A nurse is reinforcing teaching with a client who is scheduled for implantation of a vagus nerve stimulator. Which of the following statements should the nurse include in the teaching?

Choice A reason: A client who is hearing command hallucinations should be prioritized first because command hallucinations can be particularly dangerous. These hallucinations can involve voices instructing the client to harm themselves or others. Immediate assessment and intervention are crucial to ensure the client's safety and to prevent potential harm. The nurse needs to address the client's safety concerns and implement necessary precautions.

Choice B reason: A client verbalizing ideas of reference, which involve misinterpreting events or remarks as having personal significance, may experience distress and paranoia. While these symptoms require attention and management, they do not typically pose an immediate risk to the client's or others' safety. The nurse should monitor and support the client but prioritize more urgent safety concerns first.

Choice C reason: A client using neologisms, or creating new words that are not understood by others, indicates a thought disorder. While this is a significant symptom that requires intervention, it does not typically pose an immediate risk to safety. The nurse should evaluate the client's communication and thought processes and provide appropriate care.

Choice D reason: A client demonstrating clang associations, which involve linking words based on sound rather than meaning, also indicates a thought disorder. This symptom requires attention, but it does not usually pose an immediate threat to the client's or others' safety. The nurse should assess the client's condition and provide appropriate interventions but prioritize more urgent safety concerns first.

Choice A reason: While a stimulating environment can be beneficial in engaging a client with Alzheimer's disease, it is not directly related to assisting with activities of daily living (ADLs). The goal is to create an environment that simplifies tasks and reduces confusion, which might be better achieved through other methods.

Choice B reason: Offering several choices for daily activities and meals can overwhelm a client with Alzheimer's disease. Simplifying choices and providing clear, structured routines are more effective strategies. Too many options can lead to confusion and difficulty in decision-making for these clients.

Choice C reason: Providing clothing with elastic or fastening tape simplifies the process of dressing and undressing, making it easier for the client to maintain independence in ADLs. This type of clothing can reduce frustration and promote a sense of autonomy, which is crucial for clients with Alzheimer's disease.

Choice D reason: Keeping the bedroom dark while the client is sleeping can promote better sleep, but it does not directly assist with performing ADLs. Ensuring the client has adequate lighting and a safe environment during waking hours is more relevant to supporting their ability to perform daily activities.