Which should the nurse include when instructing a client on the prevention of osteoporosis?

Choice A reason: Including an average daily intake of 300 mg of calcium is not a sufficient measure to prevent osteoporosis, as it is below the recommended dietary allowance (RDA) for calcium, which is 1000 mg for adults aged 19-50 years, and 1200 mg for adults aged 51 years and older. Calcium is an essential mineral for bone health, as it helps to build and maintain the bone density and strength.

Choice B reason: Walking 20-30 minutes three days a week is not an optimal measure to prevent osteoporosis, as it is below the recommended physical activity guidelines, which suggest at least 150 minutes of moderate-intensity aerobic exercise per week, and at least two sessions of muscle-strengthening activities per week. Physical activity is beneficial for bone health, as it stimulates the bone formation and reduces the bone loss.

Choice C reason: Engaging in isometric exercise 20-30 minutes weekly is not an effective measure to prevent osteoporosis, as it is not the best type of exercise for bone health, and it is not performed frequently enough. Isometric exercise is a form of exercise that involves contracting the muscles without moving the joints, such as holding a plank or a wall sit. Isometric exercise does not provide enough mechanical stress or load to the bones, which is needed to stimulate the bone remodeling and growth.

Choice D reason: Including adequate intake of vitamin E is not a relevant measure to prevent osteoporosis, as it is not a major nutrient for bone health, and it has no direct effect on the bone metabolism. Vitamin E is an antioxidant that helps to protect the cells from oxidative stress and inflammation, which may have some indirect benefits for the bone health, but it is not a key factor. Vitamin E is also not a common deficiency, and it can be obtained from various foods, such as vegetable oils, nuts, seeds, and green leafy vegetables.

Choice A reason: Diet is not a priority assessment for a client with osteoarthritis, as it is not a direct cause or consequence of the condition. However, diet may play a role in the management of osteoarthritis, as it can affect the body weight, inflammation, and nutrition of the client.

Choice B reason: Skin surrounding the affected joint is not a priority assessment for a client with osteoarthritis, as it is not a common or serious complication of the condition. However, skin may be affected by the use of heat or cold therapy, topical medications, or joint braces, which may cause irritation, dryness, or infection.

Choice C reason: Pain is a priority assessment for a client with osteoarthritis, as it is the main symptom and the most distressing aspect of the condition. Pain can affect the client's quality of life, mobility, function, and mood. The nurse should assess the location, intensity, frequency, duration, and aggravating or relieving factors of the pain, and provide appropriate interventions to relieve the pain.

Choice D reason: Capillary refill of affected extremity is not a priority assessment for a client with osteoarthritis, as it is not a typical or significant finding of the condition. However, capillary refill may be affected by the circulation, temperature, or hydration of the client, which may influence the healing and recovery of the joint.

Choice E reason: Range of motion of affected joint is not a priority assessment for a client with osteoarthritis, but an important assessment to evaluate the function and mobility of the joint. Osteoarthritis can cause stiffness, swelling, and deformity of the joint, which can limit the range of motion and impair the activities of daily living. The nurse should assess the active and passive range of motion of the joint, and encourage the client to perform regular exercises to maintain the joint health.