A nurse is caring for a client who has an anxiety disorder and reports ongoing difficulty sleeping at night. Which of the following recommendations should the nurse make?

Choice A reason: Keeping the client's bedroom area dark at night is not advisable for individuals with Alzheimer's disease who wander. Darkness can increase confusion and the risk of falls. It is better to have a night light or dim lighting to help the client navigate safely if they get up during the night. Proper lighting can reduce disorientation and provide a safer environment for those who wander.

Choice B reason: Having the client exercise 30 minutes before bedtime is not recommended. Exercise close to bedtime can be stimulating and might make it more difficult for the client to fall asleep. It is generally advised to avoid vigorous physical activity at least a few hours before bedtime to promote better sleep. Gentle activities earlier in the day can help improve sleep quality without causing overstimulation.

Choice C reason: Placing the client's mattress on the bedroom floor is a practical safety measure for clients with Alzheimer's disease who wander at night. This approach minimizes the risk of injury from falls, as the client will be closer to the ground. By reducing the height of the bed, families can create a safer sleeping environment and help prevent potential injuries due to wandering and confusion.

Choice D reason: Encouraging the client to nap often during the day can disrupt nighttime sleep patterns. Excessive daytime napping can lead to difficulties falling asleep at night and contribute to nighttime wandering. It is essential to maintain a balanced routine with limited napping during the day to promote better sleep at night. Structured activities and proper sleep hygiene can help improve nighttime rest.

Choice A reason: This response shifts the focus from the client to the nurse, which is not therapeutic in this context. The client needs the opportunity to express their own feelings and experiences rather than hearing about the nurse's personal history. It is important for the nurse to remain professional and centered on the client's needs during conversations about grief and depression.

Choice B reason: Encouraging the client to start participating in usual activities might be premature, especially if they are not ready. Grief is a process that takes time, and clients need to move at their own pace. Instead, it is more supportive to listen and validate their current feelings rather than pushing them to resume normal activities too soon.

Choice C reason: Saying that "everyone feels depressed during the grieving process" can invalidate the client's unique experience and feelings. While it is true that grief is common after a loss, the intensity and way it manifests can vary greatly among individuals. This response may come across as dismissive, implying that the client's feelings are not important or unique.

Choice D reason: Asking the client to talk about their relationship with their partner is a therapeutic approach. This response invites the client to share their memories and feelings, which can help in processing their grief. It shows empathy and provides a safe space for the client to express their emotions, fostering a supportive and healing environment.