 90-minute nap immediately after lunch.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Giving the client a cup of hot black tea before bed is not advisable. Black tea contains caffeine, which can interfere with sleep and exacerbate sleep disturbances. It is important to avoid stimulants before bedtime to promote better sleep quality.

Choice B reason:

Waking the client at the same time each morning helps establish a consistent sleep-wake cycle, which is beneficial for managing sleep disturbances. Regular wake times can help regulate the body’s internal clock and improve overall sleep patterns.

Choice C reason:

Taking the client for a walk 2 hours before bedtime can be beneficial as physical activity can promote better sleep. However, it is not as crucial as maintaining a consistent wake time, which directly influences the sleep-wake cycle.

Choice D reason:

Allowing the client to take a 90-minute nap immediately after lunch may interfere with nighttime sleep. Long naps during the day can reduce the drive to sleep at night, leading to further sleep disturbances.

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Correct Answer is B

Explanation

Choice A reason: Midazolam is a benzodiazepine used primarily for sedation, anxiety relief, and anesthesia. It is not used as a first-line treatment for major depressive disorder.

Choice B reason: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed as a first-line treatment for major depressive disorder. SSRIs work by increasing the levels of serotonin in the brain, which can help improve mood and alleviate depressive symptoms.

Choice C reason: Cyclobenzaprine is a muscle relaxant used to relieve muscle spasms. It is not indicated for the treatment of major depressive disorder.

Choice D reason: Valproic acid is primarily used as a mood stabilizer and anticonvulsant. It is not typically used as a first-line treatment for major depressive disorder, although it may be used in cases of bipolar disorder.

A. A client who has new-onset delirium B. A client who is experiencing auditory hallucinations C. A client who is experiencing mania D. A client who has somatic symptom disorder

Correct Answer is D

Explanation

Choice A reason:

A client with new-onset delirium is experiencing an acute and often fluctuating disturbance in attention and cognition. Delirium is typically caused by an underlying medical condition, substance intoxication, or withdrawal. Assertiveness training would not be appropriate for this client as the primary focus should be on identifying and treating the underlying cause of the delirium.

Choice B reason:

A client experiencing auditory hallucinations is likely dealing with a psychotic disorder such as schizophrenia. The primary treatment for such clients involves antipsychotic medications and psychotherapy aimed at managing symptoms and improving reality orientation. Assertiveness training is not suitable for clients in the acute phase of psychosis as their ability to engage in and benefit from such training is compromised.

Choice C reason:

A client experiencing mania, a state characterized by elevated mood, hyperactivity, and impulsive behavior, is typically seen in bipolar disorder. During a manic episode, the client may have difficulty focusing and controlling their impulses, making it challenging to participate effectively in assertiveness training. The priority for these clients is to stabilize their mood with medication and supportive therapy.

Choice D reason:

A client with somatic symptom disorder experiences excessive thoughts, feelings, and behaviors related to physical symptoms. Assertiveness training can be beneficial for these clients as it helps them express their needs and concerns more effectively, reducing the focus on physical symptoms and improving their overall functioning.

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A nurse is providing teaching to the caretakers of a client who has Alzheimer’s disease with mild cognitive decline. The client is beginning to experience sleep disturbances. Which of the following instructions should the nurse include?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has a new diagnosis of major depressive disorder. Which of the following medications should the nurse expect the provider to prescribe to the client as a first-line treatment?

Correct Answer is B

Explanation

A nurse on a mental health unit is planning a group therapy session about assertiveness training. For which of the following clients should the nurse recommend the training?

Correct Answer is D

Explanation

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