A nurse in a long-term care facility is planning to use therapeutic touch for a group of selected clients who have chronic pain. The nurse should identify that the use of therapeutic touch is contraindicated for which of the following clients?

A. Determine the source of the client's stress: The first step in managing insomnia related to stress is assessing and identifying the underlying cause. Understanding the source allows the nurse to tailor interventions effectively and ensures that care addresses the root of the problem rather than just the symptoms.

B. Instruct the client to turn off their TV just before they go to bed: Reducing screen time before sleep is helpful in promoting rest, but this is a specific behavioral strategy. It should follow an assessment of the client’s stressors and sleep patterns to be applied appropriately.

C. Encourage the client to listen to soft music at the onset of stress: Relaxation techniques such as music therapy can aid stress reduction, but they are supportive measures. Without assessing the client’s unique stressors first, these interventions may not fully address the insomnia.

D. Advise the client to exercise daily in the morning: Morning exercise can improve sleep quality and reduce stress, but it is a long-term strategy. The nurse must first explore the client’s stress triggers to ensure that interventions are individualized and effective.

A. Witnessing a client's signature for informed consent: Witnessing consent is a legal responsibility, not an advocacy role. The nurse verifies the client’s signature but does not address the client’s needs or ensure their voice is represented in care decisions.

B. Instructing a client about how to apply antiembolic stockings: Teaching a client is part of health promotion and nursing education. While important, it does not represent advocacy since it does not involve speaking up or acting on behalf of the client’s expressed needs.

C. Ensuring that all clients receive equal treatment: Providing equitable care is an ethical obligation for all nurses but does not fully represent advocacy. Advocacy specifically involves acting on a client’s behalf when barriers or unmet needs are identified.

D. Requesting a social services consultation for a client who states they cannot afford their medications: This is advocacy because the nurse is acting on the client’s expressed concern and connecting them to resources that address barriers to care. It ensures the client’s health needs are supported beyond routine clinical interventions.