A nurse is visiting a client who has Alzheimer's disease in their home. The client's spouse states that the client gets increasingly agitated and restless in the evening hours and can sometimes be difficult to calm down. Which of the following behaviors does the nurse recognize that the client is experiencing?

Relocation stress syndrome

Wandering

Sundowning

Depression

Answer and Explanation

The Correct Answer is C

A. Relocation stress syndrome: Relocation stress syndrome refers to the physical and psychological symptoms experienced by individuals when they are moved from one environment to another, such as transitioning to a new residence or healthcare facility. While relocation stress syndrome can cause agitation and confusion in individuals with Alzheimer's disease, the scenario provided does not indicate a recent relocation.

B. Wandering: Wandering is a common behavior observed in individuals with dementia, where they aimlessly roam or wander in their environment. While wandering may be associated with agitation and restlessness, the scenario does not describe the client physically moving around or attempting to leave their home.

C. Sundowning: Sundowning refers to a phenomenon commonly observed in individuals with Alzheimer's disease or other forms of dementia, where they experience increased agitation, confusion, and restlessness in the late afternoon or early evening hours. Sundowning behaviors can include pacing, agitation, anxiety, irritability, confusion, and difficulty sleeping. The exact cause of sundowning is not fully understood but may be related to factors such as fatigue, sensory overload, hormonal imbalances, or disruptions in the sleep-wake cycle. Managing sundowning behaviors often involves creating a calming environment, maintaining a consistent daily routine, minimizing stimuli in the evening, and providing reassurance and comfort to the individual.

D. Depression: Depression can occur in individuals with Alzheimer's disease and may present with symptoms such as sadness, hopelessness, loss of interest in activities, changes in appetite or sleep patterns, and difficulty concentrating. However, the scenario primarily describes agitation and restlessness in the evening hours, which is characteristic of sundowning rather than depression.

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Correct Answer is D

Explanation

A. Diminished hair growth on the lower extremities: Diminished hair growth on the lower extremities is not typically a manifestation of peripheral venous disease. Instead, it may suggest poor circulation or arterial insufficiency.

B. Loss of pigmentation over the shin area: Loss of pigmentation over the shin area can occur in conditions such as chronic venous insufficiency, which is a form of peripheral venous disease. However, it is not the most characteristic manifestation.

C. Shiny appearance to the lower extremities: A shiny appearance to the lower extremities is often associated with arterial insufficiency rather than peripheral venous disease. It can indicate thinning of the skin due to poor circulation and oxygenation.

D. Swollen and enlarged veins: Swollen and enlarged veins, also known as varicose veins, are classic manifestations of peripheral venous disease. These veins result from venous insufficiency, which leads to blood pooling and increased pressure in the veins, causing them to dilate and become visibly enlarged.

A. White blood cell level of 5,900 mm3 B. Potassium level of 4.1 mEq/L C. Hemoglobin level of 14.2 g/dL D. Blood glucose level of 254 mg/dL

Correct Answer is D

Explanation

A. White blood cell level of 5,900 mm3: While abnormal white blood cell levels can indicate infection or inflammation, they are not typically associated with directly contributing to an episode of delirium. However, underlying conditions that cause abnormal white blood cell levels, such as infection or inflammation, may contribute to delirium.

B. Potassium level of 4.1 mEq/L: Potassium imbalances can lead to various neurological symptoms, including weakness, paralysis, and cardiac arrhythmias. However, a potassium level of 4.1 mEq/L is within the normal range and is unlikely to directly contribute to an episode of delirium.

C. Hemoglobin level of 14.2 g/dL: Hemoglobin levels reflect the oxygen-carrying capacity of the blood and are not directly associated with delirium. While severe anemia or hypoxia can cause neurological symptoms, a hemoglobin level of 14.2 g/dL is within the normal range and is unlikely to directly contribute to delirium.

D. Blood glucose level of 254 mg/dL: Elevated blood glucose levels, as indicated by a blood glucose level of 254 mg/dL, can contribute to an episode of delirium. Hyperglycemia can lead to alterations in cerebral metabolism, neuronal dysfunction, and impaired cognitive function, predisposing individuals to delirium. Additionally, hyperglycemia can exacerbate preexisting neurological conditions and increase the risk of developing delirium in critically ill patients. Therefore, monitoring and managing blood glucose levels are essential in preventing and managing delirium in hospitalized patients.

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Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has peripheral venous disease. Which of the following findings should the nurse recognize as a manifestation of peripheral venous disease?

Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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