A nurse is caring for a client who has narcissistic personality disorder. Which of the following treatments should the nurse recommend?

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.

Choice A reason: Feeling the need to cut alcohol use (CAGE question) flags potential abuse, a strong self-harm risk factor via impulsivity or depression. In mental health screening, this directly ties to behaviors linked to suicide or injury, making it the most relevant question here.

Choice B reason: Liver damage indicates past alcohol effects but not current intent or emotional state tied to self-harm. It’s a physical outcome, not a behavioral risk marker. This question misses the psychological focus needed for screening, so it’s not the best choice.

Choice C reason: Twin birth relates to genetics or early stressors, but no direct evidence links it to self-harm risk universally. It’s too vague for mental health screening without context. This question lacks specificity to harm, making it irrelevant here.

Choice D reason: Family alcohol use suggests environmental risk but not the client’s own behavior or feelings, key to self-harm assessment. It’s indirect, missing personal intent or distress. This historical focus is less urgent than current indicators, so it’s incorrect.