A nurse is providing teaching to a client who is newly diagnosed with Alzheimer's disease. Which of the following treatment options should the nurse include in the teaching?

Initiate hospice care services when the client has 6 months or less to live.

Improve cognitive status with transcranial magnetic stimulation.

Control anxiety with barbiturate medications.

Delay cognitive impairment with NMDA receptor antagonist medications.

Answer and Explanation

The Correct Answer is D

Choice A reason: Initiating hospice care services is generally considered when the client is in the final stages of Alzheimer's disease and has a life expectancy of 6 months or less. Hospice care focuses on comfort and quality of life, rather than curative treatments. It's an option when the disease has significantly progressed, not typically at the time of initial diagnosis.

Choice B reason: Transcranial magnetic stimulation (TMS) is a non-invasive procedure that uses magnetic fields to stimulate nerve cells in the brain and is being studied as a potential treatment for improving cognitive status in Alzheimer's patients. However, it is not yet a standard treatment and is considered experimental.

Choice C reason: Barbiturate medications are not typically used to control anxiety in Alzheimer's patients due to the risk of dependency and the potential to worsen cognitive impairment. Other medications, such as selective serotonin reuptake inhibitors (SSRIs), are generally preferred for managing anxiety in these patients⁷.

Choice D reason: NMDA receptor antagonists, such as memantine, are medications that can help delay cognitive symptoms in patients with moderate to severe Alzheimer's disease. They work by regulating the activity of glutamate, a neurotransmitter involved in learning and memory, which may be overactive in Alzheimer's disease.

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Correct Answer is A

Explanation

Choice A reason:This client experiences psychological stress that manifests as neurological symptoms, such as blindness, deafness, or paralysis, without an underlying medical cause. These deficits are real to the client, creating significant safety risks. The nurse must prioritize assessing their ability to navigate the environment safely to prevent falls or injuries related to these sudden sensory losses.

Choice B reason: Mild anxiety disorder typically does not involve sensory impairments. Anxiety may cause heightened awareness or sensitivity to stimuli but does not result in a loss of sensory function.

Choice C reason: Narcissistic personality disorder is characterized by patterns of grandiosity, need for admiration, and lack of empathy. It does not include sensory impairments as a symptom.

Choice D reason:While this client may engage in time-consuming rituals or repetitive behaviors that interfere with daily life, the disorder does not typically present with neurological or sensory impairments. Potential physical risks for these clients usually involve skin integrity issues from excessive washing or nutritional imbalances rather than the loss of primary senses like sight or hearing.

A. Blood glucose 256 mg/dL (74 to 106 mg/dL) B. WBC count 6,000/mm³ (5,000 to 10,000/mm³) C. Platelets 250,000/mm³ (150,000 to 400,000/mm³) D. Sodium 140 mEq/L (136 to 145 mEq/L)

Correct Answer is A

Explanation

Choice A reason: A blood glucose level of 256 mg/dL is significantly higher than the normal range and could indicate hyperglycemia, which is a serious side effect of risperidone. The provider should be notified immediately to manage this potential complication.

Choice B reason: A WBC count of 6,000/mm³ is within the normal range and does not typically warrant concern or the need to notify the provider.

Choice C reason: A platelet count of 250,000/mm³ is also within the normal range and is not indicative of an adverse reaction to risperidone.

Choice D reason: A sodium level of 140 mEq/L falls within the normal range and is not a cause for alarm in the context of risperidone therapy.

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A nurse is providing teaching to a client who is newly diagnosed with Alzheimer's disease. Which of the following treatment options should the nurse include in the teaching?

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