Two patients in a residential care facility have dementia. One ...

[MGLQZ]

Two patients in a residential care facility have dementia. One shouts to the other, Move along, you're blocking the road. The other patient turns, shakes a fist, and shouts, I know what you're up to; you're trying to steal my car.
 
  What is the nurse's best action?
 
  a. Administer one dose of an antipsychotic medication to both patients.
  b. Reinforce reality. Say to the patients, Walk along in the hall. This is not a traffic intersection.
  c. Separate and distract the patients. Take one to the day room and the other to an activities area.
  d. Step between the two patients and say, Please quiet down. We do not allow violence here.

Question 2

A patient has progressive memory deficit associated with dementia. Which nursing intervention would best help the individual function in the environment?
 
  a. Assist the patient to perform simple tasks by giving step-by-step directions.
  b. Reduce frustration by performing activities of daily living for the patient.
  c. Stimulate intellectual function by discussing new topics with the patient.
  d. Promote the use of the patient's sense of humor by telling jokes or riddles.

[Jadwiga9]

Answer to Question 1

ANS: C
Separating and distracting prevents escalation from verbal to physical acting out. Neither patient loses self-esteem during this intervention. Medication is probably not necessary. Stepping between two angry, threatening patients is an unsafe action, and trying to reinforce reality during an angry outburst will probably not be successful when the patients are cognitively impaired.

Answer to Question 2

ANS: A
Patients with cognitive impairment should perform all tasks of which they are capable. When simple directions are given in a systematic fashion, the patient is better able to process information and perform simple tasks. Stimulating intellectual functioning by discussing new topics is likely to prove frustrating for the patient. Patients with cognitive deficits may lose their sense of humor and find jokes and riddles meaningless.

[MGLQZ]

Excellent

[cassie_ragen]

TYSM