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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E"]
Explanation
Choice A Reason: Vital signs are a critical indicator of a patient’s health status. Normal ranges for vital signs in a resting adult include a body temperature of 97.8°F to 99.1°F (36.5°C to 37.3°C), blood pressure between 90/60 mmHg and 120/80 mmHg, a pulse rate of 60 to 100 beats per minute, and a respiratory rate of 12 to 18 breaths per minute. The client’s vital signs have stabilized from the initial erratic readings to within normal ranges by hospital day 5, indicating a positive response to the treatment plan.
Choice B Reason: Movement through the stages of grief is essential for emotional recovery, especially in the context of alcohol use disorder where the grief may have triggered the relapse. The stages of grief include denial, anger, bargaining, depression, and acceptance. Progress in these stages can be a sign of emotional healing and a successful coping mechanism in the recovery process.
Choice D Reason: Participation in group therapy is a key component of substance use disorder treatment. It provides social support, reduces isolation, and helps develop effective communication and interpersonal skills3. Active participation in group therapy sessions indicates the client’s engagement with the treatment process and their commitment to recovery.
Choice E Reason: Appetite changes are common during recovery from alcohol use disorder. Initially, there may be a loss of appetite due to the effects of alcohol on the gastrointestinal system and overall health. However, as recovery progresses, appetite usually returns, and the individual may even overeat5. An improvement in appetite suggests that the client’s physical health is improving and that they are regaining a normal relationship with food.
Choice C Reason: Cognition refers to the mental processes involved in gaining knowledge and comprehension, including thinking, knowing, remembering, judging, and problem-solving. These are higher-level functions of the brain and encompass language, imagination, perception, and planning. A person’s cognitive ability can be affected by alcohol use disorder, as alcohol can impair cognitive functions and damage brain structures. However, recovery from alcohol abuse can lead to improvements in cognitive functions. Research indicates that most noticeable improvement in cognitive function begins after one year of abstinence from alcohol. Therefore, if the client shows signs of improved cognition, such as better memory, clearer thinking, or improved problem-solving, it would indicate progress in their recovery.
Choice F Reason: The client’s resolve to limit alcohol consumption is a significant indicator of their commitment to long-term recovery. Setting limits on alcohol intake is a crucial step in the process of recovery and can help prevent relapse. For men, moderate drinking is defined as up to two drinks per day and for women, up to one drink per day3. If the client expresses a desire to limit their alcohol consumption to within these guidelines, or better yet, abstains from alcohol completely, it would demonstrate a positive change in behavior and mindset towards their health and recovery.
Correct Answer is B
Explanation
Choice A reason: Avoiding television when hearing voices is not a recognized strategy for relapse prevention in schizophrenia. While reducing stimuli during episodes of auditory hallucinations can be helpful, it is not a substitute for professional treatment and medication adherence, which are key to relapse prevention.
Choice B reason: Informing a counselor about trouble sleeping is important because sleep disturbances can be an early indicator of a potential relapse. Maintaining open communication with healthcare providers about changes in sleep patterns allows for timely interventions and adjustments in treatment to prevent a relapse.
Choice C reason: Listening to the voices is not advisable as it may reinforce the hallucinations. Instead, clients are encouraged to engage in reality-based activities and to discuss their experiences with their healthcare providers to manage symptoms effectively.
Choice D reason: Isolation can exacerbate symptoms of schizophrenia and increase the risk of relapse. It is important for individuals to maintain social contacts and support systems as part of a comprehensive relapse prevention strategy.
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