A nurse is providing care to a client with Alzheimer's disease ...

[ghost!]

A nurse is providing care to a client with Alzheimer's disease who is exhibiting suspiciousness and delusional thinking. Which of the following would be most important for the nurse to do with this client?
 
  A) Tell the client that he is experiencing delusions.
  B) Confront the client about his distorted thinking.
  C) Correct the client's interpretation of the situation.
  D) Determine the trigger for the distorted thinking.

Question 2

A client was admitted to the psychiatric unit 3 days ago because of suicidal ideation. His suicidal risk has lessened considerably, and he currently denies having any desire to kill himself. In addition, he is able to identify reasons why he wants to be a
 
  Which nursing intervention would be most appropriate at this time?
 
  A) Assigning nursing staff to stay with him during his suicidal crisis
  B) Developing a personal plan for managing suicidal thoughts when they occur
  C) Advising the client that he should consider electroconvulsive therapy treatments
  D) Administering psychotropic drugs that decrease the client's serotonin levels

[tjayeee]

Answer to Question 1

Ans: D
Suspiciousness and delusional thinking must be addressed to be certain that they do not endanger the client or others. Often, delusions are verbalized when clients are placed in situations they cannot master cognitively. The principle of nonconfrontation is most important in dealing with suspiciousness and delusion formation. No efforts should be made to ease the client's suspicions directly, or to correct delusions. Rather, efforts should be directed at determining the circumstances that trigger suspicion or delusion formation, and creating a means of avoiding these situations.

Answer to Question 2

Ans: B
The client's immediate suicidal crisis has subsided, and it is now appropriate for the nurse to focus on working with the client on symptom management. Preventing suicidal behavior requires that clients develop crisis management strategies, generate solutions to difficult life circumstances other than suicide, engage in effective interpersonal interactions, and maintain hope. The nurse can help the client develop a written plan that can be used as a blueprint for action when the client feels like he is losing control. The plan should include strategies that the client can use to self-soothe; friends and family members who could be called (including multiple phone numbers where they can be reached); self-help groups and services such as suicide hotlines; and professional resources, including emergency departments and outpatient emergency psychiatric services. Medications that increase serotonin levels may be prescribed. The role of electroconvulsive therapy to decrease suicidal behavior is under investigation.