Module 4 Knowledge Check

A resident with dementia says, "I need to get home. My daughter's school bus is coming soon." The nurse aide knows the resident is confused because her only daughter just turned 60. What is the best response by the nurse aide?

• Let's go see if Bingo has started yet. You love Bingo!

• Remember, you are in a nursing home. Your daughter is all grown up.

• Do you mean your great-granddaughter? Your daughter just turned 60.

• What do you like to do with your daughter when she gets home from school?

Answer explanation

This response shows empathy and respects the resident's current state of reality. With dementia, individuals often have difficulty remembering recent events but can vividly recall things from their past. Trying to correct or confront them about their distorted reality can cause agitation or distress.

A resident who has dementia is usually able to get dressed with some prompting. This morning the resident is more confused and needs more help with all activities of daily living. What should the nurse aide do?

• Tell the resident not to feel bad about needing more help today.

• Provide extra help as needed to avoid the resident becoming frustrated.

• Ask if the resident would prefer to stay in night clothes for the day.

• Check if the resident will get dressed for another nurse aide.

Answer explanation

Individuals with dementia may experience varying levels of clarity on different days. However, any changes should be promptly reported to the charge nurse. When assisting residents with dementia, nurse aides should be mindful of their language and avoid making residents feel bad for their inability to perform tasks. It's important to encourage residents to participate in their own care as much as possible, while still providing necessary assistance. While residents with dementia have rights, too many choices may be overwhelming and frustrating for them. Residents should be encouraged to dress in their own clothes during the day to help maintain a sense of routine and orientation.

A resident with dementia tries to get out of bed without help during the night. The care plan states the resident needs assistance to get out of bed. What should the nurse aide do first?

• Wait until the morning to assist the resident.

• Encourage the resident to get out of bed without help.

• Tell the resident to never get out of bed without assistance.

• Try to find out if there is something the resident needs.

Answer explanation

It's common for residents who experience confusion to be more disoriented at night. Typically, the actions and behaviors of confused residents are connected to their needs. For instance, a resident who is attempting to leave their bed may require assistance with using the bathroom, be experiencing discomfort due to incontinence, or feeling thirsty. It's crucial to assess and understand any potential needs and address them accordingly. In some cases, residents may also feel anxious about their surroundings, which should also be addressed. Ultimately, ensuring the safety and security of residents throughout the night is of utmost importance.

What is chronic dementia, and what are some of the characteristic features of this medical condition?

• A medical condition that causes temporary decline in memory and one other cognitive area in a previously alert individual.

• A curable disease process that causes gradual decline in memory and at least one other cognitive area in a resident who was previously alert.

• A medical condition caused by any number of different disease processes that cause a progressive, subtle decline in memory and at least one other cognitive area in a resident who was previously alert.

• A medical condition caused by any number of different disease processes that causes a sudden, significant decline in memory and at least one other cognitive area in a resident who was previously alert.

Answer explanation

Chronic dementia is caused by any number of different disease processes. It causes a progressive, subtle decline in memory.

You notice that a resident with dementia is walking with a limp on their left foot. Your first response should be to:

• Return the resident to bed.

• Provide the resident with a cane.

• Tell the nurse the resident is having foot pain.

• Remove the resident's shoe and inspect the foot.

Answer explanation

When working with residents who have dementia, they often have difficulty expressing physical discomfort or needs. This means that observing their behavior is crucial to understanding any issues they may be experiencing. For instance, a resident rubbing their stomach or complaining of stomach pain may not necessarily indicate stomach problems, but rather difficulty interpreting bodily signals such as hunger or a full bladder.

In this particular scenario, the resident is exhibiting a limp. While there could be various reasons for this, such as a shoe issue, a slipped sock, or a hip/knee problem, it's important to address the problem by doing some basic problem-solving. Checking the resident's foot could be a good starting point and also provide more detailed information to report to the nurse. Remember to always report any observations to the nurse and closely observe the resident's behavior.

True or False. Everyone who has dementia has Alzheimer’s.

• T

• True

• F

• False

Answer explanation

Sometimes people think that dementia and Alzheimer’s are the same thing when in reality, they aren’t! Dementia refers to impaired thinking, memory, reasoning, and behavior, and Alzheimer’s is just one type of dementia. Just because someone has dementia doesn’t mean they have Alzheimer’s, but if they have Alzheimer’s that means they have dementia.

You notice that a resident with dementia keeps walking over to the piano, pausing there, touching the piano, and then walking away only to return again. Which of the following is the best action for you to take?

• Take the resident back to the resident’s room.

• Distract the resident by asking about the resident’s family.

• Invite the resident to sit down at the piano with you.

• Ask the activity director to find something for the resident to do.

Answer explanation

You should take the time to interact with the resident. You should try to see if there is a problem where you could assist. In this case, the resident may be having a problem or the resident may have an interest in the piano and have forgotten what to do with the piano. You will find many clues about the residents’ needs in paying attention to the behaviors of residents with dementia. Inviting the resident to sit down at the piano and touching the keyboard to play a few notes may trigger something in the resident’s memory.

Which of the following guidelines should be followed when speaking with a resident who has cognitive impairments?

• Rush through the conversation to save time.

• Use judgmental phrases to prompt the resident's memory.

• Speak slowly and calmly.

• Give complex instructions with multiple steps.

Answer explanation

When speaking with a resident who has cognitive impairments, it is crucial to speak slowly and calmly to ensure that the resident understands what is being said. Rushing through the conversation or using judgmental phrases can be confusing and upsetting for the resident. Giving complex instructions with multiple steps may also be challenging for the resident to understand. Following these guidelines can help create a more positive and comfortable environment for the resident.

Alzheimer’s is a progressive disease. It is the gradual decrease in memory, thinking and physical ability over several years.

• T (True)

• F (False)

Answer explanation

Alzheimer's disease is a neurodegenerative disorder that typically progresses over time, resulting in a gradual decline in cognitive and physical function. It is the most common cause of dementia in older adults.

Which of the following are different behaviors that may be seen in a resident with dementia? Choose all that apply.

• Aggression and anger

• Anxiety and agitation

• Hallucinations

• Repetition

• Sleep issues and sundowning

Answer explanation

All of these behaviors may be seen with dementia patients.