A patient at a long-term care facility makes the following statements regarding management of his constipation. Which statement would require follow-up teaching by the nurse?

Choice A reason: Vitamin D is a fat-soluble vitamin that helps the body absorb calcium and phosphorus, which are essential for bone health. The main source of vitamin D is exposure to sunlight, which triggers the skin to produce it. The nurse should advise the client to spend at least 15 minutes outdoors every day, preferably in the morning or evening, when the sun is not too strong. The client should also wear sunscreen and protective clothing to prevent sunburn and skin damage.

Choice B reason: Reducing the amount of cereal in the diet is not a good recommendation for increasing vitamin D intake. Cereal is often fortified with vitamin D and other nutrients, such as iron and folic acid. The nurse should encourage the client to choose cereals that are high in vitamin D and low in sugar and fat. The client should also consume other foods that are rich in vitamin D, such as fatty fish, egg yolks, cheese, and mushrooms.

Choice C reason: Increasing intake of dietary calcium is important for preventing and treating osteoporosis, but it does not directly affect vitamin D intake. Calcium is a mineral that helps build and maintain strong bones and teeth. The nurse should recommend the client to consume foods that are high in calcium, such as dairy products, leafy greens, nuts, and tofu. The client should also take a calcium supplement if needed, as prescribed by the provider.

Choice D reason: Adding a regular exercise routine is beneficial for improving overall health and well-being, but it does not directly influence vitamin D intake. Exercise helps strengthen the muscles and bones, prevent falls and fractures, and reduce the risk of chronic diseases. The nurse should suggest the client to engage in moderate physical activity for at least 30 minutes a day, three times a week. The client should choose exercises that are appropriate for their age and fitness level, such as walking, swimming, or yoga.

Choice A reason: This is the correct answer because it shows that the RN understands delegation as a way of managing time effectively. Delegation is the process of assigning tasks to other members of the health care team who are competent and qualified to perform them. By working with the LPN and nursing assistant on dividing up patient care tasks, the RN can ensure that the tasks are done safely, efficiently, and according to the scope of practice of each team member.

Choice B reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Working overtime until everything is finished is not a sustainable or productive strategy, as it can lead to fatigue, burnout, and errors. The RN should prioritize the tasks that are most important and urgent, and delegate the tasks that can be done by others.

Choice C reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Checking to make sure that the tasks are done correctly is part of the supervision and evaluation of delegation, but it is not the main goal of delegation. The main goal of delegation is to optimize the use of resources and skills of the health care team, and to provide quality care to the patients. The RN should trust and respect the abilities of the LPN and nursing assistant, and only intervene if there is a problem or a concern.

Choice D reason: This is not the correct answer because it shows that the RN does not understand delegation as a way of managing time effectively. Completing every nursing intervention or report by the end of the shift is not always possible or realistic, especially in a busy and dynamic health care environment. The RN should focus on the outcomes and quality of care, rather than the quantity of tasks. The RN should also communicate and collaborate with the other members of the health care team, and hand over any unfinished tasks to the next shift.