Mr. Olsen, age 75 years, lives in a nursing home and is diagnosed with mild dementia. Occasionally he attempts to get out of bed during the night and is a risk for falls. What nursing intervention should the practical nurse use to ensure his safety?

Choice A reason: Placing the bed in the lowest position is a primary falls prevention strategy for patients with dementia. It minimizes the distance to the floor if the patient attempts to exit the bed unassisted, thereby reducing the impact and severity of potential injuries while maintaining the patient's dignity and autonomy. Choice B reason: Restricting fluids after 1800H (6:00 PM) is generally discouraged as it can lead to dehydration and urinary tract infections in the elderly. While it might reduce nocturia, it does not address the underlying cognitive impairment causing the patient to wander or attempt to exit the bed during the night. Choice C reason: The application of physical restraints, especially on a PRN (as needed) basis, is ethically and legally restricted. Restraints often increase agitation in patients with dementia and can lead to serious injuries or strangulation. They are considered a last resort and require specific, time-limited physician orders. Choice D reason: Using four side rails is often classified as a form of physical restraint. For a patient with dementia, side rails can create a "caging" effect, leading the patient to attempt to climb over them. This significantly increases the risk of falling from a greater height, leading to more severe head or hip injuries.