A nurse is caring for a client who was hospitalized with a high blood alcohol content level. The provider fears the client may go into withdrawal and require medical supervision. The client's manifestations included anxiety, tremors, BP 166/100 mm Hg, and tachypnea about 1 hr ago. Now the client begins yelling out that they are seeing spiders crawling all over the walls. They believe they are at home and begin calling for their mother. The nurse should recognize that the client is experiencing which of the following stages of alcohol withdrawal?

The correct answer is B: Stage 3 (severe) alcohol withdrawal. The client is experiencing hallucinations, a symptom of severe withdrawal known as delirium tremens (DTs). DTs typically occur 48-72 hours after the last drink and are characterized by severe confusion, hallucinations, and autonomic instability. The client's symptoms, including seeing spiders and calling for their mother, indicate a disorientation to person, place, and time, which is consistent with DTs. The elevated blood pressure and tachypnea also suggest autonomic hyperactivity seen in severe withdrawal. Choices A, C, and D are incorrect because the client's symptoms go beyond mild or moderate withdrawal and are not indicative of a psychotic disorder.