Progressive Care Nursing Certification (PCCN) Practice Exam

What is the best initial action for a nurse caring for a patient with hepatic failure who is confused about time, place, and person?

1. Reorient the patient

2. Increase the frequency of patient observation

3. Restrain the patient

4. Administer a mild sedative

The correct answer is: Reorient the patient

Reorienting the patient is the best initial action when caring for someone with hepatic failure who is experiencing confusion about time, place, and person. This approach aims to provide immediate support and can help alleviate confusion by reminding the patient of their surroundings, the current date, and their identity. Such a strategy can assist in reducing anxiety and promoting a sense of safety, which is essential in a setting where cognitive changes are prevalent. Caring for patients with hepatic failure often includes addressing neurological changes associated with hepatic encephalopathy, which can manifest as confusion and disorientation. By offering reorientation, the nurse is not only supporting cognitive function but also fostering engagement and participation in care, which can be beneficial for the patient's overall mental state. Increasing the frequency of patient observation is important, especially in this context, as patients with hepatic failure may be at risk for further neurological deterioration. However, it does not directly address the immediate confusion the patient is experiencing. Restraint is rarely appropriate in these situations due to ethical considerations and the potential for physical harm or distress to the patient. Physical restraints can also exacerbate agitation and confusion. Administering a mild sedative may be considered for agitation or severe anxiety but does not directly address the patient's confusion and could further impair