A client with a history of chronic renal failure receives hemodialysis treatment three times per week through an arteriovenous (AV) fistula in the left arm. Which priority intervention should the nurse include in the care plan?

Choice A reason: Neighborhood watch programs enhance community safety but do not directly address mental health needs. They lack therapeutic components to manage symptoms or prevent decompensation, which are critical for preventing readmission in clients with mental health disorders, making this factor less relevant to sustained community stability.

Choice B reason: Taking meals at a food bank addresses nutritional needs but does not directly support mental health stability. While nutrition is important, it does not provide the therapeutic interventions or coping strategies needed to manage mental health disorders and prevent relapse or hospital readmission.

Choice C reason: Participation in treatment, such as therapy or medication adherence, directly addresses mental health symptoms, improving coping skills and emotional regulation. Consistent treatment reduces relapse risk, enhances stability, and supports community integration, making it the most effective factor for preventing readmission in clients with mental health disorders.

Choice D reason: A safe living environment reduces stress and safety risks but is secondary to active treatment. Without ongoing therapy or medication, environmental safety alone cannot manage symptoms or prevent decompensation, making it less critical than treatment participation for maintaining community stability and avoiding readmission.

Choice A reason: Ignoring sexually aggressive behavior is unsafe and unprofessional, as it fails to address potential escalation or harm. Aggression may stem from impulsivity or mental health conditions, requiring intervention to ensure safety and maintain therapeutic boundaries, making this response inadequate and risky in a behavioral health setting.

Choice B reason: Setting firm limits and boundaries establishes clear expectations, reducing inappropriate behavior while maintaining safety. This approach addresses the client’s impulsivity or lack of control, common in mental health disorders, by reinforcing professional conduct and ensuring a therapeutic environment, making it the most effective and safe response.

Choice C reason: Walking away and delegating care avoids addressing the behavior, potentially escalating the client’s aggression or disrupting care continuity. It fails to establish boundaries, which are critical for managing behavioral issues in mental health settings, and may undermine the client’s trust in the therapeutic process, making it inappropriate.

Choice D reason: Reporting to the director without first addressing the behavior skips essential de-escalation steps. While reporting may be needed for persistent issues, immediate boundary-setting is more appropriate to manage aggression, maintain safety, and support therapeutic goals, making this response less effective as an initial action.