WITH ALL PASSED ANSWERS GRADED A+
1. The nurse assesses an older adult with a diagnosis of severe, late-stage
Alzheimer's disease. Which assessment findings would the nurse expect for this
client? (Select all that apply.)
a. Acute confusion
b. Hallucinations
c. Wandering
d. Urinary incontinence
e. Difficulty eating Answer - ANS: B, D, E
1. A client with early dementia asks the nurse to find her mother who is
deceased. What is the nurse's most appropriate response?
a. "We can call her in a little while if you want."
b. "Your mother died over 20 years ago."
c. "What did your mother look like?"
d. "I'll ask your father to find her when he visits." Answer - ANS: B
1. The nurse is caring for a client with chronic confusion who often yells and
screams when touched. Which nursing intervention is most appropriate when
caring for this client?
a. Provide a large clock and calendar for the patient to read.
b. Use removable restraints like a roll-waist belt to prevent wandering.
, c. Approach the patient so that the nurse can be seen clearly.
d. Place the patient in a room close to the nurses' station for frequent
observation. Answer - ANS: C
The nurse is preparing to administer Sinemet to a client whose most blood
pressure is 88/50 while lying in bed. What is the nurse's priority action at this
time?
a. Instruct the client to get out of bed slowly.
b. Withhold the drug until contacting the health care provider.
c. Ask the client about the presence of hallucinations.
d. Take the patient's apical pulse and temperature. Answer - ANS: B
A client newly diagnosed with Parkinson disease (PD) is being discharged.
Which instruction is best for the nurse to provide to the client's spouse?
a. Administer medications promptly on schedule to maintain therapeutic drug
levels.
b. Complete activities of daily living for the client.
c. Provide high-fiber, high-carbohydrate foods.
d. Speak loudly for better understanding. Answer - ANS: A
The wife of a client with Alzheimer's disease mentions to the home health
nurse that, although she loves him, she is exhausted caring for her husband.
What does the nurse do to alleviate caregiver stress?
a. Arranges for respite care
b. Provides positive reinforcement and support to the wife