A nurse is assessing a client who has Alzheimer’s disease. Which of the following findings should the nurse identify as the priority?

Choice A reason: PRN prescriptions for restraints are not standard, as restraints require specific orders renewed every 24 hours. PRN orders risk overuse, violating least-restraint principles. Regular assessment ensures necessity, preventing harm like circulation issues or psychological trauma in restrained clients.

Choice B reason: Removing restraints based on calm behavior requires provider authorization after assessing ongoing risk. Premature removal may endanger the client or others, as agitation can recur. Restraint protocols prioritize safety, requiring clinical judgment beyond observed compliance to discontinue use.

Choice C reason: Observing every 15 minutes ensures client safety, monitoring for complications like skin breakdown or circulatory impairment. Restraints pose physical and psychological risks, and frequent checks align with regulatory standards to assess behavior, necessity, and potential for de-escalation or restraint removal.

Choice D reason: Hourly documentation is insufficient, as restraints require monitoring every 15 minutes to ensure safety and compliance with standards. Less frequent checks risk missing complications like pressure injuries or agitation changes, making this inadequate for safe restraint management and client care.

Choice A reason: Interpersonal therapy focuses on relationships, not the cognitive distortions driving gambling disorder. Gambling involves dopamine-driven reward seeking, and while relationships may influence stress, addressing core beliefs about gambling is more effective for managing the addiction’s neurobiological basis.

Choice B reason: Cognitive behavioral therapy (CBT) targets distorted beliefs in gambling disorder, such as illusions of control, addressing dopamine-driven reward seeking. By restructuring thoughts, CBT reduces compulsive behaviors, making it a primary, evidence-based intervention for addressing the psychological and neurological aspects of gambling addiction.

Choice C reason: Gamblers Anonymous promotes abstinence, not controlled gambling, which is unrealistic for a behavioral addiction. Controlled gambling contradicts recovery principles, as the disorder’s reward pathway dysregulation drives compulsive behavior, making this statement incorrect and misleading for treatment goals.

Choice D reason: Systematic desensitization is used for phobias, not gambling disorder. It involves gradual exposure to feared stimuli, irrelevant to gambling’s reward-driven compulsions. CBT is more appropriate, targeting cognitive distortions and behaviors, not anxiety-based avoidance seen in phobic disorders.