A nurse is caring for a client who is at 26 weeks of gestation. Which of the following statements indicates the client is having difficulty accepting the body image changes associated with pregnancy?

A. "Our child has increased his daily caloric intake." Methylphenidate is a stimulant that commonly suppresses appetite, leading to decreased caloric intake and potential weight loss. An increase in appetite would not indicate medication effectiveness but might suggest the dose is too low or the medication is wearing off.
B. "Our child is able to complete his homework on time." Methylphenidate is used to improve attention, impulse control, and focus in children with ADHD. The ability to complete tasks, such as finishing homework on time, demonstrates improved concentration and executive functioning, which indicates the medication is working effectively.
C. "Our child has a better grasp of reality." ADHD is not primarily associated with a loss of reality testing, as seen in psychotic disorders. While methylphenidate improves focus and impulse control, it does not target symptoms such as delusions or hallucinations.
D. "Our child has lost some weight since his last appointment." Weight loss is a common side effect of methylphenidate due to appetite suppression. While this can be monitored, it does not indicate medication effectiveness in treating ADHD symptoms.

A. "Discarding worksheets containing client information in a wastebasket." Client information should be disposed of properly to prevent unauthorized access. Documents containing protected health information should be shredded or placed in designated confidential disposal bins rather than a regular wastebasket.
B. "Writing a client's diagnosis on the message board in the client's room." Publicly displaying a client’s diagnosis can lead to unauthorized disclosure of protected health information. While message boards can be used for general reminders such as scheduled tests, they should not include sensitive medical details.
C. "Discussing a client's prognosis with an assistive personnel who is caring for the client." While assistive personnel may need to know some aspects of a client’s care, discussing a prognosis typically falls outside their scope of practice and should be limited to appropriate healthcare professionals involved in decision-making.
D. "Giving change-of-shift report to a nurse outside the client's room." Conducting shift reports in a private or semi-private setting with only authorized personnel helps protect client confidentiality. While reports may sometimes occur at the bedside for continuity of care, they should be done in a way that minimizes exposure of personal health information to others who are not directly involved in the client's care.