The nursing action most likely to be effective in improving the level of orientation of a client experiencing dementia is:

A. Delirium is an acute, often sudden onset of confusion and altered mental status, usually caused by an underlying medical condition or medication. It tends to fluctuate and is typically reversible — not consistent with the progressive and long-term decline described.
B. Amnesia refers specifically to memory loss, which can be caused by trauma, disease, or psychological factors, but it does not encompass the broader cognitive decline (such as impaired judgment, language, and executive function) seen in dementia.
C. Dementia is characterized by a gradual and progressive decline in memory, thinking, and reasoning skills over time. The two-year progression described in the question is typical of dementia, especially in older adults.
D. Parkinson’s disease is a neurodegenerative disorder primarily affecting movement.While it can be associated with dementia in later stages, the primary symptoms early on are related to motor function (e.g., tremors, rigidity), not memory and cognition.

A. Exelon (rivastigmine) is an FDA-approved medication for Alzheimer's disease. It is a cholinesterase inhibitor that works by increasing levels of acetylcholine, a neurotransmitter important for memory and learning .
B. Risperdal (risperidone) is not approved by the FDA for the treatment of Alzheimer's disease. It is an atypical antipsychotic medication primarily used to treat schizophrenia and bipolar disorder. While it may be prescribed off-label for managing certain behavioral symptoms in Alzheimer's patients, its use in this context carries significant risks, including increased mortality in elderly patients with dementia-related psychosis .
C. Namenda (memantine) is an FDA-approved medication for moderate to severe Alzheimer's disease. It is an NMDA receptor antagonist that helps regulate glutamate activity, which is involved in learning and memory .
D. Aricept (donepezil) is an FDA-approved medication for all stages of Alzheimer's disease. It is a cholinesterase inhibitor that increases levels of acetylcholine in the brain .