A nurse is caring for a client who has alcohol use disorder.
Which of the following findings should indicate to the nurse that the client is experiencing the initial stage of acute withdrawal?

Choice A rationale

Consuming red wine before bed, even in small amounts, can disrupt sleep architecture. While alcohol might initially induce drowsiness, it often leads to fragmented sleep later in the night as the body metabolizes it, resulting in poor sleep quality and reduced restorative sleep.

Choice B rationale

Staying in bed for prolonged periods when unable to sleep can create a negative association between the bed and wakefulness. This can increase anxiety about sleep and perpetuate insomnia. It is generally recommended to get out of bed and engage in a relaxing activity until feeling sleepy.

Choice C rationale

Exercising vigorously close to bedtime can be stimulating and raise core body temperature, making it harder to fall asleep. The body needs time to cool down for optimal sleep initiation. It is generally recommended to avoid intense exercise at least a few hours before bed.

Choice D rationale

Caffeine is a stimulant that can interfere with sleep initiation and maintenance. Limiting caffeine intake, especially in the afternoon and evening, can significantly improve sleep quality by reducing its stimulating effects on the central nervous system. Normal caffeine intake should be limited, and eliminating it closer to bedtime is beneficial for sleep.

Choice A rationale

Repeated school absences are a common finding in conduct disorder and indicate a disregard for rules and obligations. While important to address, it does not represent an immediate safety risk compared to threats of harm.

Choice B rationale

Threats of injury to others indicate a potential for violence and pose an immediate safety risk to others. This requires the nurse's immediate attention to assess the situation, ensure safety, and implement appropriate interventions to prevent harm.

Choice C rationale

Lack of empathy for others is a core characteristic of conduct disorder, reflecting a difficulty in understanding or sharing the feelings of others. While significant for long-term management, it does not present an immediate safety concern.

Choice D rationale

A history of shoplifting indicates a pattern of rule-breaking and disregard for the rights of others, which is characteristic of conduct disorder. However, it does not represent an immediate threat of harm compared to threats of injury.