All of the following are defense behaviors observed among patients with Alzheimer's except
Denial
Confabulation
Perseveration
Rationalization
The Correct Answer is D
A. Denial is a common defense mechanism in patients with Alzheimer's disease. Individuals may refuse to accept the reality of their cognitive decline, which can lead them to deny their condition or deny symptoms, such as memory loss.
B. Confabulation refers to the unintentional creation of false memories to fill in memory gaps. It is a defense mechanism often seen in Alzheimer's patients as they attempt to make sense of their experiences or answer questions when they do not remember the correct information.
C. Perseveration is the repetition of a word, phrase, or action. Patients with Alzheimer's may exhibit perseveration when they become fixated on a thought or action and repeat it persistently, which is often a coping mechanism for confusion or disorientation.
D. Rationalization is a defense mechanism where individuals justify or explain their behaviors in a seemingly logical way to avoid feelings of guilt or discomfort. While it can be seen in many types of psychological distress, rationalization is not typically a behavior associated with Alzheimer's disease. Instead, Alzheimer's patients are more likely to demonstrate denial, confabulation, or perseveration, as they struggle with cognitive decline and memory loss.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Childbirth classes to prepare for the birth may be relevant, but they are not the priority in this situation. The immediate concern is the safety and well-being of the pregnant woman and her ability to address the abuse.
B. Risks of pregnancy complications caused by abuse are important to discuss, but the priority at this moment should be ensuring the woman knows where to get help and support regarding the domestic violence she is experiencing.
C. Instructions on the use of resources available to her may be important, but the most immediate concern is ensuring she is aware of domestic violence resources that can help her escape further harm.
D. Available resources on domestic violence should be the priority. The nurse needs to ensure that the woman knows how to access safe spaces and support systems to escape from the abusive relationship. Domestic violence poses immediate risk to both the woman and her pregnancy, and addressing it must be the first step in the care plan.
Correct Answer is C
Explanation
A. Avoidance of physical contact is not the priority intervention for a patient with delirium. While you may want to be gentle and avoid unnecessary contact, the priority is to ensure the patient's safety and provide support in a way that helps prevent injury, confusion, or further agitation.
B. Application of wrist and ankle restraints is not recommended unless absolutely necessary for patient safety (such as if the patient is at risk of harming themselves or others). Restraints should be a last resort and only used when all other interventions have failed.
C. Careful observation and supervision is the priority nursing intervention for a patient with delirium. Due to fluctuating levels of consciousness and altered perception, the patient is at risk for injury (e.g., falling, wandering). Close observation helps ensure the patient's safety and provides an opportunity to intervene if the condition worsens.
D. High level of sensory input is generally not recommended for patients with delirium, as it may increase confusion and agitation. Instead, providing a calm, quiet environment with minimal distractions is typically preferred.
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