Author Question: A client's progress notes read, states he does not want to sit or talk with others; they frighten' ... (Read 20 times)

jenna1 · **on:** Jul 19, 2018

A client's progress notes read, states he does not want to sit or talk with others; they frighten' him; stays in room alone unless strongly encouraged to come out; no group involvement; at times listens to group from a distance but does

not engage in conversation; some hypervigilance and scanning noted. The nurse decides that the client's behavior is defensive and plans care accordingly. Which strategy should the nurse employ? 1. Help the client gradually accept realistic goals.
2. Help the client identify his fears regarding participating in the group.
3. Help the client develop motivation and a plan for group involvement.
4. Help the client see that there is a possibility for change.

Question 2

A client has dementia of the Alzheimer's type. He is no longer able to walk, and he does not recognize family members, even his wife of 52 years, when they visit him.

He attempts to communicate with agitated behaviors or with occasional incoherent vocalizations. Which stage of the illness is the client in? 1. Late-stage dementia
2. Early-stage dementia
3. Middle-stage dementia
4. Late-stage confusion

reversalruiz · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

2
Rationale: This client appears to be using projection. Identifying his fears would help the client understand he is attributing to others hostile motives that do not actually exist. Helping the client accept realistic goals would benefit a client who uses fantasy as a coping defense. Helping the client see possibility for change benefits a client who copes by rationalization. Helping the client develop a plan would benefit a client who uses intellectualization to cope with anxiety.

Answer to Question 2

4
Rationale: Late-stage dementia is characterized by a loss of ambulation abilities, severe memory impairments, and communication that is limited and incoherent. Early-stage dementia does not have the severe memory loss. Clients with middle-stage dementia are still able to ambulate. Late-stage confusion is not a recognized stage of dementia of the Alzheimer's type.