A nurse is caring for a client who reports difficulty falling asleep at night. Which of the following recommendations should the nurse make?

Choice A reason: Completing exercise at least 2 hours before bedtime is an evidence-based recommendation for promoting sleep. Exercise increases alertness and body temperature, which can interfere with sleep if performed too close to bedtime. Allowing a 2-hour window helps the body return to a restful state, making this the correct answer. Choice B reason: Reading a book in bed when having difficulty sleeping is not recommended because it conditions the brain to associate the bed with wakefulness rather than sleep. Sleep hygiene practices emphasize using the bed only for sleep and intimacy to strengthen the association between bed and rest. Choice C reason: While avoiding alcohol before bedtime is beneficial, the specific recommendation is to avoid alcohol altogether as it disrupts sleep cycles and reduces REM sleep. Alcohol may initially induce drowsiness but leads to fragmented sleep later in the night. The 3-hour timeframe is not a standard evidence-based guideline, making this choice incorrect. Choice D reason: Keeping the bedroom at a cool temperature can promote sleep, but it is not the most direct or primary recommendation for difficulty falling asleep. While environmental adjustments are helpful, the strongest evidence supports timing of exercise as a key intervention. Thus, this option is supportive but not the best answer.