A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Place the client in a reclining chair.

Put locks at top of doors.

Encourage physical activity prior to bed time.

Position the mattress on the floor.

Install sensor devices on outside doors.

Answer and Explanation

Correct Answer : B,C,D,E

A.   Placing the client in a reclining chair is not recommended as it does not prevent wandering or falls and may even restrict movement leading to discomfort or pressure sores.
B.   Putting locks at the top of doors can prevent the client from wandering outside, which reduces the risk of falls and getting lost, especially during the night.
C.   Encouraging physical activity prior to bedtime can help in expending energy which may lead to better sleep and reduce restlessness and wandering at night.
D.   Positioning the mattress on the floor can minimize injury from falls that may occur when the client attempts to get out of bed during the night.
E.   Installing sensor devices on outside doors can alert the caregiver if the client attempts to leave the house, which is crucial for preventing wandering and potential falls.

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Correct Answer is A

Explanation

A. This response directly addresses the potential for self-harm, which is a critical concern when a client expresses hopelessness. It is an open-ended question that invites the client to discuss their feelings and provides the nurse with information to assess the client's safety.
B. Asking the client a why question may not be alright and this may make them to be guarded.
C. This response may come off as dismissive and lacks empathy towards the client's feelings.
D. Suggesting medication without further assessment is premature and may not address the root cause of the client's statement.

A. Weigh the client every other day. B. Remain with the client for 1 hr after meals. C. Offer snacks when the client is hungry. D. Plan a menu with the client.

Correct Answer is D

Explanation

A. Weighing the client every other day may contribute to increased anxiety and fixation on weight, which is not recommended for clients with binge eating disorder.
B. Remaining with the client for 1 hour after meals may not be feasible or practical and may not directly address the underlying issues associated with binge eating disorder.
C. Offering snacks when the client is hungry may not address the underlying psychological issues driving binge eating behavior and may inadvertently reinforce unhealthy eating patterns.

D. Planning a menu with the client promotes collaboration, empowers the client to make healthier food choices, and fosters a sense of control over their eating habits, which are important aspects of managing binge eating disorder.

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A nurse is providing teaching to the caregiver of an older adult client who has Alzheimer's disease and is being cared for at home. The client wanders at night and has a history of previous falls. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who states, "Things will never work out." Which of the following responses should the nurse make?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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