When an elderly patient is brought into the Emergency Department by family members who reported a fall the nurse became suspicious that the patient had suffered physical abuse. The patient denied that she had been abused. Her denial is most likely based on her.

A. Changing the topic provides diversion is not the most effective approach to dealing with cognitive distortions in dementia. While changing the topic might redirect the conversation temporarily, it doesn't address the underlying cognitive issue and may cause confusion or frustration in the patient.
B. Delusions should be confronted to clarify thinking is generally not advisable in dementia care. Confronting a person with dementia about their delusions or false beliefs can lead to frustration, agitation, or aggression, as they may not be able to understand or accept reality. It’s better to validate their feelings without challenging the delusion.
C. Ignoring memory deficit avoids catastrophic reactions is a valid strategy in some cases, as confronting or arguing about the memory deficit can cause distress. However, this approach focuses on not confronting the memory issue directly, rather than explaining the underlying reason for the behavior.
D. This isn't lying but rather a way to fill in the memory gaps is the most appropriate response. Patients with dementia may fabricate details or "lie" in an attempt to fill in gaps in their memory. This behavior is often an unconscious effort to make sense of their confusion or inability to recall specific events. It’s not intentional lying but rather a coping mechanism to manage memory loss.

A. Educate the victim about strategies to avoid attacks in the future is not the most therapeutic intervention immediately after the assault. While prevention strategies can be helpful later, the immediate priority is providing emotional support and ensuring the victim feels heard and understood. This helps begin the process of healing.
B. Use accepting, nurturing, and empathetic communication techniques is the most therapeutic approach. Victims of sexual assault need a safe space to express their feelings and to feel supported without judgment. Using empathetic, compassionate communication helps to validate their feelings and begins to rebuild trust. It also allows the victim to process the trauma at their own pace.
C. Discourage the expression of feelings until the victim stabilizes is not a therapeutic approach. Bottling up emotions can lead to further psychological harm. Encouraging the victim to express their feelings when they are ready can be part of the healing process. Discouraging emotional expression may make the victim feel invalidated or isolated.
D. Maintain a matter-of-fact manner and objectivity might seem neutral, but it can come across as cold or distant, which could worsen the victim’s emotional state. While maintaining professionalism is important, the victim requires emotional support, which can be achieved through empathetic and compassionate communication