The correct answer is B.

Provide the client with a calendar and a clock to promote orientation.This intervention helps the client with Alzheimer’s disease to maintain a sense of reality and reduce confusion by providing cues for time and date.

Choice A is wrong because asking the client to repeat information several times to enhance retention may increase frustration and anxiety for the client, as he or she may not be able to recall the information due to impaired memory.

Choice C is wrong because avoiding using reminiscence therapy as it may increase confusion is not supported by evidence.Reminiscence therapy is a type of intervention that involves recalling and sharing past experiences with others, which can improve mood, cognition, and socialization for clients with Alzheimer’s disease.

Choice D is wrong because correcting the client’s mistakes or inaccuracies to improve memory may also cause frustration and agitation for the client, as he or she may not be aware of the errors or may feel criticized or embarrassed.

Normal ranges for cognitive function can be assessed using tools such as the Mini-Mental State Examination (MMSE) or the Montreal Cognitive Assessment (MoCA), which measure orientation, attention, memory, language, and executive function.

The MMSE has a maximum score of 30, with scores below 24 indicating cognitive impairment.The MoCA has a maximum score of 30, with scores below 26 indicating mild cognitive impairment.

A. Ask the client to repeat information several times to enhance retention.

B. Provide the client with a calendar and a clock to promote orientation.

C. Avoid using reminiscence therapy as it may increase confusion.

D. Correct the client’s mistakes or inaccuracies to improve memory.

The correct answer isA, C and E.

These are the factors that the nurse should ask about when suspecting vascular dementia.

Vascular dementia is caused by different conditions that interrupt the flow of blood and oxygen supply to the brain and damage blood vessels in the brain.People with vascular dementia almost always have abnormalities in the brain that can be seen on MRI scans.These abnormalities can include evidence of prior strokes, which are often small and sometimes without noticeable symptoms.

Choice Ais correct becausehypertension(high blood pressure) is one of the risk factors for vascular dementia, as it can damage the small blood vessels in the brain and reduce blood flow.Controlling blood pressure may help lower the chances of developing vascular dementia.

Choice Bis wrong becausefamily history of Alzheimer’s diseaseis not a factor for vascular dementia, but for Alzheimer’s disease, which is a different type of dementia.Alzheimer’s disease is caused by abnormal protein deposits in the brain, not by impaired blood flow.

Choice Cis correct becausetransient ischemic attacks(TIAs), also known as mini-strokes, are another risk factor for vascular dementia, as they can damage brain cells and affect cognition.TIAs are temporary episodes of reduced blood flow to the brain, causing symptoms similar to a stroke but lasting only a few minutes or hours.

Choice Dis wrong becauseexposure to environmental toxinsis not a factor for vascular dementia, but for other types of dementia, such as Lewy body dementia or Parkinson’s disease dementia.These types of dementia are caused by abnormal protein deposits in the brain or nerve cell damage, not by impaired blood flow.

Choice Eis correct becausediabetes mellitusis another risk factor for vascular dementia, as it can damage the blood vessels and increase the risk of stroke and heart disease.Controlling blood sugar may help lower the chances of developing vascular dementia.

Sources:.

:Vascular Dementia: Causes, Symptoms, and Treatments | National Institute on Aging.

:Vascular dementia - Symptoms & causes - Mayo Clinic.

:causes of vascular dementia - NHS - NHS.

A. History of hypertension B.

Family history of Alzheimer’s disease C.

History of transient ischemic attacks D.

Exposure to environmental toxins E.

History of diabetes mellitus

The correct answer is A.

“I should acknowledge my loved one’s feelings and try to redirect their attention.” This statement indicates understanding of validation therapy, which is a way to approach older adults with empathy and understanding.

Validation therapy focuses on helping the person work through the emotions behind challenging behaviors, such as hallucinations, by listening, acknowledging, and rephrasing their feelings.Validation therapy also involves using reminiscence, sensory stimulation, and redirection to engage the person in a meaningful way.

Choice B is wrong because it contradicts validation therapy.

Confronting the person’s hallucinations and explaining that they are not real can increase their anxiety, confusion, and agitation.It can also damage the trust and rapport between the caregiver and the person with dementia.

Choice C is wrong because it also goes against validation therapy.

Ignoring the person’s hallucinations and changing the topic of conversation can make them feel dismissed, invalidated, and isolated.It can also prevent them from expressing and resolving their emotions.

Choice D is wrong because it is not part of validation therapy.

Agreeing with the person’s hallucinations and pretending that you see them too can reinforce their delusions and make them more persistent.It can also confuse the person and make them doubt your honesty and credibility.

Lewy body dementia is a progressive dementia that results from protein deposits in nerve cells of the brain.

It affects movement, thinking skills, mood, memory, and behavior.It is characterized by fluctuating cognition, visual hallucinations, parkinsonian symptoms, sleep disturbances, and autonomic dysfunction.

A. “I should acknowledge my loved one’s feelings and try to redirect their attention.” B.

“I should confront my loved one’s hallucinations and explain that they are not real.” C.

“I should ignore my loved one’s hallucinations and change the topic of conversation.” D.

“I should agree with my loved one’s hallucinations and pretend that I see them too.”

The correct answer is B.

Provide positive reinforcement when the client behaves appropriately.This is because positive reinforcement can help increase the frequency of desired behaviors and reduce the occurrence of inappropriate behaviors in clients with frontotemporal dementia (FTD) who exhibit disinhibition.Disinhibition is a common symptom of behavioral variant FTD (bvFTD), which is characterized by a deterioration in cognition and social behavior.

Choice A is wrong because restricting the client’s social interactions to prevent embarrassment can lead to social isolation, depression, and loss of self-esteem.Clients with FTD need social support and stimulation to maintain their quality of life.

Choice C is wrong because using physical restraints when the client becomes agitated or aggressive can increase the risk of injury, infection, and psychological distress.Physical restraints should only be used as a last resort when other interventions have failed and the client poses a serious threat to themselves or others.

Choice D is wrong because administering antipsychotic medications to control the client’s impulses can have adverse effects such as sedation, extrapyramidal symptoms, metabolic syndrome, and increased mortality.Antipsychotic medications should be used with caution and only when non-pharmacological interventions are insufficient or contraindicated.

Normal ranges for vital signs, blood tests, and other parameters are not applicable in this question.

A. Restrict the client’s social interactions to prevent embarrassment.

B. Provide positive reinforcement when the client behaves appropriately.

C. Use physical restraints when the client becomes agitated or aggressive.

D. Administer antipsychotic medications to control the client’s impulses.

The correct answer isA.

The client reports improved mood and self-esteem.Cognitive stimulation therapy (CST) is a short-term programme for people with mild to moderate dementia that involves a wide range of activities aiming to stimulate thinking and memory, such as discussion, word games, puzzles, music and creative tasks.CST can improve certain aspects of dementia, such as memory, problem-solving, communication, quality of life, and mood.

Therefore, if the client reports improved mood and self-esteem after CST, it indicates that the therapy is beneficial.

Choice B is wrong because CST does not directly target independence in activities of daily living (ADLs), although it may have some indirect effects on functional abilities.

Choice C is wrong because CST is not designed to treat delirium or depression, which are different conditions from dementia.

Delirium is an acute state of confusion that can have various causes and requires medical attention.

Depression is a mood disorder that can affect anyone and may co-occur with dementia.Both delirium and depression may need different interventions than CST.

Choice D is wrong because CST does not specifically enhance executive function and attention, which are higher-order cognitive skills that involve planning, organizing, inhibiting, switching and focusing.Executive function and attention may be impaired in dementia, but they are not the main focus of CST.