A nurse is assisting with the care of a client who has dementia. Which of the following actions should the nurse take?

Repeat orientation questions until the client gives a correct response.

Make a personal introduction to the client at each interaction.

Give the client a list of foods to choose from for dinner.

Provide the client with a dark environment for sleeping.

Answer and Explanation

The Correct Answer is B

A.   It is not effective to repeatedly ask orientation questions to a client with dementia. Dementia causes progressive memory loss and cognitive decline, and the client may not be able to provide the correct response even with repeated questioning. This approach can lead to frustration and agitation for the client.
B.   Introducing oneself at each interaction is a good practice because individuals with dementia may have difficulty remembering people or recognizing familiar faces. It helps establish rapport and reduces confusion or anxiety that may arise from not recognizing caregivers or staff.
C.   Providing choices can help empower the client and maintain some level of independence in decision- making. However, it's important to keep the choices limited and clear, as too many options can overwhelm and confuse a person with dementia. Additionally, offering familiar and preferred foods can enhance the client's comfort and enjoyment of meals.
D.   Providing a dark environment for sleeping may not be appropriate for all clients with dementia. Some individuals may become disoriented or agitated in complete darkness. It's generally recommended to provide a quiet and calm environment with subdued lighting during nighttime hours to support restful sleep.

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Free Nursing Study Resources

Correct Answer is ["A","C","E"]

Explanation

A. Incoordination, such as clumsiness or difficulty walking, can be an early sign of lithium toxicity. It reflects the neurological effects of elevated lithium levels on motor coordination.
B. Polyuria (excessive urination) is a common late symptom of lithium toxicity. Lithium interferes with the kidney's ability to concentrate urine, leading to increased urine output.
C. Nausea is a gastrointestinal symptom that can occur in the early stages of lithium toxicity. It is often accompanied by other gastrointestinal disturbances such as vomiting and diarrhea.
D. Convulsions (seizures) are not typically considered early manifestations of lithium toxicity but rather indicate severe toxicity. Seizures can occur at higher levels of lithium toxicity and require immediate medical intervention.
E. Confusion is another early sign of lithium toxicity. It reflects the impact of elevated lithium levels on the central nervous system, leading to cognitive impairment and altered mental status.

A. Witness the client signing the form. B. Discuss alternative treatment options with the client. C. Determine the client is competent to give consent. D. Discuss the benefits of ECT with the client.

Correct Answer is A

Explanation

A. One of the nurse's responsibilities during the informed consent process is to witness the client signing the consent form. This ensures that the client voluntarily agrees to undergo ECT after receiving adequate information about the procedure, its risks, benefits, and alternatives. By witnessing the signature, the nurse confirms that the client's consent is documented appropriately and legally.
B. Nurses may provide general information about ECT and its alternatives, but the detailed discussion about treatment options and their implications usually occurs during the consultation with the provider.
C. Determining if a client is competent to give consent is a legal determination typically made by a healthcare provider or a legal representative, not the nurse.
D. It is not the nurse's role to discuss the specific benefits of ECT, as these discussions are the responsibility of the healthcare provider leading the client's care.

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A nurse is assisting with the care of a client who has dementia. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

A nurse is collecting data from a client who is taking lithium. Which of the following findings should the nurse identify as early manifestations of lithium toxicity? (Select all that apply.)

Correct Answer is ["A","C","E"]

Explanation

A nurse is assisting in the care of a client who is scheduled to receive electroconvulsive therapy (ECT). Which of the following is the nurse's role during the informed consent process?

Correct Answer is A

Explanation

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