A client is receiving rehabilitation for paralysis following a spinal cord injury and is diagnosed with reflex incontinence. Which of the following is the highest priority intervention the nurse should include in the plan of care?

Choice A reason: Scheduling energy-intensive activities at the time of day when the client has higher energy levels is the best activity plan for conserving the client's energy without compromising physical or mental health, as it allows the client to perform the tasks that require more effort and endurance when they feel more alert and capable. This can help the client to avoid fatigue, frustration, and injury, and to achieve their goals more effectively. The nurse should assess the client's individual preferences and patterns of energy fluctuation, and help them to prioritize and plan their activities accordingly.

Choice B reason: Scheduling all activities within a small block of time to allow the client a longer, uninterrupted rest period is not a good activity plan for conserving the client's energy without compromising physical or mental health, as it may cause the client to overexert themselves and deplete their energy reserves. This can lead to exhaustion, pain, and stress, and impair the client's recovery and quality of life. The nurse should advise the client to balance their activities with adequate rest periods throughout the day and to avoid doing too much or too little at once.

Choice C reason: Scheduling toilet breaks before and after any other planned activity is not a good activity plan for conserving the client's energy without compromising physical or mental health, as it may not be realistic or feasible for some clients. Some clients may have urinary or bowel problems that require them to use the toilet more frequently or urgently, such as incontinence, infection, or constipation. Forcing them to follow a rigid schedule may cause them discomfort, embarrassment, or complications. The nurse should assess the client's elimination needs and habits, and help them to manage their toileting needs in a comfortable and convenient way.

Choice D reason: Scheduling the client's hygiene activities and limiting visitors is not a good activity plan for conserving the client's energy without compromising physical or mental health, as it may neglect the client's social and emotional needs. Hygiene activities are important for maintaining the client's physical health and well-being, but they can also be tiring and challenging for some clients. Limiting visitors may reduce the noise and stimulation in the environment, but it can also isolate the client from their family and friends who can provide support and companionship. The nurse should assist the client with their hygiene needs as needed, and encourage them to interact with their visitors as tolerated.

Choice A reason: The inability to take risks is not a quality of an effective nurse leader, as it may limit the leader's potential for growth, innovation, and improvement. Effective nurse leaders are willing to take calculated risks that are based on evidence, experience, and intuition. They are also able to learn from their mistakes and failures and use them as opportunities for development.

Choice B reason: Never consider being a follower is not a quality of an effective nurse leader, as it may indicate a lack of flexibility, collaboration, and respect for others. Effective nurse leaders are able to adapt to different situations and roles, depending on the needs and goals of the team. They are also able to recognize the strengths and contributions of their followers and empower them to achieve their full potential.

Choice C reason: The ability to set priorities is a quality of an effective nurse leader, as it helps the leader to focus on the most important and urgent tasks and goals. Effective nurse leaders are able to identify the needs and expectations of their clients, staff, and organization, and allocate their time, resources, and energy accordingly. They are also able to delegate tasks appropriately and efficiently.

Choice D reason: Integrity is a quality of an effective nurse leader, as it reflects the leader's honesty, trustworthiness, and ethical standards. Effective nurse leaders are able to act in accordance with their values and principles, and uphold the professional code of conduct. They are also able to communicate openly and transparently, and accept responsibility and accountability for their actions and decisions.

Choice E reason: Critical care certification is not a quality of an effective nurse leader, as it is not a requirement or a guarantee for leadership success. Critical care certification is a credential that demonstrates the nurse's knowledge and competence in providing care to critically ill patients. While it may enhance the nurse's clinical skills and confidence, it does not necessarily reflect the nurse's leadership skills or abilities. Effective nurse leaders can come from various backgrounds and specialties, as long as they have the necessary qualities and attributes that enable them to lead others effectively.