An older individual attends an exercise class in the community's parks and recreation facility at the recommendation of their primary provider. At a follow-up appointment, the client tells the nurse in the primary care office that they are unable to perform several of the exercises due to problems with vertigo and have stopped attending the classes. The nurse determines that the client is experiencing which type of negative enabling factor?

Correct Answer: A

Rationale: The correct answer is A: Accessibility of services. In this scenario, the individual is unable to attend exercise classes due to vertigo, indicating a barrier in accessing the services. The client wants to participate, but physical limitations prevent them. This negatively impacts their ability to benefit from the recommended program. Choices B, C, and D are incorrect because they do not directly address the individual's inability to access the services due to a health-related issue. Availability of resources (B) refers to the presence of necessary tools or materials, not the individual's physical condition. Community and government laws/policies (C) and issue-related skills (D) are not the primary factors hindering the individual's participation in the exercise class.

Correct Answer: D

Rationale: The correct answer is D: Limited financial resources. This is the most likely system-related barrier because building parks and recreation centers require funding, and without adequate financial resources, the program may struggle to implement these initiatives effectively. Choice A (Genetic predisposition to obesity) is incorrect as it is not a system-related barrier but rather a biological factor. Choice B (Lack of community engagement) is incorrect as it pertains to community involvement rather than a system-related barrier. Choice C (Individual client attitudes and beliefs) is incorrect as it focuses on personal factors rather than system-related barriers. Ultimately, limited financial resources pose a significant challenge for the program in building the necessary infrastructure to promote physical activity in the urban area.

Correct Answer: D

Rationale: The correct answer is D: Develop evaluation methods. After selecting activities to meet program goals, the next step in the intervention mapping framework is to develop evaluation methods. This step is crucial to assess the effectiveness of the program in achieving its objectives. Evaluation methods help gather data to measure the program's impact, identify areas for improvement, and ensure the program is meeting the needs of the community. It allows for evidence-based decision-making and continuous quality improvement. Summary: A: Draft program messages and materials - This step usually comes after developing evaluation methods. B: Conduct a community assessment - Typically done at the initial stages of program planning. C: Establish community partnerships - Important but usually done earlier in the planning process.

Correct Answer: B

Rationale: The correct answer is B because it meets the criteria of the SMART approach. Specific: It clearly states the goal of reducing alcohol use by county youth. Measurable: It includes a quantifiable target of decreasing from 5% to 4%. Achievable: The goal is realistic and attainable. Relevant: It addresses a significant issue of alcohol use. Time-bound: It specifies the deadline of December 31. Option A lacks specificity and measurability. Options C and D are incomplete and do not follow the SMART criteria.

Correct Answer: A

Rationale: The correct answer is A, obtaining Institutional Review Board (IRB) approval. The IRB ensures that research studies protect participant autonomy and informed consent by reviewing study protocols to ensure ethical standards are met. This process includes assessing risks, benefits, and participant rights. Choice B, following HIPAA guidelines, pertains to protecting patient privacy, not participant autonomy. Choice C, FERPA, relates to educational records privacy, not research participant autonomy. Choice D, ensuring FERPA, is also unrelated to research participant autonomy and informed consent. Therefore, obtaining IRB approval is the correct process to protect participant autonomy in research studies.