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. Consistency in staffing helps establish a therapeutic relationship and promotes trust and predictability, which can improve social interactions for clients with borderline personality disorder.
B. Exploring feelings of abandonment may be appropriate in therapy sessions but is not specifically aimed at improving social interactions.
C. Discussing maladaptive behaviors and working towards behavior change is important in the treatment of borderline personality disorder and should not be avoided.
D. Encouraging dependent behaviors can perpetuate maladaptive patterns and hinder progress in treatment for clients with borderline personality disorder.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Explanation

Upon assessment, the nurse should recognize that the client is at risk for developing acute confusion or delirium as evidenced by the client's disorientation to time and place, inability to focus, agitation, and anxiety upon reorientation. These symptoms suggest a disruption in cerebral metabolism, which can be caused by a variety of factors such as infection, fluid or electrolyte imbalance, or medication side effects. It is crucial to identify the underlying cause to provide appropriate care and prevent further complications. The nurse's role includes monitoring the patient's mental status, ensuring safety, and implementing therapeutic interventions to create a calming environment.

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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 planning care for a client who has borderline personality disorder. Which of the following interventions should the nurse plan to include to assist the client with impaired social interactions with others?

Correct Answer is A

Explanation

A nurse is caring for an older adult client. Exhibits Complete the following sentence by using the list of options. Upon assessment, the nurse should recognize that the client is at risk for developing dropdownas evidenced by the client's dropdown

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"C"}

Explanation

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