A man who is 60 years of age and lives in the British Isles develops dementia. Which qualities of dementia does the nurse assess to prevent patient injury related to the type of dementia this man most likely has?
a. Visual hallucina-tions c. Visuospatial prob-lems
b. Unilateral tremors d. Clumsy movements
D
The nurse assesses the patient for failing memory and incoordination, which are characteristic of Creutzfeldt-Jakob disease (CJD) or bovine spongiform encephalopathy (also known as mad cow disease). This type of dementia began appearing in adults living in the British Isles who reported eating beef from local breeders. The nurse assesses for these qualities because the age of onset is usually around 60 years. This form of dementia progresses rapidly to death; therefore the nurse anticipates that this man will rapidly deteriorate and must be prepared to anticipate changes in motor activities and memory to maintain his safety and to prevent injury.
Visual hallucinations are characteristic of Lewy body dementia. Visuospatial problems are characteristic of Parkinson disease dementia. Visuospatial problems are characteristic of frontotemporal lobe dementia.
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A client has been receiving tube feeds for the past several days. The client's plan of care identifies the nursing diagnosis Risk for Fluid Imbalance. How should this risk be best mitigated?
A) Ensure the client adheres to the correct fluid restriction while receiving feeds. B) Use the smallest amount of water necessary to flush the tube after feeds or medications. C) Administer supplementary water after considering the quantity of feeds and flushes. D) Aspirate the stomach contents if the client develops peripheral edema.
Numbers of white blood cells (WBCs) are increased in circumstances of: (Select all that apply.)
a. inflammation. b. allergy. c. invasion by pathogenic organisms. d. malnutrition. e. immune diseases.
Which level of measurement is indicated when referring to a temperature of 70° F?
a. Interval b. Nominal c. Ordinal d. Ratio
A client speaks about an adult son who is a practicing homosexual and expresses concern by stating: "I am so worried about him and I know he is going to hell."
What is the most important fact for the nurse to consider in formulating a response to this client's concern? 1. Normal sexuality is described as whatever behaviors give pleasure and satisfaction to those adults involved. 2. Since alternative lifestyles are now so well accepted in society, this parent should not feel so much concern. 3. What constitutes normal sexual expression varies among cultures and religions. 4. Sexual development is genetically determined and not affected by environment.