A patient diagnosed with moderate dementia consistently appears to be distorting the truth resulting in his wife asking, "What should I do when he lies to me about unimportant things?" Upon what rationale should the nurse's response be based?
Changing the topic provides diversion.
Delusions should be confronted to clarify thinking.
Ignoring memory deficit avoids catastrophic reactions.
This isn't lying but rather a way to fill in the memory gaps.
The Correct Answer is D
A. Changing the topic provides diversion is not the most effective approach to dealing with cognitive distortions in dementia. While changing the topic might redirect the conversation temporarily, it doesn't address the underlying cognitive issue and may cause confusion or frustration in the patient.
B. Delusions should be confronted to clarify thinking is generally not advisable in dementia care. Confronting a person with dementia about their delusions or false beliefs can lead to frustration, agitation, or aggression, as they may not be able to understand or accept reality. It’s better to validate their feelings without challenging the delusion.
C. Ignoring memory deficit avoids catastrophic reactions is a valid strategy in some cases, as confronting or arguing about the memory deficit can cause distress. However, this approach focuses on not confronting the memory issue directly, rather than explaining the underlying reason for the behavior.
D. This isn't lying but rather a way to fill in the memory gaps is the most appropriate response. Patients with dementia may fabricate details or "lie" in an attempt to fill in gaps in their memory. This behavior is often an unconscious effort to make sense of their confusion or inability to recall specific events. It’s not intentional lying but rather a coping mechanism to manage memory loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Workplace bullying includes repeated, unreasonable actions directed toward an employee intended to intimidate, degrade, or undermine. In this scenario, the charge nurse dismisses the new grad’s valid concerns and gives a difficult assignment without support, contributing to an unsafe and unsupportive environment — classic signs of bullying.
B. Workplace violence typically refers to physical acts of aggression or threats. This situation, while harmful, does not involve violence.
C. Ageism refers to discrimination based on a person’s age, which is not a factor in this scenario.
D. While new grads are expected to learn and grow into their roles, being overwhelmed with unsafe assignments and receiving no support is not normal or acceptable.
Correct Answer is C
Explanation
A. Sweating is a common symptom of opioid withdrawal and is included in the Clinical Opiate Withdrawal Scale (COWS), which is used to assess the severity of withdrawal symptoms.
B. Goosebumps (also called piloerection) are a classic physical sign of opioid withdrawal and are specifically assessed in the COWS scoring system.
C. Palpitations are not typically listed as a core symptom of opioid withdrawal in the COWS assessment. While some individuals may subjectively report feeling anxious or having an increased heart rate, palpitations are not a primary or consistent withdrawal symptom.
D. High blood pressure is a recognized symptom of opioid withdrawal and is measured in the COWS tool as part of autonomic symptoms like increased pulse and blood pressure.
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