A client with advanced Alzheimer's disease keeps searching the unit for her mother who died many years ago. How should the nurse respond?

Choice A reason: Redirecting to an activity uses distraction to reduce agitation in Alzheimer’s, where hippocampal and cortical degeneration causes disorientation and memory loss. Engaging in familiar activities leverages preserved procedural memory, calming the client without confronting their delusion, which aligns with neurobiological strategies to manage confusion and distress.

Choice B reason: Stating the mother died confronts the client’s delusion, likely increasing agitation due to impaired reality testing from Alzheimer’s-related cortical damage. This approach disregards the client’s cognitive limitations, as memory deficits prevent processing such corrections, potentially worsening emotional distress and behavioral symptoms.

Choice C reason: Asking why the client seeks her mother probes a delusion rooted in Alzheimer’s-related memory loss and hippocampal dysfunction. This may confuse or frustrate the client, as they cannot articulate reasons due to cognitive impairment. Redirection is more effective than exploring motives in advanced dementia.

Choice D reason: Assuming upset and addressing emotional distress may escalate agitation, as Alzheimer’s impairs emotional regulation due to amygdala and prefrontal cortex damage. While empathetic, this response risks focusing on the delusion, which the client cannot process, making redirection to an activity a more effective, neurobiologically informed approach.

Choice A reason: One-to-one observation is the priority after a suicide attempt, as the adolescent’s recent action indicates high risk of recurrence due to serotonin dysregulation and prefrontal cortex deficits. Continuous monitoring prevents self-harm by ensuring immediate intervention, addressing the acute neurobiological risk of impulsivity and suicidal ideation in this critical period.

Choice B reason: Encouraging peer interaction supports long-term mental health but is secondary in an acute post-suicide attempt phase. The adolescent’s serotonin imbalances and heightened impulsivity increase self-harm risk, requiring immediate safety measures over social engagement, which could overwhelm or trigger distress in a neurobiologically vulnerable state.

Choice C reason: Attending a support group aids long-term recovery by fostering social connection and coping skills. However, post-suicide attempt, the adolescent’s acute risk, driven by serotonin dysregulation and prefrontal dysfunction, prioritizes safety. Groups may be premature, as emotional instability could exacerbate distress, making observation the immediate need.

Choice D reason: Administering antidepressants addresses underlying depression but takes weeks to affect serotonin levels. Post-suicide attempt, immediate safety is critical due to ongoing impulsivity and neurobiological instability. Observation prevents harm during this high-risk period, making medication secondary until the acute crisis is stabilized.