Which of the following is an appropriate outcome for a client experiencing an acute episode of delirium?
Client will remain free from self-directed violence as evidenced by agreement to a no-suicide contract.
Client will have intact tactile senses as evidenced by ability to recognize familiar objects when placed in his or her hand.
Client will have decreased confusion as evidenced by orientation to person, place, and time.
Client will verbalize increased feelings of self-esteem as evidenced by statements acknowledging ability to perform certain tasks independently.
The Correct Answer is C
A. Client will remain free from self-directed violence as evidenced by agreement to a no-suicide contract is more appropriate for a patient who is at risk for suicide or self-harm, but it doesn't specifically address delirium, which involves acute confusion and altered consciousness. A no-suicide contract does not directly address the underlying cognitive issues in delirium.
B. Client will have intact tactile senses as evidenced by ability to recognize familiar objects when placed in his or her hand focuses on sensory perception, which may not be the most relevant outcome for a patient experiencing delirium. Delirium primarily affects cognitive functions such as attention, memory, and orientation, rather than tactile sensations.
C. Client will have decreased confusion as evidenced by orientation to person, place, and time is the most appropriate and specific outcome for delirium. Delirium is characterized by acute confusion and disorientation to time, place, and person, and improving orientation is a key goal in managing delirium.
D. Client will verbalize increased feelings of self-esteem as evidenced by statements acknowledging ability to perform certain tasks independently is more relevant for mental health disorders such as depression or anxiety, where self-esteem and independence are key focuses. While important, it is not a priority outcome for delirium, where the main concern is restoring cognitive function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Client will remain free from self-directed violence as evidenced by agreement to a no-suicide contract is more appropriate for a patient who is at risk for suicide or self-harm, but it doesn't specifically address delirium, which involves acute confusion and altered consciousness. A no-suicide contract does not directly address the underlying cognitive issues in delirium.
B. Client will have intact tactile senses as evidenced by ability to recognize familiar objects when placed in his or her hand focuses on sensory perception, which may not be the most relevant outcome for a patient experiencing delirium. Delirium primarily affects cognitive functions such as attention, memory, and orientation, rather than tactile sensations.
C. Client will have decreased confusion as evidenced by orientation to person, place, and time is the most appropriate and specific outcome for delirium. Delirium is characterized by acute confusion and disorientation to time, place, and person, and improving orientation is a key goal in managing delirium.
D. Client will verbalize increased feelings of self-esteem as evidenced by statements acknowledging ability to perform certain tasks independently is more relevant for mental health disorders such as depression or anxiety, where self-esteem and independence are key focuses. While important, it is not a priority outcome for delirium, where the main concern is restoring cognitive function.
Correct Answer is D
Explanation
A. Lewy body disease is a type of progressive dementia caused by abnormal deposits of alpha-synuclein protein in the brain. It is not associated with alcoholism.
B. Alzheimer's disease is the most common form of dementia, typically linked to age and genetic factors,not alcohol use.
C. Huntington chorea (or Huntington’s disease) is a hereditary neurodegenerative disorder, not related to alcohol use.
D. Wernicke-Korsakoff syndrome is a brain disorder directly associated with chronic alcoholism and thiamine (vitamin B1) deficiency.
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