A nurse is teaching a client about bladder retraining for incontinence. Which of the following instructions should the nurse include in the teaching?

A) Avoid eye contact with the client: Avoiding eye contact can create a sense of distance and may not promote a therapeutic relationship. Establishing appropriate eye contact can help convey attentiveness and support, even in clients experiencing hallucinations.

B) Encourage the client to lie down in a quiet room: While a quiet environment can be calming, simply lying down may not effectively address the hallucinations. Active engagement and coping strategies are often needed to help the client manage their symptoms.

C) Ask the client directly what he is hearing: This action is appropriate and therapeutic. By asking the client about their auditory hallucinations, the nurse validates the client’s experience and can help guide the conversation to better understand their perceptions and needs. This can also assist in developing coping strategies.

D) Refer to the hallucinations as if they are real: Acknowledging hallucinations as real can reinforce the delusional experience rather than helping the client to cope with or understand their symptoms. It is essential to approach the subject sensitively while maintaining a focus on reality, promoting safety and support.

A) Playing with an imaginary friend: While imaginative play does begin to develop in toddlers, having an imaginary friend is more typical in older preschool-aged children, around 3 to 4 years old. Therefore, this activity may not be expected in a 30-month-old child.

B) Playing with a large plastic truck: At 30 months old, children are typically engaged in parallel play and are interested in toys that promote gross motor skills and imaginative play. Playing with a large plastic truck is developmentally appropriate, as children at this age enjoy manipulating vehicles and may engage in simple pretend play related to driving or racing.

C) Playing with dress-up clothes: Although some children may enjoy dress-up, this activity tends to be more prominent in slightly older toddlers and preschoolers. A 30-month-old may show interest in dressing up but may not engage in it as frequently or with as much understanding of role play as older children.

D) Playing with a jump rope: Jump rope activities require a level of coordination and motor skills that are typically beyond what a 30-month-old child can achieve. At this age, children are still developing basic motor skills and would not yet be proficient in using a jump rope effectively.