A nurse is assigned to care for a client with Parkinson's disease. While supervising an unlicensed assistive personnel (UAP), which action by the UAP requires intervention by the nurse?

Choice A rationale Encouraging independence in activities of daily living is a fundamental therapeutic goal for patients with Parkinson disease. This neurological disorder involves the progressive degeneration of dopaminergic neurons in the substantia nigra, leading to tremors and bradykinesia. When the assistant encourages self-feeding, they promote fine motor coordination and preserve the client's autonomy. This action does not require intervention because it aligns with the rehabilitative focus of maintaining functional abilities for as long as possible during disease progression. Choice B rationale Clients with Parkinson disease often develop a shuffling gait and a tendency to look down, which shifts their center of gravity and increases the risk of falls. Instructing the client to look up and toward the horizon rather than at their feet helps maintain an upright posture and improves balance. This is a standard safety intervention used to counteract the postural instability and truncal hyperflexion characteristic of the disease. Therefore, the assistant is providing appropriate safety guidance during ambulation. Choice C rationale This action requires intervention because performing a complete bath for a client who is capable of participation fosters unnecessary dependence. In Parkinson's care, the focus is on maintaining the client's ability to perform self-care to prevent muscle atrophy and functional decline. The assistant should instead provide the necessary tools and allow the client to perform as much of the hygiene routine as possible. Passive care contradicts the goal of maximizing the client's physical and psychological well-being. Choice D rationale Assisting a client with Parkinson disease during ambulation is a vital safety measure to prevent falls. The disease often causes freezing of gait and impaired postural reflexes, making the transition from sitting to standing and walking precarious. Providing physical support ensures the client remains stable while moving between the bed and the bathroom. Since this action directly addresses the high fall risk associated with the client's motor deficits, it is an appropriate task for the assistant.