The doctor has explained Grace's condition as post-op Delirium, as well as the probable outcome to Grace's family. Which of the following statements by the family would indicate understanding of what to expect with regard to the nature and course of Grace's illness?
Grace will require intensive psychotherapy to recover and develop more appropriate coping mechanisms
I understand that Grace has had a general anesthetic and many pain medications and that her confusion will probably dissipate once she is more medically stable
Grace will probably slowly deteriorate until she no longer recognizes us, and can no longer care for herself because of her cognitive decline
Grace will likely improve within 4 to 6 months, once antidepressant medication is initiated
The Correct Answer is B
Choice A reason: Psychotherapy is not the primary treatment for delirium. Delirium is an acute medical emergency characterized by a clouded sensorium caused by underlying physiological disruptions. Treatment focuses on identifying and reversing the organic cause, not on addressing psychological coping mechanisms or personality traits through talk therapy.
Choice B reason: This statement correctly identifies that delirium is often caused by physiological stressors such as medications, anesthesia, or metabolic imbalances. It also accurately reflects that delirium is typically acute and reversible, with cognitive function returning to baseline once the underlying medical issues are resolved and stabilized.
Choice C reason: This statement describes the typical course of a neurocognitive disorder like Alzheimer's disease, which is characterized by a slow, progressive, and irreversible decline. Delirium, conversely, has an abrupt onset and a fluctuating course, and it is usually temporary rather than a permanent state of deterioration.
Choice D reason: Improvement within 4 to 6 months following antidepressant initiation describes the timeline for treating Major Depressive Disorder, not delirium. Delirium usually resolves much faster—within days or weeks—once the causative factor is removed, and antidepressants are not the standard treatment for acute postoperative confusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: In any psychiatric emergency where the patient is experiencing severe panic or psychosis and is non-responsive to verbal commands, safety is the absolute priority. The patient's erratic movements (running from chair to chair) pose an immediate risk of physical injury to themselves and others in the environment.
Choice B reason: While physical activity can sometimes help de-escalate lower levels of anxiety, this patient is in a state of severe panic or acute psychosis and cannot follow directions. Attempting to provide an "outlet" like exercise could increase the risk of injury or further escalate the agitation.
Choice C reason: Clarification of feelings is a therapeutic communication technique suitable for the "working phase" of the nurse-patient relationship when the patient is stable. A patient in an active, non-verbal state of panic is incapable of the cognitive processing required to clarify or discuss complex emotions.
Choice D reason: Respecting personal space is important to prevent further escalation, but it is a subset of maintaining safety. If the patient is actively running and in danger, the nurse must prioritize a safe environment and potentially physical intervention over simply maintaining a distance if that distance compromises safety.
Correct Answer is D
Explanation
Choice A reason: While dementia can have fluctuating levels of orientation, late-stage dementia is characterized by a permanent, progressive decline in cognitive function and memory. Suggesting that recognition might return provides false hope and demonstrates a lack of understanding regarding the irreversible pathophysiology of advanced neurocognitive disorders.
Choice B reason: Deferring to the health care provider is an avoidance technique that shuts down the therapeutic conversation. The nurse is professionally qualified to provide emotional support and education regarding the progression of dementia, and this response fails to address the family's immediate emotional distress.
Choice C reason: Although this statement is medically accurate regarding the prognosis of late-stage dementia, the delivery is blunt, insensitive, and lacks empathy. Effective nursing communication requires balancing clinical truth with a supportive approach that acknowledges the profound grief the family members are experiencing.
Choice D reason: This is a therapeutic communication technique known as reflection of feelings. It validates the family's emotional experience and grief without providing false reassurance. By acknowledging the pain of the situation, the nurse builds rapport and opens the door for further supportive counseling and education.
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