The partner of an older adult client who has Alzheimer's disease reports that he is not eating. The nurse observes that the client's partner refuses to assist the client with feeding. The partner insists that the client feed himself without help. Which of the following is the priority action the nurse should take?
Arrange for Meals on Wheels assistance.
Determine the client's ability to self-feed.
Direct the home health aide to assist with meals.
Refer the client's partner to an Alzheimer's support group.
The Correct Answer is B
Choice A reason: Arranging for Meals on Wheels assistance is not the priority action, as it does not address the underlying issue of the client's partner's refusal to help with feeding. Meals on Wheels may also not be suitable for the client's dietary needs and preferences.
Choice B reason: Determining the client's ability to self-feed is the priority action, as it will help the nurse assess the client's nutritional status and needs, as well as the level of support required from the partner or other caregivers. The nurse can also educate the partner on the importance of adequate nutrition and hydration for the client, and provide strategies to facilitate feeding.
Choice C reason: Directing the home health aide to assist with meals is not the priority action, as it may not be feasible or acceptable to the client or the partner. The home health aide may also not have the skills or training to assist with feeding a client with Alzheimer's disease.
Choice D reason: Referring the client's partner to an Alzheimer's support group is not the priority action, as it does not address the immediate problem of the client's lack of eating. However, it may be a helpful intervention in the long term, as it can provide the partner with emotional support, education, and resources to cope with the challenges of caring for a client with Alzheimer's disease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Bradycardia is not a manifestation of alcohol withdrawal, but rather a sign of low heart rate. Alcohol withdrawal typically causes tachycardia, or high heart rate, as the body tries to compensate for the sudden absence of alcohol.
Choice B reason: Hypothermia is not a manifestation of alcohol withdrawal, but rather a sign of low body temperature. Alcohol withdrawal typically causes hyperthermia, or high body temperature, as the body reacts to the withdrawal symptoms.
Choice C reason: Increased appetite is not a manifestation of alcohol withdrawal, but rather a sign of hunger or craving. Alcohol withdrawal typically causes decreased appetite, or anorexia, as the body loses interest in food and suffers from nausea and vomiting.
Choice D reason: Insomnia is a manifestation of alcohol withdrawal, and one of the most common and distressing symptoms. Alcohol withdrawal causes insomnia, or difficulty falling or staying asleep, as the body experiences anxiety, agitation, and nightmares.
Correct Answer is D
Explanation
Choice A reason: Providing coffee and snacks during the meetings is not an effective intervention, as it does not address the psychological needs of the veterans. Coffee may also worsen the symptoms of PTSD, such as anxiety, insomnia, and irritability, as it is a stimulant.
Choice B reason: Avoiding discussing the traumatic events experienced by the veterans is not a helpful intervention, as it may reinforce the avoidance behavior and prevent the veterans from processing and coping with their trauma. The nurse should encourage the veterans to share their experiences and feelings in a safe and supportive environment, and refer them to appropriate counseling services.
Choice C reason: Changing the meeting sites frequently is not a beneficial intervention, as it may create confusion and stress for the veterans. The nurse should establish a consistent and familiar location for the meetings, and ensure that the veterans feel comfortable and secure.
Choice D reason: Teaching the clients to practice deep breathing exercises is a useful intervention, as it can help the veterans manage their stress and anxiety, and reduce the physiological arousal associated with PTSD. Deep breathing exercises can also promote relaxation and mindfulness, and enhance the veterans' well-being.
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