A patient with Alzheimer’s disease (AD) who is being admitted to a hospital rehab facility has had several episodes of wandering away from home. Which action will the nurse include in the plan of care?

Choice A reason: CT scans can detect gallstones but are less specific and involve radiation, making them secondary to ultrasound. Ultrasound is the preferred test for its accuracy and safety, making this less optimal and incorrect compared to the primary diagnostic tool for confirming gallstones.

Choice B reason: Ultrasound is the most helpful test for confirming gallstones, offering high sensitivity and specificity without radiation. It visualizes stones clearly in the gallbladder, aligning with diagnostic guidelines, making it the correct choice for the nurse to identify as the primary radiographic test for gallstones.

Choice C reason: MRA focuses on vascular structures, not gallstones, and is irrelevant for gallbladder assessment. Ultrasound is the standard for gallstone confirmation, making this inappropriate and incorrect compared to the non-invasive, effective imaging method used in diagnosing gallbladder conditions.

Choice D reason: Abdominal x-rays detect only calcified gallstones, missing non-calcified ones, which are common. Ultrasound is more comprehensive, making this less reliable and incorrect compared to the preferred diagnostic test for accurately confirming gallstones in a clinical setting.

Choice A reason: Placing the patient near the nurse’s station allows close monitoring, reducing wandering risks in Alzheimer’s disease. This aligns with safety protocols in rehab facilities, making it the correct action to include in the care plan to manage the patient’s wandering behavior effectively.

Choice B reason: Reorienting frequently may not prevent wandering in Alzheimer’s, as cognitive deficits persist. Proximity to the nurse’s station ensures safety, making this less effective and incorrect compared to the nurse’s priority of physical monitoring to address the patient’s wandering risk.

Choice C reason: Familiar items provide comfort but don’t directly prevent wandering, a safety concern in Alzheimer’s. A room near the nurse’s station is more effective, making this secondary and incorrect compared to the nurse’s focus on immediate safety in the care plan.

Choice D reason: Asking why the patient wanders is ineffective, as Alzheimer’s impairs insight into behavior. Close monitoring via room placement prevents wandering, making this impractical and incorrect compared to the nurse’s action to ensure safety in the rehab facility care plan.