A community health nurse is conducting an educational program on various environmental pollutants. The nurse should emphasize that clients who have which of the following disorders are especially vulnerable to ozone effects?

Choice A reason: Giving care with a focus on the aggregate's needs is not the best description of client-focused community-based nursing, as it implies that the nurse is providing care to a population or a group of individuals who share some common characteristics or risk factors. This is more aligned with the concept of population-focused community-based nursing, which aims to improve the health outcomes of a defined group of people.

Choice B reason: A philosophy that guides family-centered illness care is the best description of client-focused community-based nursing, as it reflects the core values and principles of this approach. Client-focused community-based nursing is a model of care that emphasizes the individual and family as the unit of care, rather than the disease or the health problem. It involves collaborating with the client and family to identify their needs, preferences, strengths, and resources, and providing holistic, culturally sensitive, and evidence-based care that promotes health, wellness, and quality of life.

Choice C reason: Providing care with a focus on the group's needs is not the best description of client-focused community-based nursing, as it suggests that the nurse is providing care to a collective or a social unit that shares some common goals or interests. This is more aligned with the concept of community-oriented community-based nursing, which aims to improve the health status of a specific community or subpopulation.

Choice D reason: A value system in which all clients receive optimal care is not the best description of client-focused community-based nursing, as it does not capture the essence or uniqueness of this approach. While it is true that client-focused community-based nursing strives to provide high-quality care to all clients, it also recognizes that each client and family has different needs, preferences, and expectations that require individualized and tailored interventions.

Choice A reason: Providing total assistance with all ADLs is not an intervention that should be included in the client's plan. ADLs are activities of daily living, such as bathing, dressing, eating, and toileting. Providing total assistance with all ADLs can reduce the client's independence and self-esteem, and increase their dependence and learned helplessness. The nurse should encourage and assist the client to perform as much as they can by themselves and provide partial or intermittent assistance only when needed.

Choice B reason: Ordering a low-residue diet is not an intervention that should be included in the client's plan. A low-residue diet is a type of diet that limits foods that are high in fiber or indigestible material, such as whole grains, nuts, seeds, fruits, and vegetables. A low-residue diet may be recommended for clients who have inflammatory bowel disease (IBD), diverticulitis, or bowel obstruction, as it can reduce bowel frequency and irritation. However, it is not indicated for clients who have MS, unless they have other comorbidities that require it. A balanced diet that includes adequate fiber, fluids, and nutrients is more beneficial for clients who have MS.

Choice C reason: Encouraging the client to void every hour is not an intervention that should be included in the client's plan. Voiding every hour can be inconvenient and impractical for the client, and may not address their bladder problems effectively. MS can cause bladder dysfunction, such as urinary urgency, frequency, incontinence, or retention, due to nerve damage that affects bladder control. The nurse should assess the type and severity of the bladder dysfunction, and provide appropriate interventions, such as medication, catheterization, pelvic floor exercises, or bladder training.

Choice D reason: Instructing the client on daily muscle stretching is an intervention that should be included in the client's plan. Muscle stretching is a type of exercise that involves extending or elongating a muscle or group of muscles to their full length. Muscle stretching can help prevent or relieve muscle spasticity, stiffness, pain, or contractures that may occur in clients who have MS. The nurse should teach the client how to perform muscle stretching safely and correctly, and encourage them to do it daily or as prescribed.