A nurse is planning care for a client who is withdrawing from alcohol. Which of the following medications should the nurse plan to administer during the acute phase of alcohol withdrawal?

Choice A reason: Sleeping only 4 hours is common during mania and contributes to exhaustion, but it is not immediately life-threatening.

Choice B reason: Refusing to shower reflects poor self-care, which is expected in mania, but it does not pose an acute medical risk.

Choice C reason: Eating half a snack shows reduced intake but is not as urgent as fluid refusal.

Choice D reason: Refusing fluids is the priority because dehydration can quickly lead to severe complications such as electrolyte imbalance, cardiac dysrhythmias, and renal impairment. This requires immediate intervention.

Rationale for PET scan: A PET scan of the head is anticipated because the client is showing progressive cognitive decline, memory loss, and disorientation. Neuroimaging is appropriate to rule out structural or metabolic causes such as stroke, tumors, or neurodegenerative disease. This helps differentiate dementia from other neurological conditions.

Rationale for physical examination: A physical exam is anticipated because it provides a baseline assessment of the client’s overall health, identifies comorbid conditions, and evaluates neurological status. Physical findings can guide further diagnostic testing and management.

Rationale for MMSE: Administering the Mini Mental State Examination is anticipated because it is a standardized tool used to assess cognitive function, memory, orientation, and problem-solving ability. Given the client’s symptoms of forgetfulness, disorientation, and difficulty with daily tasks, the MMSE will help quantify cognitive impairment and track progression.

Rationale for medication review: Reviewing all prescribed and over-the-counter medications is anticipated because certain drugs can contribute to confusion, memory loss, or delirium. Polypharmacy and inappropriate medication use are common in older adults and can mimic or worsen dementia symptoms. Identifying and adjusting medications is a critical step in care.

Rationale for inpatient behavioral health admission: Admission to a behavioral health unit is not indicated at this stage. The client’s symptoms are consistent with progressive dementia rather than an acute psychiatric crisis. The focus should be on diagnostic evaluation, outpatient management, and support rather than psychiatric hospitalization