A nurse is caring for a client who has Alzheimer’s disease. Which of the following findings should the nurse expect?

Choice A reason: Establishing confidentiality first builds trust, the foundation of a therapeutic relationship in bipolar disorder, ensuring the client feels safe sharing. It sets clear boundaries, critical in mental health, before deeper interventions. This initial step aligns with relationship-building principles, making it the priority action.

Choice B reason: Sharing disorder information educates but assumes trust exists, premature without confidentiality established. In bipolar disorder, understanding follows rapport, not precedes it. This step is valuable later, not first, as it risks overwhelming the client without a secure base.

Choice C reason: Assisting with coping strategies requires an established relationship to tailor effectively to bipolar needs, like mood swings. It’s a later intervention, building on trust and assessment. Starting here skips foundational rapport, reducing impact, so it’s not the first action.

Choice D reason: Helping with behavioral changes, like adherence, demands trust and insight, developed after confidentiality is set. In bipolar care, this follows relationship establishment, not initiates it. This advanced step is premature, making it incorrect as the initial plan.

Choice A reason: A sliding bolt lock above the doorknob prevents wandering, a major risk in advanced Alzheimer’s due to disorientation, while remaining accessible to caregivers. This safety measure reduces elopement danger, aligning with teaching on environmental control. It shows understanding of adapting the home effectively.

Choice B reason: Notifying police within 2 hours reacts to wandering, not preventing it, a key safety goal in Alzheimer’s. Proactive measures like locks take precedence over response plans. This statement addresses aftermath, not precaution, indicating incomplete grasp of teaching.

Choice C reason: A dark bedroom risks falls or confusion in Alzheimer’s, where nightlights aid orientation and safety during sleep disruptions. Total darkness contradicts recommendations for visibility, increasing hazards. This shows misunderstanding of environmental safety needs.

Choice D reason: Giving a photo to police prepares for a missing person scenario but doesn’t prevent it, unlike locks or supervision. It’s a reactive step, not a proactive safety adaptation taught for home care. This lacks focus on prevention, so it’s incorrect.