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. Multiple sclerosis (MS) is a disabling disease of the central nervous system (brain and spinal cord). It involves the immune system attacking the protective myelin sheath covering nerve fibers, causing communication problems between the brain and the rest of the body. This progressive damage can lead to both physical and cognitive disabilities, making it a dementia-related disorder in some advanced cases.
B. Huntington chorea (Huntington’s disease) is a genetic neurodegenerative disorder that affects movement and cognitive function, but it is not primarily defined as a disorder of both the brain and spinal cord.
C. Wernicke-Korsakoff syndrome is a brain disorder linked to chronic alcohol use and thiamine (vitamin B1) deficiency. It affects memory and coordination but is not a disease of the spinal cord.
D. Alzheimer’s disease is the most common form of dementia and is strictly a brain disorder, not one that affects the spinal cord.
Correct Answer is D
Explanation
A. Quetiapine (Seroquel) is an atypical antipsychotic medication used for the treatment of conditions like schizophrenia, bipolar disorder, and major depression. It is not commonly used for the immediate short-term treatment of someone who has been sexually assaulted.
B. Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) used to treat depression, anxiety, and other mood disorders. While it may be used for long-term treatment of anxiety or depression, it is not typically the first-line choice for short-term treatment immediately after a sexual assault.
C. Cyclobenzaprine (Flexeril) is a muscle relaxant used for muscle spasms and is not typically used for short-term treatment following a sexual assault.
D. Lorazepam (Ativan) is a benzodiazepine used for its anxiolytic (anti-anxiety) and sedative properties. After a sexual assault, a victim may experience acute anxiety, panic, and distress. Lorazepam can be used short-term to help reduce anxiety, calm the individual, and assist in sleep. However, it should be used cautiously, considering the risk of dependency or sedation.
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