A nurse advises a client with osteoporosis to have three servings of milk or dairy products daily. Which of the following levels of prevention is being used by the nurse?

Choice A reason: Planning medication doses to occur before meals is a good suggestion to improve the client's nutritional status. Myasthenia gravis is a neuromuscular disorder that causes weakness and fatigue of the voluntary muscles, especially those involved in chewing and swallowing. Taking anticholinesterase medications before meals can enhance muscle strength and coordination, and make it easier for the client to eat and avoid choking or aspiration.

Choice B reason: Restricting drinking fluids before and during meals is not a good suggestion to improve the client's nutritional status. Fluid intake is important for hydration and digestion, and should not be limited unless there is a medical reason, such as fluid overload or heart failure. Drinking fluids before and during meals can also help lubricate the food and prevent dryness or irritation of the mouth and throat.

Choice C reason: Increasing the amount of fat and carbohydrates in meals is not a good suggestion to improve the client's nutritional status. Fat and carbohydrates are sources of energy, but they can also increase the risk of obesity, diabetes, or cardiovascular disease if consumed excessively. A balanced diet that includes adequate protein, vitamins, minerals, and fiber is more beneficial for the client's health and well-being.

Choice D reason: Eating three large meals per day is not a good suggestion to improve the client's nutritional status. Eating large meals can be difficult and exhausting for the client with myasthenia gravis, as their muscle strength and endurance may decline over time. Eating smaller and more frequent meals can help maintain the energy level and prevent fatigue or hunger.

Choice A reason: Developing a survey on teen pregnancies is not a priority intervention for a public health nurse who is assigned to a new community. This is a specific topic that may not be relevant or important for the whole population. A survey also requires time and resources to design, distribute, and analyze.

Choice B reason: Holding a focus group to discuss immunizations is not a priority intervention for a public health nurse who is assigned to a new community. This is a specific topic that may not be representative of the community's health needs and concerns. A focus group also requires recruitment, facilitation, and interpretation of the participants' views.

Choice C reason: Interviewing the elderly at the senior center is not a priority intervention for a public health nurse who is assigned to a new community. This is a specific group that may not reflect the diversity and characteristics of the whole population. An interview also requires consent, rapport, and recording of the responses.

Choice D reason: Performing a windshield survey is a priority intervention for a public health nurse who is assigned to a new community. This is a general method that allows the nurse to observe and assess various aspects of the environment that affect the health and well-being of the population. A windshield survey also requires minimal resources and can be done quickly and easily. A windshield survey is a method of assessing the health needs and resources of a community by driving or walking around and observing various aspects of the environment, such as housing, transportation, services, and safety. This is a priority intervention for a public health nurse who wants to get a comprehensive overview of the community and identify its strengths and weaknesses.