IGGY Chapter 39 Concepts of Care for Patients With Problems of the
Central Nervous System The Brain Exam
The nurse is teaching the daughter of a client with middle-stage Alzheimer disease. The
daughter asks, "Will the sertraline my mother is taking improve her dementia?" How
would the nurse respond about the purpose of the drug?
a. "It will allow your mother to live independently for several more years."
b. "It is used to halt the advancement of Alzheimer disease but will not cure it."
c. "It will not improve her dementia but can help control emotional responses."
d. "It is used to improve short-term memory but will not improve problem solving." -
ANSWER ANS: C
Drug therapy is not useful in the treatment of dementia or in the arrest of the
progression of Alzheimer disease. However, some psychoactive drugs may be helpful in
suppressing emotional disturbances and controlling depression, psychoses, or anxiety.
Drug therapy does not allow the client with middle-stage dementia to live safely alone.
A client with early-stage Alzheimer disease is hospitalized with chest pain. Which
nursing action is best to address this client's dementia?
a. Offer the client animal-assisted therapy as necessary.
b. Organize a routine, predictable environment.
c. Assist the client with ADLs.
d. Employ validation therapy when communicating with the client. - ANSWER ANS: B
The client with early AD does not require assistance with ADLs or validation therapy.
Animal-assisted therapy may be helpful, but this treatment is prohibited in some health
care agencies. Therefore, the best course of action is to provide a structured and
routine environment while the client is hospitalized in order to prevent an exacerbation
of the client's symptoms.
The nurse observes a client with end-stage Alzheimer disease eating breakfast. After
the meal the client states, "I am hungry and want breakfast." Which is the nurse's best
response?
, a. "I see you are still hungry. I will get you some toast."
b. "You ate your breakfast 30 minutes ago."
c. "It seems you are confused this morning."
d. "Your family will be here soon. Let's get you dressed." ANSWER ANS: A
Validation therapy with clients who have late-stage Alzheimer disease involves
acknowledgment of the client's feelings and concerns. This technique has proved more
effective in later stages of the disease because reality orientation only increases
agitation. The other statements do not validate the client's concerns.
The nurse is caring for a client with middle-stage (moderate) Alzheimer disease. The
client's caregiver states, "She is always wandering off. What can I do to manage this
restless behavior?" Which is the nurse's best response?
a. "This is a sign of fatigue. The client would benefit from a daily nap."
b. "Engage the client in scheduled activities throughout the day."
c. "It sounds like this is difficult for you. I will consult the social worker."
d. "The provider can prescribe a mild sedative for restlessness." - ANSWER ANS: B
Several strategies may be utilized when working with the client who exhibits
restlessness and wandering. One that may be helpful is engaging the client in an
organized activity. Another strategy involves frequent walks with the client. Daily naps
and a mild sedative will not be as effective in the care of restless behavior.
The social worker's consultation does not help to alleviate the concern of the caregiver.
The nurse is planning for the discharge of a client with early to moderate Alzheimer
disease. Which statement for maintaining client safety would the nurse include in the
discharge teaching for the caregiver?
a. "Provide periods of exercise and rest for the client."
b. "Place a padded throw rug at the bedside."
c. "Provide a highly stimulating environment."
d. "Install safety locks on all outside doors." ANS: D
The client with early to moderate Alzheimer disease often wanders, especially during
nighttime hours. If at all possible, alarms are installed on all outside doors to alert family
members should the client leave. At the very minimum, all outside doors should be
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