A nurse is teaching the caregiver of a client who has dementia. Which of the following behaviors should the nurse identify as increasing with the progression of the disorder? (Select All that Apply.)

Hallucinations

Paranoia

Lethargy

Impulsivity

Disregard for caregiver's feelings

Answer and Explanation

Correct Answer : A,B,D,E

A. Hallucinations: As dementia progresses, especially in conditions like Alzheimer's disease, sensory perceptions can become distorted, leading to hallucinations, where the person perceives things that are not present.

B. Paranoia: Paranoia, or irrational suspicions and mistrust, often increases as dementia progresses. The person may become increasingly fearful or suspicious of others, even caregivers or family members.

C. Lethargy: While lethargy can be a symptom of dementia, it is more commonly associated with the earlier stages of the disorder when the person may experience apathy, lack of interest, and reduced energy levels. As the disease progresses, other behavioral changes like agitation or restlessness may become more prominent.

D. Impulsivity: Impulsivity, or acting without forethought or consideration of consequences, can increase as dementia progresses, particularly in certain types of dementia like frontotemporal dementia. This can manifest as impulsive behaviors such as excessive spending, inappropriate social behavior, or risky actions.

E. Disregard for caregiver's feelings: As dementia advances, the person's ability to empathize or recognize the feelings and needs of others may decline. They may become increasingly self-focused or unaware of the impact of their actions on caregivers, leading to behaviors that disregard or overlook the caregiver's feelings and well-being.

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Correct Answer is B

Explanation

A. Poor functional ability: While poor functional ability may impact the overall prognosis and quality of life for a client with a subarachnoid hemorrhage (SAH), it is not directly associated with a high mortality rate. Functional ability can be improved with rehabilitation and supportive care.

B. Rebleeding of the injury: Rebleeding of the SAH is a significant risk factor associated with a high mortality rate. Rebleeding can lead to increased intracranial pressure, worsening neurological deficits, and even death. Preventing rebleeding is a critical aspect of managing SAH to improve outcomes.

C. Decreased cerebrospinal fluid: Decreased cerebrospinal fluid (CSF) may indicate conditions such as hydrocephalus, which can complicate the management of SAH. However, it is not directly associated with a high mortality rate compared to rebleeding.

D. Use of nimodipine: Nimodipine is a calcium channel blocker commonly used in the management of SAH to prevent cerebral vasospasm, which can lead to ischemia and worsen outcomes. While nimodipine plays a role in improving outcomes by preventing vasospasm, its use is not directly associated with mortality rates.

A. Lie on your back when sleeping. B. Lie on your front when sleeping. C. Resume your exercise routine. D. Wash your hair 24 hr after surgery.

Correct Answer is D

Explanation

A. Lie on your back when sleeping: Lying on the back when sleeping may be recommended initially after cochlear implant surgery to avoid putting pressure on the surgical site. However, this instruction should not be included in the plan of care indefinitely. Once the client is comfortable and the surgical site is healing well, they should be allowed to sleep in any position that is comfortable for them.

B. Lie on your front when sleeping: Lying on the front when sleeping is not typically recommended after cochlear implant surgery, as it may put pressure on the surgical site and disrupt healing. This position could potentially cause discomfort and increase the risk of complications. Therefore, this instruction should not be included in the plan of care.

C. Resume your exercise routine: Resuming the exercise routine immediately after cochlear implant surgery may not be advisable. The client should be instructed to avoid strenuous activities and heavy lifting for a certain period as advised by the healthcare provider. Engaging in vigorous exercise too soon after surgery could potentially disrupt the healing process and increase the risk of complications. Therefore, this instruction should not be included in the plan of care immediately after surgery.

D. Wash your hair 24 hr after surgery: After cochlear implant insertion, it is important to keep the surgical site clean to prevent infection. Washing the hair 24 hours after surgery helps to maintain cleanliness and hygiene without disrupting the surgical site. It is typically safe to wash the hair after this period as long as gentle care is taken to avoid excessive manipulation of the implant site.

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A nurse is teaching the caregiver of a client who has dementia. Which of the following behaviors should the nurse identify as increasing with the progression of the disorder? (Select All that Apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assisting with planning care for a client who has a subarachnoid hemorrhage (SAH). Which of the following relates to a high mortality rate for a client who has an SAH?

Correct Answer is B

Explanation

A nurse is preparing a plan of care for a client who is postoperative following a cochlear implant insertion. Which of the following instructions should the nurse include in the plan of care?

Correct Answer is D

Explanation

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