Which of the following statements by the caregiver of a client newly diagnosed with dementia requires further intervention by the nurse?

I will remind mother of things she has forgotten

I will keep mother busy with favorite activities as long as she can participate

I will try to find new and different things to do every day

I will encourage mother to talk about friends and family

Answer and Explanation

The Correct Answer is C

Choice A reason: Reminding a dementia patient of forgotten information supports memory function and reduces frustration. Dementia involves progressive neuronal loss, impairing short-term memory due to hippocampal and cortical damage. Gentle reminders align with cognitive support strategies, maintaining patient comfort without overwhelming their limited cognitive capacity, making this approach appropriate.

Choice B reason: Engaging in favorite activities leverages preserved long-term memory in dementia, as the disease primarily affects short-term memory and executive function due to amyloid plaques and tau tangles. Familiar tasks reduce agitation and promote well-being, as they align with the patient’s cognitive abilities, making this a scientifically sound caregiving strategy.

Choice C reason: Introducing new and different activities daily is inappropriate, as dementia patients struggle with learning and adapting due to impaired neuroplasticity and hippocampal dysfunction. Novel tasks can cause confusion and agitation, as they overwhelm cognitive reserves. Familiar routines are more effective, requiring intervention to educate the caregiver on maintaining consistency.

Choice D reason: Encouraging discussion about friends and family taps into preserved long-term memory in early dementia, as the disease initially spares autobiographical memory. Social engagement supports emotional well-being and cognitive stimulation, reducing isolation. This approach is scientifically appropriate, as it aligns with the patient’s cognitive strengths and promotes quality of life.

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Correct Answer is A

Explanation

Choice A reason: Lithium’s therapeutic range for maintenance in bipolar disorder is 0.5–1.2 mEq/L, balancing mood stabilization via sodium channel modulation and neuroprotection with safety. This range minimizes toxicity risks like tremors or renal damage, ensuring effective serotonin and dopamine regulation while maintaining safe serum concentrations.

Choice B reason: A 10–50 mEq/L lithium level is far above the therapeutic range, causing severe toxicity, including seizures or coma, due to excessive sodium channel inhibition and neuronal dysfunction. This range is lethal, disrupting renal and neurological function, making it scientifically inaccurate for maintenance or safety.

Choice C reason: A 0.1–1 mEq/L range is partially subtherapeutic, as levels below 0.5 mEq/L are ineffective for mood stabilization in bipolar disorder. Lithium requires 0.5–1.2 mEq/L to modulate sodium channels and serotonin, making this range inadequate for therapeutic efficacy while still posing minor toxicity risks.

Choice D reason: A 50–100 mEq/L lithium level is exponentially above safe limits, causing fatal toxicity, including renal failure and neurological damage, due to extreme sodium channel disruption. This range is not viable for maintenance, as it far exceeds the therapeutic window, leading to severe neurobiological and systemic harm.

A. Disturbed Sensory Perception B. Anxiety C. Post-Trauma Syndrome D. Powerlessness

Correct Answer is C

Explanation

Choice A reason: Disturbed Sensory Perception involves altered sensory processing, like hallucinations, not specific to anxiety disorders with flashbacks or hypervigilance. These symptoms stem from heightened amygdala activity and dysregulated cortisol in trauma-related disorders, not sensory distortion. This diagnosis is less precise, as it does not capture the trauma-specific psychological and autonomic responses observed.

Choice B reason: Anxiety is a broad diagnosis encompassing excessive worry and autonomic arousal, but it is less specific than Post-Trauma Syndrome for symptoms like flashbacks and numbing. These indicate a trauma-related disorder, likely PTSD, driven by amygdala hyperactivation and HPA axis dysregulation, requiring a diagnosis that addresses the traumatic etiology and specific symptoms.

Choice C reason: Post-Trauma Syndrome, aligned with PTSD, is the most appropriate diagnosis for symptoms like flashbacks, hypervigilance, and numbing, which result from trauma-induced changes in the amygdala, hippocampus, and prefrontal cortex. These cause intrusive memories, heightened arousal, and emotional detachment, accurately reflecting the neurobiological impact of trauma on stress response systems.

Choice D reason: Powerlessness reflects perceived lack of control, not specific to flashbacks or hypervigilance. While trauma can cause feelings of helplessness, the defining symptoms here involve trauma-specific neurological changes, like amygdala hyperactivity, better captured by Post-Trauma Syndrome. Powerlessness is secondary and l

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Which of the following statements by the caregiver of a client newly diagnosed with dementia requires further intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Identify the serum lithium level for maintenance and safety.

Correct Answer is A

Explanation

Which nursing diagnosis should be most useful for clients with anxiety disorders for whom the following defining characteristics have been identified: avoidance, poor concentration, nightmares, hypervigilance, exaggerated startle response, detachment, numbing, and flashbacks?

Correct Answer is C

Explanation

A client voluntarily admitted to the inpatient psychiatric unit is currently experiencing mild delirium. The client approaches the nurse and states, "I’m going to take a walk outside. I'll be back in about 10 minutes." Which is the most appropriate nursing action?

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The nurse has been teaching the caregiver about Aricept. The nurse knows teaching has been effective by which of the following statements?

Seasonal Affective Disorder is a disturbance of mood and behavior accompanied by at least 5 key features for at least 2 weeks.

A nurse is planning care for a newly admitted client who has bipolar disorder and is experiencing acute mania. Which of the following client goals should the nurse identify as the priority?

When assessing a client with delirium, the nurse will expect to see (Select all that apply)

A client has been admitted in withdrawal delirium. He is dehydrated and has a bruised, swollen tongue. He is experiencing illusions and auditory hallucinations and is confused. In developing a care plan for this client, what measure should the nurse include to ensure physiologic stability?