A nurse is assisting with teaching a client about consuming a healthy diet to reduce stress. Which of the following instructions should the nurse include?

Choice A reason : The "Good boy-nice girl" orientation is part of Kohlberg's Conventional level of moral development. In this stage, individuals are motivated by the desire to maintain relationships and gain approval from others. They make decisions based on what will please others and show concern for others by being "nice." This stage does not typically involve challenging rules but rather adhering to them to maintain social harmony⁴.

Choice B reason : The "Punishment and obedience" orientation is the first stage of Kohlberg's Preconventional level. Here, the focus is on direct consequences to the individual : actions are judged as good if they help avoid punishment. This stage is characterized by a literal obedience to rules and authority to avoid negative consequences, not by challenging them⁴.

Choice C reason : The "Law and order" orientation is the fourth stage, also within the Conventional level. In this stage, individuals are oriented to abiding by the law and respecting authority. They believe in maintaining the social order by following rules and laws. Challenging rules is not a characteristic of this stage; instead, there is a focus on upholding laws as they are⁴.

Choice D reason : The "Social contract" orientation is part of the Postconventional level of moral development, specifically the fifth stage. Individuals in this stage believe that rules and laws are flexible instruments for furthering human purposes. They can argue for the legality or principle behind the rule and may challenge rules that infringe on the rights of individuals. They understand that laws are created by people and can be changed by them. This stage involves the recognition that individual rights sometimes need to be upheld over and above the law⁴.

Choice A reason : The term "alert" is an objective finding in the nursing assessment. It refers to the client's level of consciousness and responsiveness to stimuli, which can be directly observed and measured by the nurse during the evaluation. Being alert is a state that is evident through the client's behavior, responses, and interactions.

Choice B reason : "Pacing" is an objective finding. It is a visible behavior that can be observed and documented by the nurse without the need for interpretation or reliance on what the client says. Pacing can be quantified by the number of times the client walks back and forth in a given period.

Choice C reason : "Anxiety" is a subjective finding because it is based on the client's personal feelings and cannot be directly observed or measured by the nurse. It is reported by the client and requires the nurse to rely on the client's expression of their emotional state.

Choice D reason : "Restless" is an objective finding. Restlessness can be observed as physical movements, such as the inability to stay still, fidgeting, or frequent changes in position. These are behaviors that the nurse can see and document.