Difficulty: Medium
Average Score: 95%
Simulated
The client is admitted to the hospital for alcohol detoxification. Which of the following interventions should the nurse use? Select all that apply.
Correct answer
A, B, D, E
Rationale
Interventions include: Taking vital signs (A) to monitor stability, monitoring intake and output (B) to assess hydration, reinforcing reality (D) to manage disorientation, and explaining withdrawal symptoms are temporary (E) to reduce anxiety. Restraints (C) are not routinely used unless safety is imminently threatened.