A male client with diabetes mellitus (DM) is transferred from the hospital to a rehabilitation facility following treatment for a stroke with resulting right hemiplegia. The client reports his feet feel uncomfortably cool at night, preventing him from falling asleep. Which action should the nurse implement?

Choice A reason: Obtaining a prostate-specific antigen blood level test is not a way to reduce risk factors for BPH, but a way to screen for prostate cancer, which is a different condition. Prostate-specific antigen (PSA) is a protein produced by the prostate gland, and its level may be elevated in men with prostate cancer or other prostate problems, such as BPH or prostatitis. However, PSA testing is not recommended for all men, and it has some limitations and risks. The nurse should discuss the benefits and harms of PSA testing with the client and help him make an informed decision.

Choice B reason: Taking vitamin supplements is not a proven way to reduce risk factors for BPH, and it may have some adverse effects, such as interactions with medications or increased bleeding. There is no clear evidence that any specific vitamin or mineral can prevent or treat BPH, and some studies have suggested that high doses of certain vitamins, such as vitamin E or folic acid, may increase the risk of prostate cancer. The nurse should advise the client to eat a balanced diet that includes fruits, vegetables, whole grains, and lean proteins, and to consult a doctor before taking any supplements.

Choice C reason: Increasing physical activity is a beneficial way to reduce risk factors for BPH, as well as to improve overall health and well-being. Physical activity can help maintain a healthy weight, lower blood pressure, reduce inflammation, and enhance blood flow to the pelvic area, which may prevent or delay the development of BPH. The nurse should encourage the client to engage in moderate-intensity aerobic exercise, such as brisk walking, cycling, or swimming, for at least 150 minutes per week, and to include some strength training and flexibility exercises as well.

Choice D reason: Consuming a high protein diet is not a helpful way to reduce risk factors for BPH, and it may have some negative effects, such as increasing the risk of kidney stones, gout, or osteoporosis. A high protein diet may also increase the intake of saturated fat, cholesterol, and sodium, which can raise the risk of cardiovascular disease and hypertension, which are also risk factors for BPH. The nurse should advise the client to limit the intake of animal protein, such as red meat, poultry, eggs, and dairy products, and to choose plant-based protein sources, such as beans, nuts, seeds, and soy products, more often.

Choice A reason: Reorienting to day and time frequently is a nursing intervention that the nurse should implement, because it can help the client to reduce confusion, anxiety, and disorientation, which may contribute to the auditory hallucinations. The nurse should use simple and clear language, speak slowly and calmly, and provide cues and reminders, such as a clock, a calendar, or a picture, to help the client to orient to reality.

Choice B reason: Applying soft wrist restraints bilaterally is not a nursing intervention that the nurse should implement, unless it is absolutely necessary and ordered by the doctor. Restraints can increase the client's agitation, anxiety, and fear, and they can also cause physical and psychological harm, such as skin breakdown, nerve damage, or loss of dignity. The nurse should use restraints only as a last resort, after trying other less restrictive alternatives, such as verbal de-escalation, distraction, or medication.

Choice C reason: Administering a PRN dose of lorazepam is a nursing intervention that the nurse should implement, if it is prescribed by the doctor and indicated by the client's condition. Lorazepam is a benzodiazepine that can help the client to relax, reduce anxiety, and sedate the central nervous system, which may alleviate the auditory hallucinations. The nurse should monitor the client's vital signs, level of consciousness, and respiratory status, and report any adverse effects, such as hypotension, bradycardia, or respiratory depression.

Choice D reason: Turning the television on for distraction is not a nursing intervention that the nurse should implement, because it can worsen the client's auditory hallucinations, confusion, and agitation. The television can provide too much stimulation, noise, and information, which can overload the client's sensory perception and interfere with their ability to distinguish reality from hallucination. The nurse should provide a quiet and calm environment, and limit the sources of auditory input.

Choice E reason: Presenting a calm, supportive demeanor is a nursing intervention that the nurse should implement, because it can help the client to feel safe, comfortable, and respected, and to establish a trusting relationship with the nurse. The nurse should show empathy, compassion, and patience, and avoid arguing, criticizing, or dismissing the client's hallucinations. The nurse should acknowledge the client's feelings, validate their distress, and reassure them that they are not alone.