A patient, aged 77 years, has Alzheimer's disease. She goes to day care during the week and is otherwise cared for by her daughter and grandchildren. The nurse at the day care center noticed multiple bruises on the patient's palms, elbows, and buttocks. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes she cannot recognize me and accuses me of trying to poison her. I can't concentrate at work, and it's wrecking the family. Sometimes I just cannot bear it." Which nursing diagnosis would be most important to address for this family?

Correct Answer: D

Rationale: The correct nursing diagnosis to address in this scenario is D: Caregiver role strain related to increased care needs. This is the most important as it focuses on the daughter's challenges and emotional burden due to her mother's condition. The daughter's statements reveal feelings of overwhelm, guilt, and exhaustion, which are key indicators of caregiver role strain. By addressing this nursing diagnosis, the healthcare team can provide support and resources to help the daughter cope with the demands of caring for her mother. Choice A (Knowledge deficit pertaining to dementia) is not the most important in this situation as the daughter's issue is not lack of knowledge but rather emotional stress. Choice B (Grieving related to mother's deterioration) is not the priority as addressing the daughter's emotional strain is more urgent than addressing grief. Choice C (Risk for injury related to cognitive impairment) is also important but not as immediate as addressing the caregiver's emotional well-being.

Correct Answer: C

Rationale: Rationale for Correct Answer (C): Providing a safe, nonintimidating environment is crucial to encourage the client to disclose domestic violence. This approach helps establish trust and confidentiality, making the client feel secure to share sensitive information. It creates a conducive setting for open communication without fear of repercussions. Summary of Incorrect Choices: A: Interviewing her in the presence of another professional may not ensure privacy and could potentially increase the client's discomfort or fear of being overheard. B: Speaking with the client in the absence of her husband might not guarantee safety and confidentiality, as the client may still feel threatened or hesitant to reveal the abuse. D: Allowing the client to initiate the topic of violence puts the burden on the client, who may already be feeling overwhelmed or unable to bring up the sensitive issue without support and encouragement.

Correct Answer: C

Rationale: The correct answer is C: Desensitizes people to the violence around them. Exposure to violence in the media can desensitize individuals, leading them to become less sensitive or responsive to violent acts in real life. This desensitization can contribute to a normalization of violence and reduce the perceived severity of violent behaviors. This can potentially lead to an increase in tolerance for violence in society. Incorrect choices: A: Has no effect on the increase of violence in society - This is incorrect because research has shown that exposure to media violence can have an impact on behavior. B: Assists individuals to distinguish appropriate behaviors from inappropriate behaviors - This is incorrect as exposure to violence in the media may blur the lines between appropriate and inappropriate behaviors. D: Broadens the viewer's knowledge about world happenings - This is incorrect as exposure to violence in the media may not necessarily lead to a broader understanding of world events, especially if the focus is on sensationalized or graphic content.

Correct Answer: D

Rationale: The correct answer, D, is the most appropriate plan because it addresses the client's current needs and safety concerns. Firstly, assessing diet and meal preparation is important due to the client's dysphasia, which may impact their ability to eat safely. Secondly, assessing the environment for safety problems is crucial as the client has dementia and may be at risk of accidents. Lastly, referral to a dementia program is necessary to provide specialized care and support for the client's condition. Choices A, B, and C are incorrect because they do not directly address the specific needs of the client in terms of dementia, dysphasia, and safety concerns. They focus on unrelated interventions that are not as critical in this scenario.

Correct Answer: A

Rationale: The correct answer is A: @-amyloid protein deposits in the brain. This theory of Alzheimer's etiology is supported by current research, indicating that the accumulation of @-amyloid protein plaques in the brain is a key characteristic of the disease. These plaques lead to neuronal damage and cognitive decline. Option B, abnormal serotonin reuptake, is not associated with Alzheimer's. Option C, excessive acetylcholine in the frontal cortex, is incorrect as Alzheimer's is characterized by acetylcholine deficiency. Option D, prion infection of gray matter, is not linked to Alzheimer's disease. In summary, the presence of @-amyloid protein deposits in the brain is a key feature of Alzheimer's pathology, distinguishing it from psychosocial origins.