A nurse is caring for a client who has borderline personality disorder (BPD). As part of the client's plan of care, the nurse reviews the day's schedule with the client each morning. As the nurse begins to review the schedule with the client, the client says, "Why don't you shut up already? I can read it myself, you know!" Which of the following responses should the nurse give the client?

A. 6 years:

By the age of 6, children typically have developed more advanced motor skills and coordination. Descending stairs by placing both feet on each step and holding onto the railing may be considered overly cautious for a 6-year-old.

B. 5 years:

At the age of 5, children may still be refining their motor skills, but they are usually capable of descending stairs using a more fluid motion, such as placing one foot on each step. Holding onto the railing for support is common but may not be as necessary as in younger children.

C. 4 years:

This is the correct answer. At the age of 4, children often descend stairs by placing both feet on each step and holding onto the railing for support. This method allows for increased stability and safety as they continue to develop balance and coordination.

D. 3 years:

While some children may start to learn how to descend stairs independently by the age of 3, they are more likely to use a one-foot-per-step method or require close supervision. Placing both feet on each step and holding onto the railing for support is less common at this age.

Therefore, option C is the most appropriate age for the described behavior, as it aligns with typical developmental milestones for stair-descending skills in children.

A. "I use a suppository every night to have a bowel movement": This statement indicates an appropriate understanding of managing bowel function, as regular bowel movements are essential for individuals with spinal cord injury to prevent complications such as constipation.

B. "I only need to catheterize myself twice every day": Individuals with spinal cord injury and paralysis often require intermittent catheterization at regular intervals to empty their bladders completely and prevent urinary retention. Twice-daily catheterization may not be sufficient for adequate bladder management and could lead to urinary complications such as urinary tract infections or bladder overdistention. The client may need further teaching to understand the importance of more frequent catheterization.

C. "I carry a water bottle with me because I drink a lot of water": Staying hydrated is crucial for individuals with spinal cord injury to prevent urinary tract infections and maintain overall health. Carrying a water bottle indicates an appropriate understanding of the importance of hydration.

D. "I do wheelchair exercises while watching TV": Engaging in wheelchair exercises is beneficial for maintaining strength, mobility, and overall health for individuals with spinal cord injury. This statement demonstrates an understanding of the importance of physical activity and exercise in the client's daily routine.