Which of the following strategies is more effective when working with a patient with dementia quizlet?

Working with patients who are cognitively impaired presents an ongoing communication challenge. For instance, they likely will have trouble following any instructions about their care, including how and when to take prescriptions. Make sure someone can closely monitor care management, and try to involve a care partner whenever possible.

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• Which of the following strategies is more effective when working with a patient of advanced age quizlet?
• Which of the following strategies is more effective when working with a deaf or hard of hearing patient?
• Which of the following is an effective strategy for communicating with patients of other cultures?
• What is the most important information the nurse should share with the patient during orientation phase?

Here are 15 tips for effectively working with and communicating with cognitively impaired patients.

1. Try to address the patient directly, even if his or her cognitive capacity is diminished.
2. Gain the person's attention. Sit in front of and at the same level as him or her and maintain eye contact.
3. Speak distinctly and at a natural rate of speed. Resist the temptation to speak loudly.
4. Help orient the patient. Explain (or re-explain) who you are and what you will be doing.
5. If possible, meet in surroundings familiar to the patient. Consider having a family member or other familiar person present at first.
6. Support and reassure the patient. Acknowledge when responses are correct.
7. If the patient gropes for a word, gently provide assistance.
8. Make it clear that the encounter is not a "test" but rather a search for information to help the patient.
9. Use simple, direct wording. Present one question, instruction, or statement at a time.
10. If the patient hears you but does not understand you, rephrase your statement.
11. Although open-ended questions are advisable in most interview situations, patients with cognitive impairments often have difficulty coping with them. Consider using a yes-or-no or multiple-choice format.
12. Remember that many older people have hearing or vision problems, which can add to their confusion.
13. Consider having someone call the patient to follow up on instructions after outpatient visits.
14. If the patient can read, provide written instructions and other background information about the problem and options for solutions.
15. Address potential issues of driving, getting lost, and home safety each time you see the patient. And, encourage regular physical activity, social activity, hobbies, and intellectual stimulation, as well as a healthy diet. Some studies link these approaches to the maintenance of cognitive function.

This content is provided by the NIH National Institute on Aging (NIA). NIA scientists and other experts review this content to ensure it is accurate and up to date.

Content reviewed: May 17, 2017

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The mother of a two year-old child tells the nurse she thinks her child is in pain. The nurse should:

1) Assess the child for pain using the FLACC scale (Face, legs, activity, cry, consolability).

2) Administer pain medication as prescribed.

3) Notify the primary care provider of a change in behavior.

4) Assess the child using the FACES scale.

1

A three-year old toddler becomes restless from ear pain during a visit to the Pediatrician's office. The nurse decides it is best to use which of the following strategies:

1)Play a video game.

2) Restrain the toddler.

3)Distract the toddler using hand puppets.

4)Administer narcotic (opioid) pain medication as ordered by the physician.

3

A client is crying and grimacing after surgery but denies pain and refuses pain medication. The best action by the nurse is to:

1) Encourage client's expression of beliefs and emotions about the use of pain medication.

2)Administer pain medications without the knowledge of the patient.

3) Notify the physician of client's refusal to take pain medication.

4) Talk to the family about a history of addiction.

1

Which client is most likely to be prescribed long term use of opioids?

1)A child after an appendectomy.

2)An adult client with neuropathy.

3)An older client with a stroke.

4)An adult client with cancer.

4

A nurse teaches an older adult client about misuse of medications. Which subsequent behavior/s by the client indicates the instruction was effective?

1) Combining prescribed medications with over the counter ones.

2) Using someone else's medication.

3) Taking medications on time and, if a dose is missed, taking the next one on time.

4) Having prescriptions from several health care providers.

3

A client who is legally blind has been admitted to an acute care unit at the hospital. Which action by the nurse would best promote adjustment to the environment?

1) Post a sign on the door indicating the client is blind.

2) Explain unit noises and physical surroundings.

3)Give clear, concise, simple instructions to the client.

4)Speak slowly and in a low-pitched voice while facing the client.

2

Which nursing intervention would be most appropriate to meet safety needs when caring for an older adult with sensory change?

1) Assist with preparing a bath because the client may be less able to feel the temperature.

2) Massage with additional pressure because perception is diminished.

3) Use minimal touch with an older adult because touch may feel uncomfortable.

4) Use care when administering an injection because older adults experience more pain.

1

During assessment of an older adult client, what is most important for the nurse to do first?

Question 8 options:

Interviewing the client with family present to verify responses to questions.

Speak loudly and use many gestures.

Restating terms or phrases in different ways if the client does not understand.

Interviewing the client quickly to conserve the client's energy.

1

An older adult with a history of dementia and was hospitalized three days ago is having trouble sleeping with some periods of confusion during waking hours. What is the best interpretation by the nurse regarding this data? The client is:

Question 9 options:

Unable to manage health proactively.

The client is having a disrupted sleep cycle because of the environment.

Having difficulty coping with hospitalization.

May be experiencing hallucinations triggered by confusion.

3

The nurse enters a client's room who was previously oriented, but now she doesn't recognize anyone or know where she is. Which nursing action is a priority?

Question 10 options:

Provide therapeutic listening.

Assess blood pressure.

Move client near nurse's station.

Complete a CAM assessment tool to assess for delirium.

4

A client with suspected Alzheimer's disease is undergoing a diagnostic workup. When the family asks the nurse reasons for the tests, the nurse responds that the diagnosis of Alzheimer's disease is usually based on which of the following?

Question 11 options:

Physiologic findings.

A definitive CT scan.

Laboratory test findings.

Ruling out other causes for symptoms.

4

To which evaluation criterion should the nurse give first priority to when planning the care of a client with dementia?

Question 12 options:

Preventing further deterioration.

Supporting family care givers.

Finding a suitable long-term care placement.

Preventing injury.

4

A nurse writing a care plan for a client with dementia would include which of the following goals of nursing care?

Question 13 options:

Assist the client with activities of daily living.

Keep the loss of capacity for self-care to a minimum.

Maintain adequate hydration and nutrition.

Reorient the client to reality.

4

Which intervention/s would the nurse perform to support optimal memory function for a client with dementia?

Question 14 options:

Orient the client to reality.

Restrain the client when agitated.

Develop stimulating and meaningful therapeutic activities.

Remind the client of forgotten events.

3

The nurse is interviewing a client regarding urinary health. Which response would the nurse include during the collection of subjective data?

Select all that apply.

1. "Do you have difficulty starting your stream of urine?"

2. "After you urinate, does your bladder feel full or empty?"

3. "Do you ever have an accident or wet yourself when you sneeze?

4. "Do you have to hurry to the bathroom when you have to urinate?"

5. "Your recent urinalysis reveals protein in the urine."

1,2,3,4

The nurse is conducting a breast health workshop for a group of women. Which would the nurse include in this workshop when outlining risk factors for breast cancer?
Select all that apply.

1. Caucasian race.

2. Positive family history.

3. Low socioeconomic status.

4. Hormone replacement therapy.

5. Female age 35 to 40.

1,2,3,4

The nurse is performing a breast examination and is palpating into the tail of Spence. Why is it appropriate to palpate this area of the breast during an examination?

1. It does not contain any lymph nodes.

2. It can show the difference between fibrocystic disease and fibroadenomas.

3. Breast cancer occurs more frequently in this area.

4. Peau d'orange may occur in this area of the breast.

3

The nurse has completed testicular self-exam teaching for a male client. Which client statements indicate appropriate understanding of the content presented?
Select all that apply.

1. "I will feel firm areas where the testicles and epididymis are located."

2. "I should perform this exam monthly."

3. "I should be in a warm room or the shower to perform this exam."

4. "I should apply gentle pressure to each testicle to feel the area."

5. "It is normal to feel testicular pain during this exam."

2,3,4

The nurse is caring for a client with a right femur fracture. Which type of bone does the nurse identify the femur as when discussing the fracture with the client?

1. Short.

2. Long.

3. Flat.

4. Irregular.

2

The client is recovering from orthopedic surgery on a fractured arm. When discussing the effects of the fracture with the client, which skeletal bone functions will the nurse include in the teaching session?
Select all that apply.

1. Provide a body framework.

2. Provide movement.

3. Maintain posture.

4. Generate heat.

5. Calcium storage.

1,5

The nurse asks the client to pull the toes up towards the nose during an examination of the lower extremities. Which is the nurse assessing based on this description?

1. Inversion.

2. Plantar flexion.

3. Eversion.

4. Dorsiflexion.

4

Which of the following strategies is more effective when working with a patient of advanced age quizlet?

Which of the following strategies is more effective when working with a deaf or hard of hearing patient?

Which of the following is an effective strategy for communicating with patients of other cultures?

What is the most important information the nurse should share with the patient during orientation phase?