A nurse enters a client's room and sees smoke coming from the trash can next to the client's bed. Which of the following actions should the nurse take first?

Choice A reason: This is the correct answer because auscultating the client's abdomen for bowel sounds is an assessment that can provide information about the client's bowel motility and function. The nurse should listen for at least 5 minutes in each quadrant and note the frequency, intensity, and quality of bowel sounds.

Choice B reason: This is not an appropriate action to take first because providing privacy with a set time to defecate is an intervention that can promote regular bowel elimination and prevent constipation. The nurse should perform this action after assessing the client's bowel sounds and other factors that may affect defecation, such as pain, medication, diet, and activity.

Choice C reason: This is not an appropriate action to take first because encouraging oral intake of fluids is an intervention that can soften stool and facilitate bowel movement. The nurse should perform this action after assessing the client's bowel sounds and fluid balance status.

Choice D reason: This is not an appropriate action to take first because administering a fiber-based laxative is an intervention that can increase bulk and stimulate peristalsis. The nurse should perform this action after assessing the client's bowel sounds and contraindications for laxatives, such as bowel obstruction, impaction, or perforation.

Choice A reason: This is not a good statement because refined grains are processed carbohydrates that have low nutritional value and high glycemic index, which can increase blood sugar and insulin levels and promote fat storage. The nurse should advise the client to choose whole grains instead, which are rich in fiber, vitamins, minerals, and antioxidants.

Choice B reason: This is not a good statement because rewarding oneself with special foods can undermine the weight loss efforts and create a negative association between food and achievement. The nurse should suggest other ways of rewarding oneself that are not food-related, such as buying new clothes, going to the movies, or getting a massage.

Choice C reason: This is not a good statement because planning meals so up to 40 percent of calories come from fats can exceed the recommended intake of fats, which is 20 to 35 percent of total calories. The nurse should also emphasize the importance of choosing healthy fats, such as monounsaturated and polyunsaturated fats, over saturated and trans fats, which can increase the risk of cardiovascular disease.

Choice D reason: This is a good statement because consuming 500 fewer calories per day than the estimated calorie needs can create a moderate energy deficit that can lead to a gradual and sustainable weight loss of about one pound per week. The nurse should also encourage the client to increase physical activity to burn more calories and preserve lean muscle mass.