Which nursing intervention is designed to help the client with progressive memory deficit associated with dementia function in his environment?

Avoiding frustrating the client by performing ADLs for the client.

Telling jokes or riddles and discussing new items.

Bringing new topics and options to the client's attention.

Assisting the client to perform simple tasks by giving step-by-step directions.

Answer and Explanation

The Correct Answer is D

Choice A Reason:
Avoiding frustration by performing activities of daily living (ADLs) for the client may seem helpful, but it can actually lead to increased dependency and a faster decline in the ability to perform these tasks. It is important to encourage independence as much as possible.

Choice B Reason:
Telling jokes or riddles and discussing new items might provide temporary entertainment but does not necessarily help a client with dementia function better in their environment. It could also potentially cause confusion or frustration if the client does not understand or remember the context.

Choice C Reason:
Bringing new topics and options to the client's attention can be overwhelming and may contribute to confusion. Clients with dementia benefit from consistency and routine, which helps them feel more secure and oriented.

Choice D Reason:
Assisting the client to perform simple tasks by giving step-by-step directions is a beneficial intervention. It supports the client's ability to maintain independence and function within their environment for as long as possible. This approach aligns with the goal of maximizing the client's abilities and fostering a sense of accomplishment.

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Correct Answer is C

Explanation

Choice A Reason
Ceftriaxone is an antibiotic that may be prescribed during COPD exacerbations to treat or prevent infection. A white blood cell count of 16,000 u/L indicates an elevated level, which could be a response to infection. Therefore, ceftriaxone would be appropriate, and there is no need to question this medication based on the white blood cell count.

Choice B Reason
Zafirlukast is a leukotriene receptor antagonist used for the prophylactic treatment of asthma, and it may be used off-label for COPD. AST and ALT levels are liver enzymes, and the values provided (AST of 30 units/L and ALT of 20 units/L) are within normal ranges. Thus, there is no immediate concern regarding liver function that would prompt the nurse to question the use of zafirlukast.

Choice C Reason
Theophylline is a bronchodilator used in the treatment of COPD. However, a theophylline level of 21 mg/dL is above the therapeutic range, which is generally considered to be 5-15 mg/dL. Levels above 20 mg/dL are associated with toxicity and can lead to serious side effects such as seizures or arrhythmias. Therefore, the nurse should question this medication due to the high theophylline level.

Choice D Reason
Prednisone is a corticosteroid that may be used to reduce inflammation during COPD exacerbations. A glucose level of 110 mg/dL is slightly elevated but may be expected as corticosteroids can increase blood sugar levels. This would not typically be a reason to question the use of prednisone unless the patient has poorly controlled diabetes or other specific contraindications.

A. Smoking, hypertension, obesity, diabetes, and hyperlipidemia. B. Family history, stress, hypertension, and age. C. Alcohol consumption, obesity, diabetes, stress, hyperlipidemia. D. Personality type, hyperlipidemia, diabetes, and smoking.

Correct Answer is A

Explanation

Choice A Reason:

Smoking, hypertension, obesity, diabetes, and hyperlipidemia are all well-established risk factors for heart disease. Smoking damages the lining of the arteries, leading to a buildup of fatty material which narrows the artery. Hypertension can cause hardening and thickening of the arteries, which can lead to a heart attack or stroke. Obesity increases the likelihood of high blood pressure, high cholesterol levels, and diabetes, all of which are risk factors for heart disease. Diabetes increases the risk of heart disease significantly, as high blood sugar levels can damage blood vessels and the nerves that control the heart. Hyperlipidemia, particularly high levels of LDL cholesterol, can lead to plaque buildup in the arteries, increasing the risk of heart attack or stroke.

Choice B Reason:

Family history is a non-modifiable risk factor for heart disease, as genetics can play a role in an individual's likelihood of developing heart conditions. Stress can contribute to heart disease risk factors such as hypertension and is associated with other unhealthy behaviors. Hypertension and age are both significant risk factors; the risk of heart disease increases with age and with sustained high blood pressure.

Choice C Reason:

Alcohol consumption in excess can lead to high blood pressure, heart failure, or stroke. Obesity, diabetes, and stress are all risk factors as previously mentioned. Hyperlipidemia is also a modifiable risk factor that can be managed through diet, exercise, and medication.

Choice D Reason:

Personality type itself is not a direct risk factor for heart disease, but certain personality traits can lead to stress, which is a risk factor. Hyperlipidemia, diabetes, and smoking are all direct risk factors for heart disease as they contribute to the development of cardiovascular conditions.

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Which nursing intervention is designed to help the client with progressive memory deficit associated with dementia function in his environment?

Nursing Test Bank

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