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    HESI PN Exit Proctored ExamQuestion 104
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    HESI PN Exit Proctored Exam

    An older female adult who was admitted to a long-term care facility yesterday is confused about what day of the week it is. Her history does not indicate that she was confused prior to admission. What action should the practical nurse (PN) take?

    Explanation & Rationale

    This is the best action for the PN to take because it provides reality orientation and helps the client cope with the change in environment. The client may be experiencing acute confusion or delirium due to stress, medication, infection, or other factors. The PN should remind the client of the date, time, and place frequently and use other strategies such as calendars, clocks, and familiar objects to reduce confusion. A. Documenting the client's loss of memory in the record is not enough and does not address the client's needs. B. Notifying the family of the change in the client's condition is not a priority and may not be necessary if the confusion is temporary or reversible. D. Encouraging the client to rest during the day is not appropriate and may worsen the confusion or disrupt the sleep-wake cycle.

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