A nurse is reinforcing teaching with a client who has cancer and is undergoing external radiation therapy. Which of the following instructions should the nurse include in the teaching?

A) Social withdrawal: While social withdrawal can be a sign of depression or a worsening cognitive decline in clients with Alzheimer's disease, it does not immediately threaten the client's safety. It is important to monitor and address, but it is not the priority concern that requires immediate intervention.

B) Wandering outside at night: This is the priority issue and requires immediate intervention. Wandering, especially at night, poses a significant safety risk to clients with Alzheimer's disease. The client may become lost, disoriented, or fall, leading to injury. Immediate steps should be taken to ensure the environment is safe, such as installing locks or alarms on doors, and potentially seeking further evaluation or care interventions to manage this behavior.

C) Difficulty articulating words: Difficulty with speech or articulation can occur as part of Alzheimer's disease, especially in the later stages. While it can be distressing for the client and family, it does not present an immediate threat to the client's safety. This issue should be addressed as part of the overall care plan, but it is not as urgent as wandering.

D) Inability to remember their partner's name: Memory loss, including difficulty remembering names, is a common symptom of Alzheimer's disease. While it can be emotionally difficult for both the client and their family, it does not pose an immediate risk to the client’s safety or well-being. This symptom should be monitored, but it is not the top priority for immediate intervention.

A) *Once you have completed a living will, it cannot be changed: This statement is inaccurate. A living will can be revised or updated at any time while the client is still capable of making decisions. The client can amend or revoke their living will if they change their mind about their wishes regarding end-of-life care or other medical decisions.

B) "You will need an attorney to appoint a health care surrogate": This statement is incorrect. While legal assistance might be beneficial in some cases, it is not required to appoint a health care surrogate. The appointment can typically be done through a simple form provided by the facility, and it is not necessary to hire an attorney for this process.



C) "You should appoint a family member as your health care surrogate": While appointing a family member as a health care surrogate is common, it is not a requirement. The person appointed should be someone who understands the client’s wishes and will act in the client's best interest. It is important to select someone who can make tough decisions, but it
doesn’t have to be a family member.

D) "Your health care surrogate will make decisions on your behalf if you are unable": This statement is correct. A health care surrogate is a person appointed to make medical decisions on behalf of the client if they are unable to do so themselves due to incapacity. This role is critical when the client cannot communicate their wishes due to illness or injury.