A nurse is reviewing a client's medication list. Which medication has been indicated for improvement in cognitive functioning in mild to moderate Alzheimer's disease?

A. "Age-related cognitive changes may lead to alterations in mental status." Age-related cognitive changes, such as mild cognitive impairment, can increase the risk of delirium, but the statement is too general. Delirium is typically acute and caused by specific factors like medication, infection, or metabolic imbalances, not just normal age-related changes . Therefore, this choice is incorrect.

B. "Lack of rigorous exercise may lead to alterations in mental status." While lack of exercise can impact overall health and well-being, it is not a direct risk factor for delirium. Delirium is more closely associated with acute medical conditions, medication interactions, or environmental factors . Therefore, this choice is incorrect.

C. "Decreased social interaction may lead to profound isolation and psychosis." Decreased social interaction can lead to isolation and mental health issues like depression, but it is not a direct cause of delirium. Delirium typically results from acute physiological changes rather than social factors . Therefore, this choice is incorrect.

D. "Taking multiple medications may lead to adverse interactions or toxicity." Polypharmacy, or taking multiple medications, is a significant risk factor for delirium in older adults due to the potential for adverse drug interactions and toxicity. This can lead to acute changes in mental status characteristic of delirium . This choice is correct.

A. Stand directly in front of the client when talking. Standing directly in front of a client with a history of anger and aggression can be perceived as confrontational and may escalate the situation. It's better to stand at an angle and maintain an open posture to appear less threatening. Therefore, this choice is incorrect.

B. Avoid wearing necklaces during client care. Wearing necklaces or other loose jewelry can pose a safety risk if a client becomes aggressive and grabs them. Avoiding such items is a precaution to prevent potential harm. This choice is correct.

C. Provide immediate verbal feedback for escalating behavior. Providing immediate verbal feedback is important to de-escalate aggressive behavior by addressing it promptly and setting clear boundaries. This helps in managing the client's behavior effectively. This choice is correct.

D. Bring security with you for all client interactions. While bringing security can be necessary in certain high-risk situations, it is not appropriate or practical for all interactions and can increase the client's anxiety or aggression. Instead, security should be involved based on risk assessment and the specific context. Therefore, this choice is incorrect.

E. Review the layout of the facility. Knowing the layout of the facility is important for ensuring safety and planning escape routes if a situation becomes unsafe. It helps staff navigate the environment efficiently in case of an emergency. This choice is correct.