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?

Answer: C, D, E

A. The preschooler speaks in three-word sentences.
Speaking in three-word sentences is generally considered developmentally appropriate for a preschooler. By age 3 to 4, children typically use sentences that are more complex, but this is still within a normal range for early language development.

B. The preschooler talks to himself when reading.
Talking to oneself, especially during activities like reading, can be a normal behavior for preschoolers. This self-talk can actually be a part of cognitive development, helping them to process information and reinforce learning, and does not necessarily indicate a need for speech therapy.

C. The preschooler speaks in a nasally tone.
A nasally tone may suggest a speech issue such as a cleft palate or other resonance problems. If the child consistently exhibits this speech pattern, it could indicate a need for further evaluation by a speech therapist to determine the underlying cause and appropriate interventions.

D. The preschooler stutters when speaking.
Stuttering can be a significant speech concern that may require intervention. While some children experience normal disfluencies as they learn to speak, persistent stuttering that interferes with communication is a valid reason to refer the child for speech therapy.

E. The preschooler mispronounces words.
While mispronunciation can occur during language development, consistent or unusual mispronunciations beyond what is typical for the child’s age may indicate a speech sound disorder. If the mispronunciations affect the child's ability to communicate effectively, a referral to a speech therapist would be warranted for assessment and intervention.

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.