A nurse is preparing to administer testosterone gel to a client who has hypogonadism. Which of the following actions should the nurse take?

Choice A reason: Decreasing fluid intake to firm stools is incorrect, as adequate hydration (2-3 L/day) is essential to prevent constipation, especially with opioids like oxycodone, which slow intestinal motility. Low fluid intake hardens stools, exacerbating constipation risk by reducing water content in the colon, indicating a misunderstanding of prevention strategies.
Choice B reason: Increasing dietary fiber intake (25-35 g/day) adds bulk to stools, stimulating peristalsis and counteracting opioid-induced slowed motility. Soluble and insoluble fiber, found in fruits, vegetables, and whole grains, promotes regular bowel movements. This statement reflects correct understanding of dietary measures to prevent constipation during opioid therapy.
Choice C reason: Taking a laxative only when constipated is reactive, not preventive. Opioids like oxycodone commonly cause constipation by reducing peristalsis via mu-opioid receptors in the gut. Prophylactic use of stool softeners or laxatives is recommended to maintain regular bowel movements, making this statement incorrect as it lacks a preventive approach.
Choice D reason: Exercising less to conserve energy worsens constipation, as physical activity stimulates intestinal motility, countering opioid-induced slowing. Regular movement, like walking, promotes bowel function by enhancing peristalsis and blood flow to the gut. This statement indicates a misunderstanding, as reduced activity increases constipation risk.

Choice A reason: Assigning a health care surrogate does not always require legal consultation, as forms are often available without attorney involvement. While legal advice can clarify complex cases, it is not mandatory, making this statement misleading and incorrect for general advance directive education.
Choice B reason: A health care surrogate makes decisions when the client is incapacitated, as specified in advance directives. This ensures the client’s wishes are followed, aligning with the purpose of surrogacy in healthcare planning, making it accurate and essential information for the teaching session.
Choice C reason: Advance directives can be changed at any time by a competent client, provided the changes are documented and communicated. Stating they cannot be changed is incorrect, as flexibility is a key feature, making this misinformation inappropriate for teaching.
Choice D reason: Advance directives are generally honored across states, though specific requirements may vary. Stating they are only valid in one state is overly restrictive and incorrect, as reciprocity is common, making this an inaccurate point for advance directive education.