A nurse is reinforcing teaching about complete and incomplete proteins with a client who has a prescription for a high-protein diet. The nurse should identify which of the following foods as sources of complete proteins? (Select all that apply.)

A. Document in the client's medical record every 15 min: Frequent documentation is required to monitor the client’s safety, physical and psychological status, and ongoing need for restraints. This includes checking circulation, skin integrity, respiratory status, and mental condition. Documentation every 15 minutes ensures compliance with regulatory standards and provides a detailed record of care while the client is restrained.

B. Offer toileting to the client every 4 hr: Clients in restraints should be offered toileting, hydration, and nutrition more frequently than every 4 hours, generally every 1–2 hours, to prevent complications such as skin breakdown, urinary retention, or dehydration. Waiting 4 hours is unsafe and does not meet standard restraint care guidelines.

C. Remove the restraint when the client falls asleep: Restraints should not be removed solely based on sleep. Continuous monitoring is essential, and restraints are only removed or adjusted based on the client’s behavior, safety status, and provider orders. Sleep does not automatically indicate that the client is safe to be unrestrained.

D. Request that the provider write an as-needed prescription for restraints: Restraints cannot be prescribed on an as-needed basis. They must be ordered with specific parameters including type, duration, and reason for use. Using restraints without a proper order or relying on as-needed instructions is outside legal and professional practice standards.

A. A nurse shares her time fairly among clients: This action demonstrates justice, which involves treating clients equitably and distributing resources or time fairly. While important ethically, it does not exemplify fidelity, which focuses on faithfulness and keeping commitments.

B. A nurse tells a client the truth: Telling the truth reflects the ethical principle of veracity, emphasizing honesty and transparency in communication. It is distinct from fidelity, which centers on maintaining trust through promises and commitments.

C. A nurse allows a client to make her own choices: Supporting client autonomy involves respecting the client’s right to make informed decisions about their care. While ethically essential, autonomy differs from fidelity because it is about decision-making rights rather than keeping commitments or promises.

D. A nurse keeps a promise made to a client: Fidelity is the principle of being faithful to commitments, maintaining trust, and keeping promises. When a nurse follows through on a commitment to a client, it demonstrates reliability and loyalty, reinforcing the therapeutic nurse–client relationship.