D.B. is admitted to a long-term care facility. He has impaired memory related to effects of dementia. An appropriate nursing intervention for him is to:

Let him know what behavior is socially appropriate

Maintain familiar routines of sleep, meals, drug administration, and activities.

Promote orientation at every encounter with the patient by asking the day, time, and place

Assist him with all self-care to maintain self-esteem

Answer and Explanation

The Correct Answer is B

A. Let him know what behavior is socially appropriate. While it is important to gently redirect inappropriate behavior, individuals with dementia may not retain this information due to impaired memory and cognitive decline. This approach is not as effective as maintaining familiar routines.
B. Maintain familiar routines of sleep, meals, drug administration, and activities. Consistent routines help reduce confusion and anxiety in individuals with dementia. Predictable schedules reinforce a sense of security, making it easier for the patient to remember daily activities and participate in self-care. Disruptions to routine can lead to increased agitation and disorientation.
C. Promote orientation at every encounter with the patient by asking the day, time, and place. While gentle reorientation can be helpful, repeatedly questioning the patient about time and place may lead to frustration, agitation, or embarrassment. A better approach is to use environmental cues (e.g., clocks, calendars, labeled rooms) and offer reassurance.
D. Assist him with all self-care to maintain self-esteem. Encouraging independence in self-care to the extent possible is crucial for maintaining dignity and self-esteem. Providing total assistance when unnecessary can lead to learned helplessness and increased dependence. Instead, the nurse should offer support only when needed while encouraging the patient to perform tasks independently.

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Correct Answer is A

Explanation

A. Lorazepam. Lorazepam (a benzodiazepine) is the first-line medication for status epilepticus because it acts quickly to stop seizures. It enhances gamma-aminobutyric acid (GABA) activity, leading to rapid suppression of neuronal excitability. It is usually administered intravenously (IV) for fast onset.
B. Lisinopril. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor used for hypertension and heart failure. It has no role in stopping seizures or treating status epilepticus.
C. Phenytoin. Phenytoin is used for long-term seizure control but is not the first-line medication for stopping active seizures. It is often administered after benzodiazepines to help prevent seizure recurrence rather than terminating the ongoing seizure.
D. Atenolol. Atenolol is a beta-blocker used for hypertension and tachycardia. It does not have anticonvulsant properties and is not used to treat seizures.

A. The client B. The client's daughter, who is the primary caregiver C. The client's partner D. The client's son, who has a durable power of attorney

Correct Answer is A

Explanation

A: "The client." Since the client is alert and oriented to person, place, and time, they have the capacity to understand the procedure and provide informed consent. Informed consent must be obtained from the client themselves when they are competent to make decisions, even if they have a history of dementia.
B: "The client's daughter, who is the primary caregiver." While the daughter's role as a primary caregiver is important, she cannot sign the informed consent unless the client is deemed incapable of doing so. Informed consent must come from the client when they are capable of understanding the implications of the procedure.
C: "The client's partner." The partner may provide support and advocate for the client but does not have the legal authority to sign the informed consent unless the client has granted them that right. Informed consent should be obtained directly from the client when they are capable of making decisions.
D: "The client's son, who has a durable power of attorney." The son can make medical decisions on behalf of the client if the client is incapacitated. However, since the client is currently alert and oriented, they should sign the informed consent themselves, making this option unnecessary in this situation.

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D.B. is admitted to a long-term care facility. He has impaired memory related to effects of dementia. An appropriate nursing intervention for him is to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a patient that is experiencing status epilepticus. Which of the following prescribed medications should the nurse anticipate to administer?

Correct Answer is A

Explanation

A nurse is caring for a client who has a history of dementia. The client is alert and oriented to person, place, and time, and has advance directives. The client is scheduled for a procedure that requires informed consent. Which of the following persons should sign the informed consent?

Correct Answer is A

Explanation

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