A nurse learns that which of the following is the single biggest risk factor for developing cancer?

Choice A rationale:
Weight gain is the most objective and reliable indicator of improved nutritional status in patients with HIV-II and wasting syndrome. It directly reflects an increase in lean body mass, which is essential for restoring physical strength, immune function, and overall health.
A weight gain of 2 lb (1 kg) in a month is considered a clinically significant improvement for this patient population. It demonstrates that the patient is consuming more calories than they are expending, leading to a positive energy balance and tissue growth.
Other assessment findings, such as food intake, food choices, and oral discomfort, can be subjective and influenced by various factors, such as appetite, taste changes, nausea, fatigue, and psychosocial issues. While they provide valuable information about the patient's nutritional status, they do not directly measure the actual improvement in body composition.
Choice B rationale:
Consuming 90% of meals and snacks is a positive sign that the patient is adhering to their dietary recommendations. However, it does not guarantee that they are consuming enough calories to promote weight gain. The patient's individual energy needs and the nutritional content of the meals and snacks must be considered.
Choice C rationale:
Choosing high-protein foods is important for building and repairing tissues, but it does not ensure adequate overall caloric intake. The patient may still be experiencing a calorie deficit if they are not consuming enough total calories, even if they are focusing on protein-rich foods.
Choice D rationale:
Decreased oral discomfort can facilitate better food intake, but it does not directly reflect weight gain or improved nutritional status. The patient may still have challenges with appetite, nausea, or other factors that hinder their ability to consume enough calories.

Choice A rationale:
It is incorrect to state that the client will not be able to bathe with a central vascular access device.
While certain precautions are necessary to keep the device dry and clean during bathing, bathing is still possible and important for maintaining hygiene.
The nurse should provide specific instructions on how to protect the device during bathing, such as using a waterproof cover or avoiding direct water contact.
Choice B rationale:
It is inaccurate to claim that there is no risk of infection associated with a central vascular access device, even when sterile technique is used during insertion.
Infection is a serious potential complication, and it's crucial to emphasize ongoing infection prevention measures to the client.
The nurse should educate the client about signs and symptoms of infection to watch for and the importance of prompt reporting to healthcare providers.
Choice C rationale:
It is not always necessary to wear a sling on the arm with the central vascular access device.
The need for a sling may depend on the type of device, the client's condition, and the healthcare provider's recommendations.
If a sling is indicated, the nurse should provide instructions on proper use and care to maintain comfort and prevent complications.
Choice D rationale:
This is the correct statement to include in the client's teaching.
Thorough cleaning of the connections prior to accessing the device is essential for preventing infection.
The client should be empowered to advocate for themselves and ensure that all providers follow proper infection control procedures.