A nurse is caring for a client who has Alzheimer's disease and is experiencing sundown syndrome with anxiety. Which of the following actions should the nurse take?

Introduction: Sundown syndrome involves increased nocturnal confusion and agitation in dementia, necessitating environmental modifications that reduce sensory overload to facilitate a calmer transition during the evening hours. A. Providing a low-stimulation environment is the primary intervention for sundowning. Reducing noise, dimming lights, and minimizing staff transitions help lower the cognitive load on the client. Excessive stimuli can overwhelm an already compromised brain, leading to heightened anxiety, pacing, and potentially combative behavior in the late afternoon. B. Offering multiple activities can increase confusion and frustration. Clients with Alzheimer's disease struggle with executive function and decision-making. Providing too many choices can lead to "choice paralysis," which exacerbates anxiety. The nurse should instead offer simple, structured activities that are familiar and require minimal complex processing. C. Variation in routine is detrimental to clients with dementia. Consistency and predictability are essential for maintaining a sense of safety and reducing disorientation. Changes in the daily schedule or environment can trigger episodes of agitation and worsen the symptoms of sundown syndrome by removing familiar external cues. D. Questioning the client frequently about their orientation can be distressing and may highlight their cognitive deficits, leading to increased agitation or "catastrophic reactions." Instead of constant quizzing, the nurse should use gentle reorientation or validation therapy to support the client's emotional needs without causing unnecessary psychological stress.