A nurse is supervising an assistive personnel (AP) who is providing client care. The nurse should identify that which of the following actions by the AP demonstrates effective use of supplies?

A. "I limit my time spent out in the sunlight.": While moderate sun exposure can be beneficial for psoriasis, excessive sun exposure can worsen the condition or increase the risk of skin cancer. Limiting sunlight is generally a safe practice unless the client is avoiding it entirely, which is not indicated here.

B. "I try not to look at the scales on my body.": This statement suggests significant emotional distress or poor coping related to body image. Psoriasis can have profound psychological effects, including depression and anxiety, which must be reported to the provider to address the client’s mental health needs alongside physical treatment.

C. "I remove old medication on my skin before applying a new dose.": Proper application of topical medications includes cleaning old residue to promote better absorption of the new dose. This practice is appropriate and demonstrates an understanding of correct medication use.

D. "I do not use fabric softener when I wash my clothing.": Avoiding fabric softeners is a helpful strategy for clients with psoriasis because softeners can leave residues that irritate sensitive skin. This statement reflects good self-care behavior rather than a concern needing provider intervention.

A. Nonmaleficence: Nonmaleficence refers to the obligation to do no harm and to avoid causing injury. While this principle is always important in healthcare, the central issue in this scenario involves respecting the client's decision-making rights rather than directly preventing harm.

B. Autonomy: Autonomy is the ethical principle that supports a client's right to make their own healthcare decisions, even if those decisions differ from the wishes of others, including family members. Respecting the 18-year-old client's choice to decline surgery honors their legal and moral right to self-determination.

C. Beneficence: Beneficence involves taking actions that promote the well-being and best interests of the client. While advocating for the surgery could be seen as promoting beneficence, the nurse’s primary ethical duty in this situation is to respect the client’s independent decision.

D. Justice: Justice is concerned with fairness and the equitable distribution of healthcare resources. Although justice is a core ethical principle, it does not directly apply to an individual’s right to refuse treatment as seen in this situation.