The nurse teaches the client that fiber provides the bulk in the stools to allow for easier defecation. The nurse recognizes that teaching is effective when the client's menu choices include more:

A. "How often do you punish him by giving him a time-out or by using physical discipline?": This response focuses on the mother's disciplinary methods rather than addressing the child's behavior directly. It may come across as judgmental or critical of the mother's parenting approach and does not provide helpful guidance or support.

B. "Physical punishment is not the best way to modify a child's behavior.": This response is appropriate because it addresses the mother's concern about punishment for the child's behavior. It educates the mother about the ineffectiveness and potential harm of physical punishment in modifying behavior. Instead, positive reinforcement, redirection, and open communication are recommended strategies for guiding children's behavior.

C. "It isn't unusual for him to fondle his genitals, as this is part of his exploration of his body.": This response normalizes the child's behavior of touching and playing with his genitals as part of natural childhood development. It reassures the mother that such behavior is common and not necessarily indicative of abnormality or misconduct. Education about normal childhood sexual development can alleviate parental concerns and promote understanding and acceptance.

D. "Constantly touching the genitals indicates a urinary tract infection in a toddler.": This response is incorrect and may unnecessarily alarm the mother. While frequent touching of the genitals could indicate discomfort or irritation associated with a urinary tract infection in a toddler, it is not the case for a 7-year-old child. Additionally, it is essential to avoid making medical diagnoses without proper assessment by a healthcare professional.

E. "Give him a little time, and he'll grow out of it. He's just too young to understand right now." This response acknowledges the child's developmental stage and suggests that the behavior is likely temporary and will naturally resolve as the child matures. It reassures the mother that the behavior is typical for a child of this age and may not require immediate intervention.

A. Tell him that he shouldn't feel embarrassed, saying that there are more people than we know who feel this way: While offering reassurance and normalization of the client's feelings may be well-intentioned, it may not address the client's immediate needs or provide tangible support. Additionally, assuming that "more people than we know" feel this way may not be accurate and could potentially invalidate the client's experience.

B. Provide information about support groups and other community resources for questioning and/or transgender people: This is the correct response. Providing information about support groups and community resources acknowledges the client's feelings and offers practical assistance in accessing additional support and resources. It demonstrates empathy, validation, and a commitment to assisting the client in finding the help and support they need.

C. Suggest that the client seek mental health care for medication to help him deal with his anxiety: While mental health care may be beneficial for addressing anxiety related to gender identity concerns, suggesting medication as the first line of treatment may not be appropriate without a comprehensive assessment by a mental health professional. Additionally, focusing solely on medication overlooks the importance of psychosocial support and other interventions.

D. Share with him that your nephew has experienced this, and tell him about that outcome: Sharing personal anecdotes may not be helpful in this situation, as it could potentially detract from the client's experience and needs. Each individual's experience with gender identity is unique, and the client may benefit more from information about professional resources and support groups.