A 79-year-old client with Alzheimer's disease is exhibiting significant memory impairment, cognitive impairment, extremely impaired judgment in social situations, and agitation when placed in a new situation or around unfamiliar people. The nurse should include the following strategy in the client's care:

• A.Maintain routines and usual structure and adhere to schedules.
• B.Encourage the client to attend all structured activities on the unit, whether she wants to or not.
• C.Ask the client to go to an activity once. If she gives no response right away, change the question around, asking the same thing.
• D.Give the client two or three choices to decide what she wants to do.

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In working with a manipulative client, which of the following nursing interventions would be most appropriate?

• A.Bargaining with the client as a strategy to control the behavior
• B.Redirecting the client
• C.Providing a consistent set of guidelines and rules
• D.Assigning the client to different staff persons each day

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A 48-year-old client is being seen in her physician's office for complaints of indigestion, heartburn, right upper quadrant pain, and nausea of 4 days' duration, especially after meals. The nurse realizes that these symptoms may be associated with cholecystitis and therefore would check for which specific sign during the abdominal assessment?

• A.Cullen's sign
• B.Rebound tenderness
• C.Murphy's sign
• D.Turner's sign

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A post-lung surgery client is placed on a chest tube drainage system. When explaining to the family how the system works, the nurse states that the water-seal bottle of a three-bottle chest drainage system serves which of the following purposes?

• A.Collection bottle for drainage
• B.Pressure regulator
• C.Preventing accumulation of blood around the heart
• D.Preventing air from entering the chest upon inspiration

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A male client was diagnosed 6 months ago with amyotrophic lateral sclerosis (ALS). The progression of the disease has been aggressive. He is unable to maintain his personal hygiene without assistance. Ambulation is most difficult, requiring him to use a wheelchair and rely on assistance for mobility. He recently has become severely dysphasic. Nursing interventions for dysphasia would be aimed toward prevention of:

• A.Loss of ability to speak and communicate effectively
• B.Aspiration and weight loss
• C.Secondary infection resulting from poor oral hygiene
• D.Drooling

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