In a long-term care facility, a nurse is having a discussion with the nurse aides about ways to deal with dementia clients who are uncooperative with mouth care. Appropriate methods to use include which of the following?
Having another nurse aide assist in holding the client’s mouth open with a tongue depressor
Involving the client in the process of oral hygiene, such as using the hand-over-hand technique to brush the client's teeth
Speaking to the client sternly and instructing the client to open their mouth and cooperate immediately
Quickly performing oral hygiene without explanation since the client is uncooperative
The Correct Answer is B
Choice A reason: This method is not appropriate because it can cause physical and psychological harm to the client. It can injure the client's mouth, trigger a gag reflex, or cause choking. It can also make the client feel violated, frightened, or angry. This can worsen the client's behavior and damage the trust between the client and the caregiver.
Choice B reason: This method is appropriate because it can help the client maintain their dignity, autonomy, and sense of control. It can also stimulate the client's cognitive and motor skills, and encourage the client to participate in their own care. This can improve the client's mood and behavior, and foster a positive relationship between the client and the caregiver.
Choice C reason: This method is not appropriate because it can cause emotional and psychological harm to the client. It can make the client feel disrespected, humiliated, or threatened. It can also increase the client's anxiety, agitation, or resistance. This can worsen the client's behavior and damage the trust between the client and the caregiver.
Choice D reason: This method is not appropriate because it can cause physical and psychological harm to the client. It can injure the client's mouth, trigger a gag reflex, or cause choking. It can also make the client feel ignored, neglected, or devalued. This can worsen the client's behavior and damage the trust between the client and the caregiver.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Can bring about long-term changes in lifestyle is true because persistent pain, also known as chronic pain, is pain that lasts for more than three months or beyond the expected healing time. Persistent pain can affect the physical, psychological, social, and emotional aspects of a person's life, and may require adjustments in daily activities, work, hobbies, relationships, and self-care.
Choice B reason: Is generally gone within 4 months is false because persistent pain does not have a clear end point and may persist for years or even a lifetime. Persistent pain is different from acute pain, which is pain that is sudden, sharp, and usually related to an injury or illness. Acute pain typically lasts for a short time and resolves when the underlying cause is treated.
Choice C reason: Is usually described as a burning pain is false because persistent pain can have various descriptions, depending on the cause, location, and intensity of the pain. Some common words that people use to describe persistent pain are aching, throbbing, stabbing, shooting, tingling, or numbness.
Choice D reason: Leads to significantly altered vital signs is false because persistent pain does not usually cause noticeable changes in vital signs, such as blood pressure, heart rate, respiratory rate, or temperature. This is because the body adapts to persistent pain over time and does not react as strongly as it does to acute pain. However, this does not mean that persistent pain is less severe or less important than acute pain.
Correct Answer is ["B","C","D","E"]
Explanation
Choice A reason: Isolated systolic hypertension is not a result of end-organ damage from chronic hypertension, but rather a risk factor for it. Isolated systolic hypertension is a condition where the systolic blood pressure is elevated (>140 mmHg) while the diastolic blood pressure is normal (<90 mmHg). It is common in older adults due to the stiffening of the arteries, and can increase the risk of cardiovascular and cerebrovascular events.
Choice B reason: Atrial fibrillation is a result of end-organ damage from chronic hypertension. Atrial fibrillation is an irregular and often rapid heart rate that can cause poor blood flow and increase the risk of stroke and heart failure. Chronic hypertension can damage the heart muscle and the electrical system of the heart, leading to atrial fibrillation.
Choice C reason: Renal insufficiency is a result of end-organ damage from chronic hypertension. Renal insufficiency is a condition where the kidneys are unable to filter waste and fluid from the blood adequately. Chronic hypertension can damage the blood vessels and the nephrons of the kidneys, leading to renal insufficiency.
Choice D reason: Stroke is a result of end-organ damage from chronic hypertension. Stroke is a sudden interruption of blood supply to the brain, causing brain cell death and neurological deficits. Chronic hypertension can damage the blood vessels in the brain, making them prone to rupture (hemorrhagic stroke) or blockage (ischemic stroke).
Choice E reason: Cardiac disease is a result of end-organ damage from chronic hypertension. Cardiac disease is a broad term that encompasses various disorders of the heart, such as coronary artery disease, heart attack, heart failure, and cardiomyopathy. Chronic hypertension can damage the heart by increasing the workload and the oxygen demand of the heart, causing the heart to enlarge and weaken over time.
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