The nurse is performing a history and physical assessment for a client in the clinic with moderate dementia. The client becomes agitated when asked questions and inquires why so many questions are being asked. What are the best actions for the nurse to take to obtain the necessary data? Select all that apply.
Persistently ask the same question until answered.
Give the client ample time to answer the questions asked.
Ask simple questions instead of compound questions.
Provide simple explanations to the client as often as required.
Take frequent breaks during the interview process.
Correct Answer : B,C,D,E
Choice A reason: Persistently asking the same question can increase agitation in clients with dementia.
Choice B reason: Allowing ample time for responses can reduce pressure and agitation in clients with dementia.
Choice C reason: Simple questions are easier for clients with dementia to understand and respond to.
Choice D reason: Providing simple explanations can help clients with dementia understand the purpose of the questions.
Choice E reason: Taking frequent breaks can help prevent fatigue and agitation during the assessment process.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Separating finances is a practical step but does not address the underlying issues of alcoholism as a family illness.
Choice B reason: Attending Al-Anon meetings is a positive step towards understanding and coping with the effects of a family member's alcoholism.
Choice C reason: Allowing the client to face the consequences of their actions can be part of setting boundaries, which is important in dealing with alcoholism.
Choice D reason: Calling in sick for the client enables the behavior and prevents the client from facing the natural consequences of their alcoholism, indicating a need for further education on the illness.
Correct Answer is D
Explanation
Choice A reason: The statement about fear being a response to an unknown threat is a common perception, but it does not reflect an understanding of anxiety as a broader concept.
Choice B reason: While anxiety and fear are related, they are not the same; fear is a response to a known or understood threat, whereas anxiety is often more diffuse and not tied to a specific stimulus.
Choice C reason: This statement reflects a negative view of anxiety and does not acknowledge that anxiety can sometimes be a normal and even productive response to stress.
Choice D reason: Recognizing that anxiety is a natural part of life and cannot be completely eliminated reflects an understanding of anxiety as a normal human emotion and is indicative of a successful education session.
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