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 B

Explanation

- Choice A Rationale: This statement does not indicate spiritual distress. On the contrary, it suggests that the client's faith is a source of strength and hope, which is typically a sign of positive spiritual well-being.
- Choice B Rationale:

This statement suggests a disruption in the client's spiritual practices, which could lead to spiritual distress as it interferes with a meaningful coping mechanism.

- Choice C Rationale: Similar to choice A, this statement reflects a positive aspect of the client's spirituality. Finding comfort in meditation is indicative of a beneficial spiritual practice and does not suggest distress.
- Choice D Rationale:

This reflects active spiritual support, which is helpful during illness and not indicative of spiritual distress.

A. The client develops an inability to concentrate. B. The client exhibits an inflated sense of self. C. The client begins sleeping more than usual. D. The client increases participation in social activities.

Correct Answer is A

Explanation

A. Inability to concentrate is a common early sign of relapse in schizophrenia. It can indicate worsening symptoms and difficulty in maintaining focus and attention.
B. An inflated sense of self is not typically associated with relapse in schizophrenia. It may be a symptom of other psychiatric disorders, such as bipolar disorder or narcissistic personality disorder.
C. Increased sleeping can be a symptom of depression but is not specific to schizophrenia relapse.
D. Increased participation in social activities is not typically associated with relapse in schizophrenia. It may indicate improvement in social functioning or adaptation to the illness.

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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.)

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Naxlex Comprehensive Predictor Exams

A nurse is assessing the spiritual beliefs of a client. Which of the following client statements indicates spiritual distress?

Correct Answer is B

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Correct Answer is A

Explanation

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