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.****
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 think you are misreading the question. a. is a realistic intervention that i believe should be in the plan of care. that is not my point though. by saying that d. should not be in the plan of care you are saying that you would not omit humor with this patient. that is why d is the right answer, because you would not want to omit humor. if your answer is a then you are saying that d should stay and that you will avoid humor. is this making any sense?
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 think you are misreading the question. a. is a realistic intervention that i believe should be in the plan of care. that is not my point though. by saying that d. should not be in the plan of care you are saying that you would not omit humor with this patient. that is why d is the right answer, because you would not want to omit humor. if your answer is a then you are saying that d should stay and that you will avoid humor. is this making any sense?
Also you are answering as textbook answers not real life. THe questions were poorly worded. YOu shouldn't use sarcasm with alzheimers pts. Humor ok, sarcasm no. Also reorient instead of challenge. Don't ya love school?
Chicookie and Yardbarbie - Would you concede that it's a poorly written question? And that getting it right has little to do with remembering and comprehending various aspects of Alzheimers and the associated nursing care?
Given that we don't know anything about this patient, it could very well be that THIS particular doesn't respond well to humor... so how can we conclude it definitely wouldn't be on the on care plan? We can't know for sure either if the patient responds well to being "challenged" (reoriented), but in general, a well-studied student will know that most late stage Alzheimers patients don't respond very well to their version of reality being challenged.
So again, I argue that getting this answer right (D) or wrong (A) doesn't reflect a student's ability to remember and apply their nursing knowledge.
Ared1 - I do appreciate your humor! : ) But, no! I don't love this aspect of nursing education. This doesn't even seem to be a textbook answer. It's an NCLEX style question where the "best" answer isn't objectively best and it isn't even testing one's knowledge about Alzheimers or nursing care... except that if there's no reason to exclude the use of humor from a care plan, then one shouldn't exclude it. Yes, there may be a good rationale for why D is considered best. But there are also good rationale's why A would be best. It's a pet peeve of mine that questions such as this can make or break a student's success when there is so much more useful stuff to test on.
I would definitely say D. The reason is, and your teacher should have been able to tell you this; All of the other answers are in some way demeaning to the client. They are not respectful at all. Learning how to take these tests is a challenge in thinking "what is right" not just what do I think is the right thing to do. We are learning a new way of thinking about the world and of relating to people. Respect is of the utmost importance. By humor I think they ment go along with him. I've been a teacher for 25 years and involved in many multiple choice state exams. Taking this type of test means you can immediately rule out two answers as totally ludicrous. The two that are left will both be ok, but one will be better. It's ALWAYS like that. Learn to take tests and you will do great.
Chicookie and Yardbarbie - Would you concede that it's a poorly written question? And that getting it right has little to do with remembering and comprehending various aspects of Alzheimers and the associated nursing care?
Given that we don't know anything about this patient, it could very well be that THIS particular doesn't respond well to humor... so how can we conclude it definitely wouldn't be on the on care plan? We can't know for sure either if the patient responds well to being "challenged" (reoriented), but in general, a well-studied student will know that most late stage Alzheimers patients don't respond very well to their version of reality being challenged.
So again, I argue that getting this answer right (D) or wrong (A) doesn't reflect a student's ability to remember and apply their nursing knowledge.
Ared1 - I do appreciate your humor! : ) But, no! I don't love this aspect of nursing education. This doesn't even seem to be a textbook answer. It's an NCLEX style question where the "best" answer isn't objectively best and it isn't even testing one's knowledge about Alzheimers or nursing care... except that if there's no reason to exclude the use of humor from a care plan, then one shouldn't exclude it. Yes, there may be a good rationale for why D is considered best. But there are also good rationale's why A would be best. It's a pet peeve of mine that questions such as this can make or break a student's success when there is so much more useful stuff to test on.
Yes it is a poorly written question, but that is nursing school for you. =D
I bet this question was something they might have stressed in class. Those questions were always odd.
I would go with answer A because challenging a person involves a level of communication and thought process which due to the advanced stage of the disease the client does have, anymore. As someone else mentioned challenging a person in such a manner is appropriate for a different mental disease such as one of the personality disorders. If I am wrong I would appreciate if someone clarifies my error for I indeed found the question intriguing. feliz3
I am a long term care educator and I would definitely say that A is the most correct answer. D could also be correct with some clarification. The rationale for this has already been well defined by previous posters. I hope that your instructors would be open to discussion on this question since their intent was obviously not well communicated, i.e.: the test question was poorly worded.
i would go with answer a because challenging a person involves a level of communication and thought process which due to the advanced stage of the disease the client does have, anymore. as someone else mentioned challenging a person in such a manner is appropriate for a different mental disease such as one of the personality disorders. if i am wrong i would appreciate if someone clarifies my error for i indeed found the question intriguing. feliz3
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.****
after some thought about the way this question is worded, i believe the correct answer is d because the last sentence of the question says: which intervention would not appear in this plan? answer d: "avoid using humor with the client because he will not understand." that intervention should not appear in the plan of care because that intervention is based on making assumptions that may or may not be accurate for that particular client, and doing that is bad nursing. as for answer a to challenge means to remind the client the right date by placing a calendar where he can see the current date, and by telling the client the current date, so that answer a is appropriate. however, d is not, so that's the answer. feliz3
Frequently in Nursing exams it can be a matter of choosing the one that is most wrong.
So yes when first reading the question I probably would have chosen the same one you did. But thinking about the wording....
"Challenge the client to alter distorted thought patterns and view self and the world more realistically."
To me that can mean reminding them that I'm not their daughter....just reorientation...not that I'm trying to indoctrinate them to their former thinking.
Definitely D. You have to read the question. Why would you ever avoid humor? I have worked in hospice and nursing homes, and believe me humor is the way to get through the pain of losing everything. Laughter and joy is great therapy. It gives you endorphins and relieves pain.
A goes back to the basics of reality orientation, somethng you should have learned in Fundamentals. We don't want to feed into confusion. We remind the patient of reality and try to help him or her stay in the now.
This is why so many grads cry about failing their boards. You have to be able to reason out the answer and why you chose it. Sometimes more than one answer could be right, which one is most correct? Usually two answers are obviously wrong, and two are possible, but one is the best answer and there is a reason why.
BTW, I worked as an item writer for NCLEX once, and I think this is the sort of question that would be a good one for boards, though some of the wording might be considered "tricky" and might be changed slightly.
feliz3
yardbarbie
3 Posts
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 think you are misreading the question. a. is a realistic intervention that i believe should be in the plan of care. that is not my point though. by saying that d. should not be in the plan of care you are saying that you would not omit humor with this patient. that is why d is the right answer, because you would not want to omit humor. if your answer is a then you are saying that d should stay and that you will avoid humor. is this making any sense?