This was a question on our test today. What do you think the answer is?

[JDotHamp]

mr. winston is an 89-year-old who was diagnosed with alzheimer's disease 5 years ago. since he is in the last stages of his disease, he has been referred to a local hospice program. the interdisciplinary team meets to discuss his plan of care. which intervention would not appear in this plan of care?

a.challenge the client to alter distorted thought patterns and view self and the world more realistically. b.reminisce about past experiences with the client, as appropriate. c.assist the client in labeling the painful emotion that he is feeling. d.avoid using humor with the client because he will not understand.

****i picked a but the correct answer is d. of course they couldn't offer me a reason. the reason i chose a was because in the last stage of the disease no matter what you say if they want to go ride a plane that is what they are "going" to do.****

[Wishinonastar, BSN]

NCLEX questions are written in a more precise manner- avoiding key and leading words. They are supposed to make you think- not guess. All professional tests GRE, GMAT, NCLEX, etc. are written this way. Learn to have a rationale for your answers. That is how you can best prepare for NCLEX. WHY is it the right answer?

[greysanatomyfan]

I would also say A. It makes the most sense to me!

[jjjoy, LPN]

NCLEX questions are written in a more precise manner- avoiding key and leading words. They are supposed to make you think- not guess. All professional tests GRE, GMAT, NCLEX, etc. are written this way. Learn to have a rationale for your answers. That is how you can best prepare for NCLEX. WHY is it the right answer?

I took the GRE and I thought the questions were much more straight forward than NCLEX style questions. They were still challenging, but if you knew the material, you would get the right answer. The test taking strategies, such as avoiding key and leading works, were useful when you didn't know the material quite well enough to pinpoint the correct answer and had to make a best guess. NCLEX are written such that even if you know the material, you still have to apply the test taking strategies in order to determine "the best" answer.

[student200977]

I was between A and D, but after reading the question again very carefully I would have gone with D as my final answer. I eliminated A, yes they are in hospice, but I would keep in mind to re-orient the client to reality, and since the question asks what would you NOT include in the careplan I would NOT want to AVOID humor, because it can be therapeutic.

[ElliShay]

The only logical answer is E, nursing instructors write questions that make entirely no sense due to a lack of experience in the material being taught. Their knowledge is strictly learned from reading various articles, publications and text books and never from actual experience. Most entered the field of nursing only to find it was "not for them." Then having the good fortune of partnering with a financially capable significant other that was able to "foot the bill" while they continued to higher degrees, were able to continue their education and thus become "educators," with no real knowledge and especially experience of the content they are teaching. Ambiguous questions are their forte. Of course they cannot explain or give a rationale, they have none, at least not of their own.

But to get back to the question of "end stage Alzheimers. What can you possibly say to someone who understands probably nothing? Oh! Now I get it...The question is a Joke!!! LOL

Wow... pretty harsh... I am an educator with years of acute care experience in various areas. I also have been trained as an item writer, and I have written for the NCLEX. I take pride in the exams I give--they are based upon the current practice analysis and a carefully planned blueprint. I can ALWAYS provide a referenced rationale for both the correct and incorrect options. How can you be sure that "nursing instructors write questions that make entirely no sense due to a lack of experience....etc. etc. etc." You are labeling a huge and diverse group of people as "educators with no real knowledge" who got their knowledge "from reading various articles, publications and text books and never from actual experience." I respectfully ask you to be mindful of your word choices. I, for one, worked very hard to pay for my advanced degrees, and I continue to work two jobs--simply to ensure that I remain current in my field.

I will say no more--since I am in a student thread.

[Wishinonastar, BSN]

Wow... pretty harsh... I am an educator with years of acute care experience in various areas. I also have been trained as an item writer, and I have written for the NCLEX. I take pride in the exams I give--they are based upon the current practice analysis and a carefully planned blueprint. I can ALWAYS provide a referenced rationale for both the correct and incorrect options. How can you be sure that "nursing instructors write questions that make entirely no sense due to a lack of experience....etc. etc. etc." You are labeling a huge and diverse group of people as "educators with no real knowledge" who got their knowledge "from reading various articles, publications and text books and never from actual experience." I respectfully ask you to be mindful of your word choices. I, for one, worked very hard to pay for my advanced degrees, and I continue to work two jobs--simply to ensure that I remain current in my field.

I will say no more--since I am in a student thread.

I will add that all the instructors I have known are required to keep their skills and knowledge up to date as part of their job description. Most of them work as nurses in other jobs. I got a shot from my critical care instructor once when she was working in the ER! Many of them worked their way throught grad school while holding a NURSING JOB and started out as floor nurses just like everyone else. Just because you don't understand or know someone's background, do not make assumptions.

[FATKAT]

I also would have picked the answere A and I had the same rationale as you.

[k-love]

At first I thought it was A. But then I read D over and you wouldn't stop using humor. I think that when they say "challange" they mean to reorient the client when he is confused which would be the right thing to do. It's more like challange his distorted thinking, not in a forcefull way. So I would go with D

[Danger_s]

I wish professors would consider questions like this one, they are very ambiguous, it seems answer A is the right choice, I think both A & D are not to be included in the plan of care but Between avoiding Humor and challenging the client with final stage alzheimer's disease seems to be the most damaging to the client than just simply forgetting to make a joke. Umm, we will have to see what the books say about Advance Alzheimer's Disease care.

[RochesterRN-BSN, BSN, RN]

As a psych nurse who deals with straight psych patients but we get this kind of patient despite that it is more organic/disease related ---can't be corrected with meds--and have to say that I would have chosen A for most any of these patients and D is hard as no patient is the same--not to say that you would sit and tell and actual joke but joking around sometimes helps.... some patients may not get any of it but another may --I don't think you can put all alzheimers patients in the same pot. But none of them would I try to convince them of a difference in reality in a way they word it--challenge. Yes we may gently reorient....