During a home health visit the nurse notices that an older male client with type 2 diabetes mellitus is wearing loose cloth slippers. The client reports that he cannot comfortably wear other shoes because his toenails get in the way. The nurse inspects the clients feet and finds long thick nails that curl down under some of the toes. Which action should the nurse take?

Correct Answer: C

Rationale: In this scenario, the most appropriate action for the nurse to take is to schedule an appointment for the client with a podiatrist (Option C). This choice is correct because the client's toenails are not only long and thick but also curling under the toes, indicating a need for professional intervention. Podiatrists are specialized healthcare providers who can safely and effectively address nail care issues in diabetic clients to prevent complications such as infection or injury. Option A is incorrect because demonstrating proper foot care to the client and family would not address the immediate need for professional toenail trimming. Option B is also incorrect as a home health aide may not have the necessary skills or training to safely trim the client's toenails, especially given the specific condition of thick and curled nails in a diabetic individual. In an educational context, it is crucial for nurses to recognize when a client's condition requires specialized care beyond their scope of practice. Collaboration with other healthcare professionals, like podiatrists in this case, ensures comprehensive and appropriate management of clients' health needs, especially in vulnerable populations like older adults with diabetes. This scenario underscores the importance of interprofessional communication and referrals in community health nursing practice.

Correct Answer: B

Rationale: In this scenario, the most appropriate initial action for the nurse to take is to review the client's current medication regimen (Option B). This is the correct choice because before addressing the issue of expired medications, the nurse must first assess the client's current medication usage to ensure they are receiving the necessary treatment for their health conditions. Option A, instructing the client to dispose of the expired medications, is not the best first step because it does not address the immediate concern of ensuring the client's current health needs are being met. Additionally, there may be specific disposal protocols that need to be followed for medications. Option C, contacting the client's healthcare provider, while important, should come after assessing the client's current medication regimen. The nurse needs to have a clear understanding of the client's medication history and needs before involving the healthcare provider. Option D, educating the client on the dangers of taking expired medications, is not the priority at this moment. While education is crucial, the immediate focus should be on ensuring the client's current medication regimen is appropriate and addressing any potential gaps in their care. In an educational context, this question highlights the importance of prioritizing client safety and effective nursing assessment in community health settings. Nurses must use critical thinking skills to determine the most appropriate course of action based on the client's needs and the situation at hand. Understanding the sequence of steps in addressing medication concerns is vital for providing quality care in community health nursing practice.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) explore the reasons for the client's forgetfulness. This option is the most appropriate first step because it allows the nurse to assess the underlying causes of the client's non-adherence to medication. By exploring the reasons behind the forgetfulness, the nurse can uncover potential barriers such as cognitive issues, financial constraints, lack of understanding, or side effects that may be contributing to the client's behavior. Option A) educate the client on the importance of medication adherence may be necessary, but it should come after understanding the client's reasons for forgetfulness. Simply providing education without addressing the root cause may not effectively improve adherence. Option C) providing the client with a pill organizer assumes that forgetfulness is the only issue at play and may not address the underlying reasons for non-adherence. Option D) adjusting the client's medication schedule should also come after exploring the reasons for forgetfulness to ensure that any changes made are appropriate and effective. In the context of community health nursing, it is essential to take a holistic and patient-centered approach to address medication adherence issues. By first exploring the reasons behind the forgetfulness, nurses can tailor interventions to best support the client in managing their hypertension effectively.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) assess the client's risk for falls. This is the most appropriate initial action for the nurse to take. By assessing the client's risk for falls, the nurse can address immediate safety concerns and prioritize interventions to prevent potential accidents or injuries. Option A) suggesting the client hires a cleaning service may address the cluttered environment but does not directly address the safety issue of falls. Option B) assisting the client in organizing the living space also focuses on the clutter but does not address the immediate risk of falls. Option D) providing the client with information on home safety is important but should come after assessing the specific risk factors present in the client's environment. Educationally, this question highlights the importance of prioritizing interventions based on the immediate needs of the client. Assessing risk factors is fundamental in developing a holistic and individualized care plan, especially in community health nursing where environmental factors play a significant role in overall health and safety. It is crucial for nurses to identify and address safety concerns proactively to promote the well-being of their clients.

Correct Answer: B

Rationale: In this scenario, the correct response is option B: explore the client's dietary habits and challenges. This option is the most appropriate initial action because it allows the nurse to gather crucial information about the client's specific struggles with maintaining a healthy diet. By understanding the client's barriers, preferences, and lifestyle factors influencing their dietary choices, the nurse can tailor interventions effectively. Option A, providing the client with meal planning resources, may be premature without understanding the client's individual needs and obstacles. Option C, referring the client to a nutritionist, is not the first step as the nurse should assess the situation before involving additional healthcare professionals. Option D, educating the client on the importance of a healthy diet, is not as effective as exploring the client's challenges first, as education alone may not address the underlying issues hindering the client's dietary adherence. In the educational context, this question highlights the importance of a client-centered approach in community health nursing. By prioritizing a thorough assessment of the client's needs and challenges, nurses can develop personalized and effective interventions to support clients in achieving optimal health outcomes. This approach aligns with the principles of holistic care and individualized treatment in community health nursing practice.