The partner of an older adult client who has Alzheimer's disease reports that he is not eating. The nurse observes that the client's partner refuses to assist the client with feeding. The partner insists that the client feed himself without help. Which of the following is the priority action the nurse should take?

Choice A reason: Organizing an influenza immunization clinic with the American Red Cross is a service that the nurses should plan to provide to the congregation, as it is consistent with the role and scope of parish nursing. Parish nurses, or faith community nurses, are registered nurses who provide education, counseling, referral, advocacy, and volunteer coordination within the context of their faith community¹. They focus on holistic healing and prevention of illness, rather than hands-on care². Organizing an influenza immunization clinic is an example of a preventive and educational service that can benefit the health of the congregation and the community.

Choice B reason: Performing wound care in the home of members is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as wound care, medication administration, or blood pressure monitoring². They may refer members to other health care providers or agencies for these services, or teach members how to perform self-care³.

Choice C reason: Providing end of life care for members who are terminal is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as pain management, symptom control, or palliative care². They may provide spiritual and emotional support, counseling, and advocacy for members who are terminal, or refer them to hospice or other end of life care services³.

Choice D reason: Facilitating discharge from the facility to the home is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide case management, discharge planning, or home health care². They may collaborate with other health care professionals or community agencies to ensure continuity of care and smooth transition for members who are discharged from the facility to the home³.

Choice A reason: Discussing the benefits of eating a well-balanced diet with the client's family is not the first action that the nurse should take. This is an important intervention that can help the client and the family to improve their nutrition and reduce the risk of further complications, but it should be done after the nurse has assessed the family's coping and learning needs.

Choice B reason: Assisting the client and the client's partner with finding an affordable exercise program is not the first action that the nurse should take. This is an important intervention that can help the client and the partner to increase their physical activity and enhance their cardiovascular health, but it should be done after the nurse has evaluated the client's physical and functional status.

Choice C reason: Offering to accompany the client and the client's partner during health care provider visits is not the first action that the nurse should take. This is an important intervention that can help the client and the partner to receive support and guidance during the treatment process, but it should be done after the nurse has established rapport and trust with the family.

Choice D reason: Asking family members about the impact of the disease on relationships within the family is the first action that the nurse should take. This is based on the principle of family-centered care, which states that the nurse should recognize and respect the family as the primary source of support and care for the client. The nurse should ask open-ended questions, listen actively, and express empathy to the family members, and explore how the disease has affected their roles, responsibilities, emotions, and communication.