Which of the following statements by the caregiver of a client newly diagnosed with dementia requires further intervention by the nurse?

Choice A reason: Redirecting to an activity uses distraction to reduce agitation in Alzheimer’s, where hippocampal and cortical degeneration causes disorientation and memory loss. Engaging in familiar activities leverages preserved procedural memory, calming the client without confronting their delusion, which aligns with neurobiological strategies to manage confusion and distress.

Choice B reason: Stating the mother died confronts the client’s delusion, likely increasing agitation due to impaired reality testing from Alzheimer’s-related cortical damage. This approach disregards the client’s cognitive limitations, as memory deficits prevent processing such corrections, potentially worsening emotional distress and behavioral symptoms.

Choice C reason: Asking why the client seeks her mother probes a delusion rooted in Alzheimer’s-related memory loss and hippocampal dysfunction. This may confuse or frustrate the client, as they cannot articulate reasons due to cognitive impairment. Redirection is more effective than exploring motives in advanced dementia.

Choice D reason: Assuming upset and addressing emotional distress may escalate agitation, as Alzheimer’s impairs emotional regulation due to amygdala and prefrontal cortex damage. While empathetic, this response risks focusing on the delusion, which the client cannot process, making redirection to an activity a more effective, neurobiologically informed approach.

Choice A reason: Tylenol with Codeine (acetaminophen and codeine) in tablet form (1T) typically refers to a standard dose, but in liquid form, the concentration varies. Assuming a common elixir (120 mg acetaminophen/12 mg codeine per 5 mL), 15 mL delivers the standard dose. 15.5 mL slightly exceeds this, risking overdose and potential hepatotoxicity from acetaminophen, making it incorrect.

Choice B reason: Tylenol with Codeine elixir is commonly 120 mg acetaminophen and 12 mg codeine per 5 mL. One tablet equivalent (1T) typically corresponds to 15 mL, delivering 360 mg acetaminophen and 36 mg codeine, aligning with standard dosing for pain relief. This volume ensures therapeutic efficacy without exceeding safe limits, matching pharmacological guidelines.

Choice C reason: A 40 mL dose of Tylenol with Codeine elixir (120 mg acetaminophen/12 mg codeine per 5 mL) would deliver 960 mg acetaminophen and 96 mg codeine, far exceeding safe single-dose limits. This risks acetaminophen-induced liver toxicity and opioid-related respiratory depression, as it disrupts the therapeutic window, making this choice scientifically inappropriate.

Choice D reason: A 30 mL dose of Tylenol with Codeine elixir (120 mg acetaminophen/12 mg codeine per 5 mL) provides 720 mg acetaminophen and 72 mg codeine, doubling a typical single dose. This excessive amount increases the risk of hepatotoxicity and opioid side effects like sedation or respiratory depression, rendering it unsuitable for standard administration.