The day shift nurse at the long-term care facility learns that a patient with dementia experienced sundowning late in the afternoon on the previous two days. Which is the best action by the nurse?

A Keep window blinds open during the day

B Have the patient take a mid-morning nap.

C Provide hourly orientation to time and place.

D Move the patient to a quiet room in the afternoon.

Answer and Explanation

The Correct Answer is A

Choice A Rationale: Keeping window blinds open during the day is a non pharmacological approach to help regulate the patient's circadian rhythm and may reduce the severity of sundowning, a common phenomenon in dementia.

Choice B Rationale: Having the patient take a mid-morning nap may disrupt the patient's sleep-wake cycle and worsen sundowning.

Choice C Rationale: Providing hourly orientation to time and place may be overwhelming for the patient and not necessarily effective in addressing sundowning.

Choice D Rationale: Moving the patient to a quiet room in the afternoon may not address the underlying issue of sundowning and may not be practical in a long-term care setting.

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Correct Answer is A

Explanation

Choice A Rationale: The nurse will include instructions on draining the bladder with a clean intermittent catheter at appropriate intervals to prevent urinary retention and complications. This should be done every 3 to 6 hours, depending on the amount of fluid intake and output.

Choice B Rationale: Decreasing fluid intake is not typically recommended for individuals with spinal cord injuries, as adequate hydration is important.

Choice C Rationale: Observing the urine for a foul odor is relevant to monitor for urinary tract infections, but it is not a preventive measure.

Choice D Rationale: Keeping an indwelling catheter in place at all times is not typically recommended due to the increased risk of urinary tract infections and other complications.

A. The client received an influenza vaccine 4 weeks ago B. The client is an avid golfer C. The client cans jams and preserves D. The client has a history of diabetes

Correct Answer is A

Explanation

Choice A Rationale: The client receiving an influenza vaccine 4 weeks ago is relevant because Guillain-Barre syndrome can sometimes be triggered by infections or vaccinations, including influenza vaccines.

Choice B Rationale: The client's hobby of golfing is not directly related to the described symptoms.

Choice C Rationale: Canning jams and preserves is not directly related to the described symptoms.

Choice D Rationale: A history of diabetes, while important for the client's overall health, may not be directly related to the current manifestations.

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The day shift nurse at the long-term care facility learns that a patient with dementia experienced sundowning late in the afternoon on the previous two days. Which is the best action by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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