A nurse in a long-term care facility is caring for a client who has dementia and reports difficulty falling asleep at night. Which of the following actions should the nurse take to promote adequate rest?

Choice A reason: Walking before bedtime may overstimulate the client, disrupting the circadian rhythm. Dementia impairs sleep regulation, and physical activity close to bedtime can increase alertness, delaying sleep onset. Evening calming routines are more effective for promoting rest in clients with cognitive decline. Choice B reason: Limiting caffeine to four beverages daily is insufficient, as caffeine, a stimulant, disrupts sleep by blocking adenosine receptors, even in small amounts. For dementia clients, complete caffeine avoidance is recommended, as their sensitive neurological state exacerbates sleep disturbances, making this action inadequate. Choice C reason: Morning exercise promotes a healthy circadian rhythm, enhancing sleep quality in dementia clients. Physical activity increases daytime alertness and melatonin production, aiding nighttime rest. Group classes also provide social stimulation, reducing agitation and supporting cognitive health, making this a scientifically sound intervention for sleep promotion. Choice D reason: Long afternoon naps can disrupt the sleep-wake cycle, reducing nighttime sleep drive in dementia clients. Naps longer than 30 minutes may cause circadian misalignment, worsening insomnia. Brief, early naps are preferable, as prolonged daytime sleep exacerbates sleep difficulties in neurodegenerative conditions.