A nurse in a long-term care facility is caring for a client who has dementia and reports difficulty falling asleep at night. Which of the following actions should the nurse take to promote adequate rest?

Schedule the client for a morning group fitness class at the facility.

Limit the client to no more than four caffeinated beverages a day.

Walk around the hallway with the client an hour before bedtime

Allow the client several hours in the afternoon to take a nap

Answer and Explanation

The Correct Answer is A

A. Schedule the client for a morning group fitness class at the facility: Regular morning exercise promotes healthy sleep patterns by helping regulate the body's circadian rhythm. Engaging in physical activity early in the day can reduce restlessness at night.

B. Limit the client to no more than four caffeinated beverages a day: While caffeine should be limited, the most effective approach is to avoid caffeine entirely in the afternoon and evening to prevent sleep disruption, rather than just limiting it to four beverages a day.

C. Walk around the hallway with the client an hour before bedtime: Although light physical activity can promote sleep, intense exercise or walking too close to bedtime can sometimes increase alertness and make it harder for the client to fall asleep.

D. Allow the client several hours in the afternoon to take a nap: Long naps, especially in the afternoon, can disrupt the client's sleep cycle and make it more difficult for them to fall asleep at night. Limiting naps during the day is typically more helpful.

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Correct Answer is D

Explanation

A. "I will learn how to voluntarily control my blood pressure and heart rate": This statement refers to biofeedback, which focuses on controlling physiological responses like heart rate and blood pressure. It is not part of cognitive reframing, which targets thoughts.

B. "I will focus on a mental image while concentrating on my breathing.": This is describing guided imagery and relaxation techniques. While these are effective stress management strategies, they are not part of cognitive reframing, which focuses on altering negative thought patterns.

C. "I will progressively relax each of my muscle groups when feeling stressed.": This statement refers to progressive muscle relaxation, which helps with physical relaxation but does not involve changing thought patterns.

D. "I will practice replacing negative thoughts with positive self-statements": This is an accurate description of cognitive reframing. It involves identifying negative thoughts and replacing them with more balanced or positive ones to manage stress and improve emotional well-being.

A. The client does not recognize their partner, B. The client places their shoes on the wrong feet. C. The client is unable to remember their personal history D. The client engages in wandering

Correct Answer is D

Explanation

A. The client does not recognize their partner: While this is concerning, it is a common symptom of Alzheimer's disease as it progresses. However, it is not immediately life-threatening or a direct risk to the client’s safety.
B. The client places their shoes on the wrong feet: This is a typical manifestation of cognitive decline in Alzheimer's disease. While it may affect the client's independence, it is not an urgent issue that requires immediate intervention compared to other symptoms.
C. The client is unable to remember their personal history: Memory loss, especially related to personal history, is a hallmark symptom of Alzheimer's disease. Although it affects the client's cognitive function, it is not a crisis situation requiring priority intervention.
D. The client engages in wandering: Wandering is the priority concern in this scenario. It poses a significant safety risk, as the client may become lost, confused, or injured. Ensuring the client's safety by addressing wandering behavior is essential in managing Alzheimer's disease.

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A nurse in a long-term care facility is caring for a client who has dementia and reports difficulty falling asleep at night. Which of the following actions should the nurse take to promote adequate rest?

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