A nurse is assisting with the care of a client who has dementia.
Which of the following actions should the nurse take?.

. Make a personal introduction to the client at each interaction.

Give the client a list of foods to choose from for dinner.

Repeat orientation questions until the client gives a correct response.

Provide the client with a dark environment for sleeping.

Answer and Explanation

The Correct Answer is A

Choice A rationale:

Making a personal introduction to the client at each interaction is a recommended approach for clients with dementia. It helps to orient the client and establish a connection, which can reduce confusion and anxiety.

Choice B rationale:

Giving a client with dementia a list of foods to choose from for dinner may be overwhelming due to impaired decision-making abilities.

Choice C rationale:

Choice D rationale:

Providing a dark environment for sleeping can be disorienting for a client with dementia. A low level of light can help the client maintain orientation to their surroundings.

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Correct Answer is B

Explanation

Choice A rationale:

A consistent state of depression is not indicative of delirium, but rather a mood disorder.

Choice B rationale:

Fluctuating levels of orientation are a hallmark sign of delirium and should be reported to the provider.

Choice C rationale:

Obsessive behaviors are not typically associated with delirium, but may be indicative of an anxiety disorder.

Choice D rationale:

Gradual memory loss is more indicative of dementia, not delirium, which is typically a sudden onset.

A. Timeout B. Restraint. C. Diversion. D. Therapeutic hold.

Correct Answer is A

Explanation

Choice A rationale:

A timeout is a de-escalation technique where the client is allowed to spend time alone in a safe environment to regain control.

Choice B rationale:

Restraint is not a de-escalation technique. It is a last resort measure used when other methods have failed and the client is a danger to themselves or others.

Choice C rationale:

Diversion is a technique used to distract the client from a stressful situation, not a de-escalation technique.

Choice D rationale:

A therapeutic hold is a type of physical restraint, not a de-escalation technique.

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A nurse is assisting with the care of a client who has dementia.
Which of the following actions should the nurse take?.