Which routine screening is recommended for older adults to detect colorectal cancer?

Choice A rationale

Focusing on tasks instead of the client's feelings describes a task-oriented approach rather than a therapeutic relationship. While completing clinical tasks is necessary for physical care, the therapeutic relationship requires a focus on the client's subjective experience and emotional well-being. Neglecting the client's feelings can lead to a sense of depersonalization, where the individual feels like a set of symptoms rather than a human being. Empathy and active listening are the drivers of therapeutic success.

Choice B rationale

Maintaining clear and professional boundaries is the foundation of a safe and effective nurse-client relationship. These boundaries protect both the client and the nurse by ensuring that the focus remains entirely on the client's therapeutic goals. Boundaries define the limits of the professional role and prevent the relationship from becoming personal or exploitative. Without these limits, the nurse's objectivity may be compromised, and the client may feel confused about the nature of the support they are receiving.

Choice C rationale

Discussing the nurse's personal life with the client is known as self-disclosure and should be used very sparingly, if at all. When a nurse talks about their own problems or life events, the focus shifts away from the client. This can burden the client with the nurse's issues and blur the professional lines of the relationship. A therapeutic relationship must be client-centered, meaning every interaction is intentionally designed to benefit the client rather than satisfy the nurse's social needs.

Choice D rationale

Establishing social friendships with the client is a violation of professional boundaries and can lead to unethical situations. A therapeutic relationship is asymmetrical by nature, as it exists to serve the needs of the client through the nurse's expertise. Friendships imply a mutual exchange of support and a social equality that does not fit the clinical context. Converting a professional connection into a friendship can impair the nurse's clinical judgment and create dependencies that hinder the client's independence.

Choice A rationale

Fortified meals are designed to provide essential vitamins and minerals, such as Vitamin D, B12, and calcium, which are often deficient in older populations. Consuming these meals daily typically prevents nutritional deficits rather than contributing to malnourishment. In clinical practice, fortification is a primary intervention to ensure that caloric intake meets metabolic demands when appetite is decreased due to physiological changes or chronic illness.

Choice B rationale

Engaging in regular physical activity helps maintain muscle mass and metabolic rate in older adults. While excessive exercise without adequate caloric compensation could theoretically lead to weight loss, moderate activity generally stimulates appetite and improves nutrient absorption. It prevents sarcopenia, which is the age-related loss of muscle tissue. Physical activity is considered a protective factor against the frailty often associated with severe malnourishment in geriatric patients.

Choice C rationale

Substance use disorder significantly increases the risk of malnourishment because it often leads to the prioritization of the substance over food intake. Alcohol or drug use can interfere with the absorption of nutrients in the gastrointestinal tract and alter metabolic processes. Additionally, substances can suppress the appetite or lead to cognitive impairments that prevent the individual from preparing or purchasing healthy meals, resulting in severe deficiencies.

Choice D rationale

A strong social network is a protective factor against malnutrition in the elderly. Social isolation is a well-documented cause of "tea and toast" syndrome, where lonely individuals lose the motivation to cook balanced meals. Having friends or family members to eat with increases the likelihood of adequate caloric intake and provides a support system to identify early signs of weight loss or declining health before they become critical.