A nurse is caring for an older adult client who has dementia and whose family reports he gets up and wanders around at night. Which of the following actions should the nurse take?

Keep the client's personal items within reach.

Tell the family that someone should plan to stay with the client.

Place the client in a quiet room at the end of the hallway.

Provide bright lighting in the client's room at night.

Answer and Explanation

The Correct Answer is A

A. Keep the client's personal items within reach. Keeping the client's personal items within reach can provide a sense of familiarity and comfort, which may reduce anxiety or disorientation, thereby decreasing the tendency to wander.

Incorrect options:

B. "Tell the family that someone should plan to stay with the client.": While family involvement is important, this suggestion may not always be feasible. Additionally, it’s the nurse’s role to ensure the safety of the client within the facility.

C. "Place the client in a quiet room at the end of the hallway.": Isolating the client may increase confusion and feelings of disorientation.

D. "Provide bright lighting in the client's room at night.": Bright lights at night can disrupt sleep and may cause further disorientation. Dim or soft lighting or use of night lights in the room is generally more appropriate to promote restful sleep.

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Correct Answer is B

Explanation

A. Improved speech patterns:

While selegiline may contribute to overall improvement in motor function and quality of life for individuals with Parkinson's disease, it is not specifically known for targeting speech patterns.

B. Decreased tremors:

This is the correct therapeutic outcome. Selegiline is a monoamine oxidase type B (MAO-B) inhibitor that helps increase dopamine levels in the brain. Reduction of tremors is a common therapeutic effect in Parkinson's disease.

C. Increased bladder function:

Selegiline primarily affects motor symptoms in Parkinson's disease and is not directly associated with changes in bladder function.

D. Diminished drooling:

While drooling can be a symptom of Parkinson's disease, selegiline's primary focus is on motor symptoms, and its impact on drooling may be variable. Other interventions may be considered for managing drooling in Parkinson's disease.

A. Offer to request a prescription for an indwelling urinary catheter. B. Keep a night light on in the client's room. C. Put the side rails up and tell the client to call for assistance to the bathroom. D. Limit the client's fluid intake in the evening.

Correct Answer is B

Explanation

A. Offer to request a prescription for an indwelling urinary catheter.

Indwelling urinary catheters come with their own set of risks and complications. It is generally not recommended to use them solely for the purpose of preventing falls unless there are other medical indications for their use. Catheters increase the risk of infection and other complications, and their use should be based on clear medical necessity.

B. Keep a night light on in the client's room.

This option directly addresses the client's concern about falling during the night. Providing a night light in the room helps to alleviate disorientation, making it safer for the client to navigate to the bathroom. It is a practical and non-invasive intervention.

C. Put the side rails up and tell the client to call for assistance to the bathroom.

While using side rails can be a fall prevention measure, it's important to consider that they are not without risks. Side rails can lead to entrapment or injury if not used appropriately. In addition, telling the client to call for assistance is good advice, but relying solely on this instruction may not address the immediate concern of disorientation in new surroundings.

D. Limit the client's fluid intake in the evening.

While limiting fluid intake in the evening might reduce the frequency of bathroom trips, it is not the most appropriate response to the client's concern. Dehydration can lead to other health issues and should not be used as the primary strategy for fall prevention.

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A nurse is caring for an older adult client who has dementia and whose family reports he gets up and wanders around at night. Which of the following actions should the nurse take?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has Parkinson's disease and is taking selegiline 5 mg by mouth twice daily. Which of the following therapeutic outcomes should the nurse monitor for with a client who is taking this medication?

Correct Answer is B

Explanation

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Correct Answer is B

Explanation

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