An elderly client diagnosed with a neurocognitive disorder is exhibiting behavioral problems on a daily basis. At change of shift, the client's behavior escalates from pacing to screaming and flailing. Initially, which action should a nurse implement in this situation?
Assess environmental triggers and potential unmet needs.
Anticipate the behavior and restrain when pacing begins.
Medicate the client with prn antianxiety medications.
Consult the psychologist regarding behavior-modification techniques.
The Correct Answer is A
A. Assess environmental triggers and potential unmet needs: Behavioral escalation in clients with neurocognitive disorders is often a form of communication. Identifying triggers, such as noise, lighting, discomfort, or unmet needs, helps address the underlying cause and prevent harm while promoting safety and dignity.
B. Anticipate the behavior and restrain when pacing begins: Physical restraints can increase agitation, risk of injury, and psychological distress. Restraints are considered a last resort and are only used when all other interventions fail and safety is threatened.
C. Medicate the client with prn antianxiety medications: Pharmacological intervention may be necessary in some cases, but initial assessment and nonpharmacological interventions are prioritized. Medications are reserved for situations where behaviors pose a safety risk or are unmanageable by other means.
D. Consult the psychologist regarding behavior-modification techniques: Consultation can provide long-term strategies, but immediate assessment of triggers and needs is the first step. Understanding the cause of escalation guides effective interventions in real time.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Tachycardia, increased BP: Patients with anorexia nervosa more commonly present with bradycardia and hypotension due to malnutrition, decreased cardiac muscle mass, and autonomic changes. Tachycardia and hypertension are not typical findings.
B. Amenorrhea: Amenorrhea is a common physical manifestation of anorexia nervosa in females. It results from hypothalamic-pituitary-gonadal axis suppression due to low body weight, nutritional deficiencies, and energy imbalance. Menstrual irregularities often precede other complications.
C. Esophageal tears: Esophageal tears are more commonly associated with repeated vomiting in bulimia nervosa, particularly after forceful purging episodes, rather than restrictive anorexia nervosa without purging.
D. Increase in bone density: Anorexia nervosa leads to decreased bone density (osteopenia or osteoporosis) due to low estrogen, poor nutrition, and impaired bone metabolism. Bone density loss increases fracture risk.
Correct Answer is A
Explanation
A. The diagnosis of ODD often includes refusal to comply with adult's rules or requests: Children with oppositional defiant disorder frequently display persistent defiance, argumentativeness, and refusal to follow directions from authority figures. This behavior is a core diagnostic criterion and is central to the disorder.
B. The diagnosis of ODD always includes damaging other people's property on purpose: Deliberate property damage is more characteristic of conduct disorder rather than ODD. While defiance may include spiteful behaviors, property destruction is not required for an ODD diagnosis.
C. The diagnosis of ODD occurs before the age of 3: ODD is typically diagnosed in early childhood or school-aged children, but onset is usually after age 3. Symptoms appearing before age 3 are not typically classified as ODD.
D. The prevalence of ODD is higher in girls than in boys: ODD is more commonly diagnosed in boys, especially during childhood. Prevalence in girls increases slightly during adolescence, but overall, boys are more frequently affected.
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