The nurse is caring for a patient undergoing surgery with the nursing diagnosis of deficient knowledge related to lack of previous surgical experience. Which nursing intervention is appropriate? (Select all that apply.)

Choice A reason: Emptying the drain device every shift is important to prevent infection and accumulation of fluid, which can impede healing.

Choice B reason: Minimizing use of the affected arm is not recommended; rather, gentle exercises to promote circulation and prevent lymphedema are usually encouraged.

Choice C reason: Measuring the circumference of both arms can be part of monitoring for lymphedema, but it is not the priority in immediate post-mastectomy care.

Choice D reason: Placing the affected arm below the level of the heart is not recommended as it can increase swelling; elevation is usually advised.

Choice A reason: An illusion is a misinterpretation of a real external stimulus, which is not the case here as there is no snake.

Choice B reason: Attention-getting behavior is a possibility, but given that Mr. G is specifically referencing a snake that isn't there, it suggests a hallucination.

Choice C reason: A hallucination is a sensory perception in the absence of external stimuli, which fits Mr. G's description of seeing a snake that isn't there.

Choice D reason: A delusion is a firmly held false belief; while Mr. G may have this, the immediate experience he's describing is a hallucination, not a delusion.