This question is killing me, please help me clarify?

[tabz4u2]

On my exam last Friday i had this question:

You a nurse who is providing a care plan for a nursing assistant for a client who has Stage II Alzheimers. Which would be appropriate to add to the care plan?

1. Put deadbolts on the doors on the outisde.

2. Put a padded rug by the bedside.

3. Use black and white knobs for the kitchen stove.

4. Turn the lights off in the bedroom at night.

I picked 4

[Esme12, ASN, BSN, RN]

Ah, I see what you mean.

For this particular question I would still pick the lights option as the best option. This is something that will be carried out by the nursing assistant. Would the assistant be the one installing deadbolts on the door?

But you want this population the have as close to a routine as possible and the best possible rest. Confusing night and day by leaving lights on 24/7 can cause more agitation and confusion in this population from the loss of day and night and sleep deprivation.

You do not want the wandering them town while you sleep in the other room.

[nurseprnRN, BSN, RN]

The way I answered this was to think of it in terms of patient safety ...deadbolt aren't safe, they may keep the patient in but as was mentioned above what if there was a fire? Padded rug would be a risk for falls. Knobs on the stove should be removed and hidden away so the Alzheimer's patient isn't able to start the stove.

That left me with the lights out option as the best answer even though I didn't quite have the rationale for why till GrnTea gave it above (normal environmental cues helpful for Alzheimer's patients who may have messed up sleep cycles).

Remember, you don't always get the BEST answer in your choices-- sometimes they don't include it on purpose to make you think about the implications of the remaining ones. Sometimes you just have to choose the best answer of the ones you get.

In this case, you always, always, always choose safety first when you are instructing an aide, or really, anytime, but remember this is an "instruct the aide" thing. The others are all unsafe, even if your particular patient's sleep cycle isn't screwed up.

[carolinapooh, BSN, RN]

They don't mean putting the locks on the outside of the door they mean on the doors that you exit out of like your "front" door or your side door....I am sure everyone of you have deadbolts on your doors you lock them every time you exit out of your homes or you unlock them every time you enter your home. My Med-sug book even calls front doors outside doors and I had the longest argument with my professor about the meaning and it took me a minute to wrap my head around the author's meaning. It all boiled down to different regions word meanings.

I gently disagree.

'Put a deadbolt on a door on the outside' is not the same meaning as 'put a deadbolt on an outside door'. And I know what an outside door is. So I do see what you mean, but that's really not what's said.

[nurseprnRN, BSN, RN]

" Put deadbolts on the doors on the outisde." (sic)

That said to me, "On the outside of the doors (plural)." No doors should have deadbolts on the outside, none of them, because anyone on the other side of any deadbolted door could be at risk for being trapped in an emergency.