An older adult client with dementia who is refusing to allow an unlicensed assistive personnel (UAP) to assist in bathing, is becoming increasingly agitated and stating the UAP "wants to hurt me and tie me up." Which approach should the nurse use with the client?

Reduce the client's interaction with others during the day.

Clarify reality with the client about delusional thoughts.

Awaken the client earlier for daily morning care.

Use distraction and therapeutic communication skills.

Answer and Explanation

The Correct Answer is D

Rationale

A. This approach might inadvertently increase feelings of isolation and worsen agitation. Older adults with dementia often benefit from social interaction and engagement. Limiting interaction could lead to increased confusion and behavioral issues.

B. Attempting to correct or argue with the client about their delusions is generally not effective and can escalate agitation. Clients with dementia may not have the cognitive ability to understand or accept reality as others perceive it. Therefore, trying to clarify or correct delusional thoughts is unlikely to be helpful and may increase distress.

C. While maintaining a consistent routine is beneficial for clients with dementia, forcibly awakening the client earlier could disrupt their natural sleep patterns and contribute to increased confusion and agitation. It's important to balance the need for routine with the client's individual sleep and rest patterns.

D. This approach focuses on redirecting the client's attention away from the distressing thoughts and behaviors. Distraction techniques involve engaging the client in activities or topics that they find enjoyable or comforting. Therapeutic communication skills include active listening, empathy, and validating the client's emotions without reinforcing delusions.

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Correct Answer is A

Explanation

Rationale

A. Pairing the newly hired UAP with the most experienced UAP can provide mentoring and guidance. This allows the experienced UAP to share knowledge, demonstrate best practices, and help the new UAP navigate unfamiliar situations or complex care needs. It promotes skill development and ensures that care is provided effectively and safely.

B. Assigning less complex clients to the newly hired UAP initially can help ease them into their role and build confidence. It allows them to focus on learning routines, policies, and procedures without the added stress of managing highly complex care situations. However, this approach should be temporary and paired with opportunities for training and skill development.

C. Direct observation of the newly hired UAP's care delivery is crucial to assess their competency in various tasks. It provides firsthand insight into their skills, adherence to protocols, and ability to handle

client needs independently. Based on observations, appropriate feedback and additional training can be provided as needed.

D. Reviewing the UAP's skills checklist and discussing their previous experience with the hiring manager or supervisor provides essential background information. This helps in understanding the UAP's strengths, areas for improvement, and any specific training needs. It ensures that appropriate assignments and support are provided based on their skill level.

A. Review medications for drug and food interactions. B. Observe carefully for extrapyramidal symptoms (EPS) C. Appraise light sensitivity, tiredness, and dizzy spells. D. Encourage the client to engage in social activities.

Correct Answer is A

Explanation

Rationale

A. Older adults are more susceptible to medication side effects due to changes in metabolism and polypharmacy. Reviewing the client's current medications, including over-the-counter medications for allergies and insomnia, can identify potential culprits.

B. Some medications used for allergies or insomnia, such as antihistamines or sedatives, can cause EPS in older adults. EPS include symptoms like tremors, rigidity, or involuntary movements. These symptoms can indicate adverse reactions that require immediate attention and adjustment of medication.

C. These symptoms could be side effects of medications commonly used for allergies and insomnia. They may also indicate other underlying health issues or medication interactions. Assessing these symptoms helps in determining their severity and whether they require further evaluation or intervention.

D. Social isolation can contribute to changes in behavior, especially in older adults. While social activities are beneficial for mental health, in this case, addressing the potential medication-related issues (options A and B) takes precedence to ensure the client's safety and well-being.

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An older adult client with dementia who is refusing to allow an unlicensed assistive personnel (UAP) to assist in bathing, is becoming increasingly agitated and stating the UAP "wants to hurt me and tie me up." Which approach should the nurse use with the client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A newly hired unlicensed assistive personnel (UAP) is assigned to a home healthcare team along with two experienced UAPS. Which intervention should the home health nurse implement to ensure adequate care for all clients?

Correct Answer is A

Explanation

Correct Answer is A

Explanation

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