A nurse is assisting with the admission of a client who has Hodgkin's disease and is receiving chemotherapy. Because a private room is not available, the nurse should recommend that the client share a room with a client who has which of the following diagnoses?

A. Loss of urinary control: Thoracic spinal cord injuries disrupt autonomic and somatic pathways controlling bladder function. Damage at the thoracic level can impair signals between the brain and the sacral micturition center, leading to neurogenic bladder. Clients may experience urinary retention, incontinence, or reflexive voiding, requiring monitoring and interventions such as catheterization or bladder training.

B. Inability to clear secretions: Impaired secretion clearance is primarily a risk for cervical spinal cord injuries, which compromise innervation of the diaphragm and accessory respiratory muscles. Thoracic injuries usually preserve diaphragmatic function, allowing effective breathing and cough reflex, so secretion clearance is typically maintained.

C. Decreased fine motor hand movement: Fine motor control of the hands depends on cervical spinal cord innervation, particularly C6–C8 levels. A thoracic injury does not affect upper extremity motor neurons, so hand dexterity and fine motor skills are generally preserved.

D. Difficulty swallowing: Dysphagia occurs with lesions affecting cranial nerve nuclei or high cervical spinal cord injuries that impair pharyngeal and laryngeal muscle innervation. Thoracic spinal cord injuries do not impact swallowing mechanisms because these structures are innervated above the level of the thoracic spine.

A. Wheat toast and jelly: Wheat contains gluten, which triggers an immune response in clients with celiac disease. Consuming wheat products can damage the intestinal villi and exacerbate malabsorption and gastrointestinal symptoms, making this an inappropriate choice.

B. Graham crackers with peanut butter: Graham crackers are typically made with wheat flour and contain gluten. Even paired with peanut butter, this snack is unsafe for a child with celiac disease and should be avoided to prevent intestinal injury and nutrient deficiencies.

C. Beef barley soup: Barley contains gluten and is contraindicated for clients with celiac disease. Including barley in the diet can provoke symptoms such as diarrhea, abdominal pain, and long-term intestinal damage.

D. Corn tortillas with black beans: Corn and black beans are naturally gluten-free and safe for children with celiac disease. This combination provides a balanced source of carbohydrates and protein without triggering the autoimmune response associated with gluten ingestion.