A nurse is caring for a client who has an upper cervical spinal cord injury and a halo device. Which of the following actions should the nurse take?

A. Ensure one finger can be inserted between the vest and client's skin: Allowing one finger’s space prevents skin breakdown while maintaining proper immobilization. This ensures the vest is snug enough to stabilize the cervical spine but not so tight that it causes pressure ulcers or discomfort. B. Use the halo device to turn the client in bed: The halo device is rigid and should never be used as a lever to move the client, as this can cause cervical spine injury. Turning and repositioning should be done by supporting the head, neck, and torso manually, not by pulling on the device. C. Use a pen to itch under the vest: Inserting objects under the vest can damage the skin and increase the risk of infection or pressure injuries. Clients should be taught to relieve itching by gentle tapping or using approved tools outside the vest. D. Tighten halo pins when loose: Halo pins should only be adjusted by a healthcare provider. Tightening pins independently can cause skull fractures, nerve injury, or increased pain, making this action unsafe for nursing practice.