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.****

[CaliLvr000, BSN, RN]

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.****

i would have picked d. you can narrow it down right away, clearly b and c are incorrect....a is more correct then d because with any client with an altered mental status you are supposed to "try" to orient them to time/place/self. this would be an example of making the client view the world more "realistically." d is worded weird in that it says "he will not understand," we can not judge what they can understand or not, and humor like the above poster said, is therapeutic.

[flightnurse2b, LPN]

so the answer was D!

gotta love nursing school tests.

[kenyohunt1]

I would say the ans is D. You are supposed to always reorient a confused person. That is why on alzheimer's units they always have a board that has the current date, and other info to keep clients oriented. I work in Hospice and always use humor in my practice. Just because a patient is confused does not mean they will not understand or even contribute something of humor. Humor can go a long way to put people and families at ease and help them to open up to you.

[Ms. Nurse Assistant, LPN]

do most tests look like this in nursing school?

[flightnurse2b, LPN]

do most tests look like this in nursing school?

alot of test questions do look like this in nursing school. a scenario and four answer choices are given. two answes you can usually eliminate off the top. then sometimes there are two "good" answers but ultimately, sometimes due to one small phrase or word, one answer is the "best" choice.

[shoegalRN, RN]

do most tests look like this in nursing school?

Uhh, that would be an astounding YES! LOL

[yelnikmcwawa]

I think that you are viewing "challenge" as a negative thing. For dementia patients, challenging their thought processes can be simple things like showing them a picture of their loved ones and talking about the people in their lives to help "work" their brain, per say. Even though he is in his end stage of life, it is helpful to continue to challenge dementia patients. This has shown to improve their quality of life and has also been suggested that it can prolong their lives. You want to keep their brain exercised, so helping them to remember their past and critically think about life as they know it is very beneficial.

You would never take this term "challenge" to mean that you would correct them or tell them that they are wrong or crazy. Just "help" them process their thoughts in more coherent ways.

Humor is also beneficial for the dying. It too has been shown to improve the quality of lives. A person with dementia may not be able to process humor the same ways we do, but there are appropriate ways to keep these patients laughing. The correct answer is definitely D.

[PattyB RN]

It seems "D" is the only possible answer. You can't actually get the patient to do any of the suggestions in A,B, or C and to use humor with a patient who is "last stage" alzheimers is pointless, perhaps even demeaning to the patient. I used to hate when questions weren't explained... how are we supposed to learn? I do feel humor is an important part of the human condition but if the person really won't be able to process it, it's lost. And you know what? Possible answer "A"is too complex! I wouldn't be able to do it and I don't have alzheimers. Yikes!

[morte, LPN, LVN]

if the patient is TRULY in the LATE stages of this horrible disease; none of the options are appropriate....but i would have chosen A........NO you dont always try to orient a confused person....and the calendars and such are there because "state" wants them there, not that they serve a usefull purpose.....

[Ms. Nurse Assistant, LPN]

Answer D is incredibly smug and judgemental so yeah I see why that is the correct answer.

[PattyB RN]

Really? "A"? I can't begin to imagine challenging the patient to alter distorted thought patterns...what the heck? In late stage? I had an uncle and a mother in law with that horrific disease and "A" wouldn't have been an option...they were non-verbal. Maybe the quetsion didn't give enough info to answer it. I still say "D"

[PattyB RN]

It's true that sometimes in nursing school we had to choose the best answer out of the four not necessarily what we would actually do. I'm just happy I don't have to take those tests anymore! Too much second guessing!