NURS 342 module 4A Exam With Verified Solutions 2025
The nurse is teaching the daughter of a client who has 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."ANS: C
Drug therapy is not effective for treating dementia or halting the advancement of
Alzheimer
disease. However, certain psychoactive drugs may help suppress emotional
disturbances and
manage depression, psychoses, or anxiety. Drug therapy will not allow the client with
middle-stage dementia to safely live independently
A client with early-stage Alzheimer disease is admitted to the hospital with chest pain.
Which
nursing action is most appropriate to manage this client's dementia?
a.
Provide animal-assisted therapy as needed.
b.
Ensure a structured and consistent environment.
c.
Assist the client with activities of daily living (ADLs).
d.
Use validation therapy when communicating with the client.ANS: B
The client who has early Alzheimer disease (AD) does not require assistance with ADLs
or
validation therapy. While animal-assisted therapy may be helpful, some health care
agencies
do not allow this intervention. Therefore, the most appropriate action is to provide a
structured
and consistent environment while the client is hospitalized to prevent worsening of the
client's
symptoms.
The nurse observes a client with late-stage Alzheimer disease eat breakfast. Afterward
the
,client states, "I am hungry and want breakfast." What 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 appears you are confused this morning."
d.
"Your family will be here soon. Let's get you dressed."ANS: A
Use of 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 cares 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?" What 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."ANS: B
Several strategies may be used to cope with restlessness and wandering. One strategy
is to
engage the client in structured activities. Another is to take the client for frequent walks.
Daily
naps and a mild sedative will not be as effective in the management of restless
behavior.
Consulting the social worker does not address the caregiver's concern.
The nurse prepares to discharge a client with early to moderate Alzheimer disease.
Which
statement to maintain 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
Clients with early to moderate Alzheimer disease have a tendency to wander, especially
at
night. If possible, alarms would be installed on all outside doors to alert family members
if the
client leaves. At a minimum, all outside doors should have safety locks installed to
prevent the
client from going outdoors unsupervised. The client would be allowed to exercise within
his
or her limits, but this action does not ensure his or her safety. Throw rugs are a slip and
fall
hazard and would be removed. A highly stimulating environment would likely increase
the
client's confusion.
The nurse is teaching a family caregiver about how best to communicate with the client
who
has been diagnosed with Alzheimer disease. Which statement by the caregiver
indicates a
need for further teaching?
a.
"I will avoid communicating with the client to prevent agitation."
b.
"I should use simple, short sentences and one-step instructions."
c.
"I can try to use gestures or pictures to communicate with the client."
d.
"I will limit the number of choices I provide for the client."ANS: A
Communication with the client is important to provide cognitive stimulation. Using short
simple sentences, using gestures and pictures, and limiting choices provided for the
client will
help promote communication
The nurse teaches assistive personnel (AP) about how to care for a client with early-
stage
Alzheimer disease. Which statement would the nurse include?
a.
"If she is confused, play along and pretend that everything is okay."
b.
"Remove the clock from her room so that she doesn't get confused."
c.
"Reorient the client to the day, time, and environment with each contact."
d.
"Use validation therapy to recognize and acknowledge the client's concerns."ANS: C
, Clients who have early-stage Alzheimer disease would be reoriented frequently to
person,
place, and time. The AP would reorient the client and not encourage the client's
delusions.
The room would have a clock and white board with the current date written on it.
Validation
therapy is used with late-stage Alzheimer disease.
The primary health care provider prescribes donepezil for a client diagnosed with early-
stage
Alzheimer disease. What teaching about this drug will the nurse provide for the client's
family
caregiver?
a.
"Monitor the client's temperature because the drug can cause a low grade fever."
b.
"Observe the client for nausea and vomiting to determine drug tolerance."
c.
"Donepezil will prevent the client's dementia from progressing as usual."
d.
"Report any client dizziness or falls because the drug can cause bradycardia."ANS: D
Donepezil is a cholinesterase inhibitor that may temporarily slow cognitive decline for
some
clients but does not alter the course of the disease. The family caregiver would want to
monitor the client's heart rate and report any incidence of dizziness or falls because the
drug
can cause bradycardia. It does not typically cause fever or nausea/vomiting
After teaching the wife of a client who has Parkinson disease, the nurse assesses the
wife's
understanding. Which statement by the client's wife indicates that she correctly
understands
changes associated with this disease?
a.
"His masklike face makes it difficult to communicate, so I will use a white board."
b.
"He should not socialize outside of the house due to uncontrollable drooling."
c.
"This disease is associated with anxiety causing increased perspiration."
d.
"He may have trouble chewing, so I will offer bite-sized portions."ANS: D
Because chewing and swallowing can be problematic, small frequent meals and a
supplement
are better for meeting the client's nutritional needs. A masklike face and drooling are
common
The nurse is teaching the daughter of a client who has 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."ANS: C
Drug therapy is not effective for treating dementia or halting the advancement of
Alzheimer
disease. However, certain psychoactive drugs may help suppress emotional
disturbances and
manage depression, psychoses, or anxiety. Drug therapy will not allow the client with
middle-stage dementia to safely live independently
A client with early-stage Alzheimer disease is admitted to the hospital with chest pain.
Which
nursing action is most appropriate to manage this client's dementia?
a.
Provide animal-assisted therapy as needed.
b.
Ensure a structured and consistent environment.
c.
Assist the client with activities of daily living (ADLs).
d.
Use validation therapy when communicating with the client.ANS: B
The client who has early Alzheimer disease (AD) does not require assistance with ADLs
or
validation therapy. While animal-assisted therapy may be helpful, some health care
agencies
do not allow this intervention. Therefore, the most appropriate action is to provide a
structured
and consistent environment while the client is hospitalized to prevent worsening of the
client's
symptoms.
The nurse observes a client with late-stage Alzheimer disease eat breakfast. Afterward
the
,client states, "I am hungry and want breakfast." What 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 appears you are confused this morning."
d.
"Your family will be here soon. Let's get you dressed."ANS: A
Use of 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 cares 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?" What 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."ANS: B
Several strategies may be used to cope with restlessness and wandering. One strategy
is to
engage the client in structured activities. Another is to take the client for frequent walks.
Daily
naps and a mild sedative will not be as effective in the management of restless
behavior.
Consulting the social worker does not address the caregiver's concern.
The nurse prepares to discharge a client with early to moderate Alzheimer disease.
Which
statement to maintain 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
Clients with early to moderate Alzheimer disease have a tendency to wander, especially
at
night. If possible, alarms would be installed on all outside doors to alert family members
if the
client leaves. At a minimum, all outside doors should have safety locks installed to
prevent the
client from going outdoors unsupervised. The client would be allowed to exercise within
his
or her limits, but this action does not ensure his or her safety. Throw rugs are a slip and
fall
hazard and would be removed. A highly stimulating environment would likely increase
the
client's confusion.
The nurse is teaching a family caregiver about how best to communicate with the client
who
has been diagnosed with Alzheimer disease. Which statement by the caregiver
indicates a
need for further teaching?
a.
"I will avoid communicating with the client to prevent agitation."
b.
"I should use simple, short sentences and one-step instructions."
c.
"I can try to use gestures or pictures to communicate with the client."
d.
"I will limit the number of choices I provide for the client."ANS: A
Communication with the client is important to provide cognitive stimulation. Using short
simple sentences, using gestures and pictures, and limiting choices provided for the
client will
help promote communication
The nurse teaches assistive personnel (AP) about how to care for a client with early-
stage
Alzheimer disease. Which statement would the nurse include?
a.
"If she is confused, play along and pretend that everything is okay."
b.
"Remove the clock from her room so that she doesn't get confused."
c.
"Reorient the client to the day, time, and environment with each contact."
d.
"Use validation therapy to recognize and acknowledge the client's concerns."ANS: C
, Clients who have early-stage Alzheimer disease would be reoriented frequently to
person,
place, and time. The AP would reorient the client and not encourage the client's
delusions.
The room would have a clock and white board with the current date written on it.
Validation
therapy is used with late-stage Alzheimer disease.
The primary health care provider prescribes donepezil for a client diagnosed with early-
stage
Alzheimer disease. What teaching about this drug will the nurse provide for the client's
family
caregiver?
a.
"Monitor the client's temperature because the drug can cause a low grade fever."
b.
"Observe the client for nausea and vomiting to determine drug tolerance."
c.
"Donepezil will prevent the client's dementia from progressing as usual."
d.
"Report any client dizziness or falls because the drug can cause bradycardia."ANS: D
Donepezil is a cholinesterase inhibitor that may temporarily slow cognitive decline for
some
clients but does not alter the course of the disease. The family caregiver would want to
monitor the client's heart rate and report any incidence of dizziness or falls because the
drug
can cause bradycardia. It does not typically cause fever or nausea/vomiting
After teaching the wife of a client who has Parkinson disease, the nurse assesses the
wife's
understanding. Which statement by the client's wife indicates that she correctly
understands
changes associated with this disease?
a.
"His masklike face makes it difficult to communicate, so I will use a white board."
b.
"He should not socialize outside of the house due to uncontrollable drooling."
c.
"This disease is associated with anxiety causing increased perspiration."
d.
"He may have trouble chewing, so I will offer bite-sized portions."ANS: D
Because chewing and swallowing can be problematic, small frequent meals and a
supplement
are better for meeting the client's nutritional needs. A masklike face and drooling are
common
