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A nurse is reinforcing teaching with the caregiver of a client who has Alzheimer's disease.
The caregiver reports that the client awakens at night and wanders.
Which of the following strategies should the nurse suggest?

Place a lock at the top of doors leading outside.

Use light restraints while the client is in bed.

Administer an antianxiety medication before bedtime.

Encourage the client to nap during the day.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Placing a lock at the top of doors helps prevent the client from wandering outside, ensuring safety.

Choice B rationale

Using light restraints is not recommended due to ethical concerns and potential harm.

Choice C rationale

Administering antianxiety medication should not be the first strategy due to potential side effects and over-medication.

Choice D rationale

Encouraging napping during the day may worsen nighttime wakefulness and wandering.

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Correct Answer is A

Explanation

Choice A rationale

Acknowledging the client's fear and providing reassurance without confirming the hallucination helps build trust and reduce anxiety.

Choice B rationale

Correcting the client by stating it is a syringe, not a snake, dismisses their fear and can increase distress.

Choice C rationale

Emphasizing the provider's requirement for the blood specimen does not address the client's fear and can worsen anxiety.

Choice D rationale

Telling the client they are mistaken dismisses their hallucination and can increase their distress and mistrust.

A. I can encourage my child to think about what they did that allowed this event to happen. B. I anticipate that my child will feel some self-blame. C. I should encourage my child to focus solely on the future. D. I will have to do all I can to monitor my child's relationships.

Correct Answer is B

Explanation

Choice A rationale

Blaming the adolescent for the assault can increase feelings of shame and guilt, exacerbating the trauma and hindering recovery. It's important to provide support without assigning blame.

Choice B rationale

Anticipating self-blame, while acknowledging a common response, doesn't offer the positive support needed for recovery. The focus should be on affirming the adolescent's lack of culpability.

Choice C rationale

Solely focusing on the future might dismiss the adolescent's current emotional needs and the process of working through their trauma. A balanced approach is necessary.

Choice D rationale

Actively monitoring the adolescent's relationships can demonstrate vigilance and support, helping to create a safe environment for recovery.

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A nurse is reinforcing teaching with the caregiver of a client who has Alzheimer's disease.The caregiver reports that the client awakens at night and wanders.Which of the following strategies should the nurse suggest?

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Naxlex Comprehensive Predictor Exams

A nurse in a mental health facility is collecting a blood specimen from a client.The client is hallucinating and states, "That looks like a snake, and I won't let it take all of my blood.”. Which of the following responses should the nurse make?

Correct Answer is A

Explanation

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Correct Answer is B

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A nurse is reinforcing teaching with the caregiver of a client who has Alzheimer's disease.
The caregiver reports that the client awakens at night and wanders.
Which of the following strategies should the nurse suggest?