The communi ty health nurse is planning a series of educational courses about the heal thcare system and meeti ng heal thcare needs for t he community center. Which adjunct issue shoul d the nurs e address for a group of ol der adul ts.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) retirement issues. When planning educational courses for older adults at a community center, addressing retirement issues is crucial because it directly impacts their healthcare needs. Retirement often brings about changes in insurance coverage, financial concerns, access to healthcare services, and social support systems, all of which play a significant role in maintaining their health and well-being. Option A) peer concerns may be important for social support but may not directly impact healthcare needs in the same way retirement issues do for older adults. Option B) adult daycare is more relevant for individuals requiring daily care or supervision, not necessarily all older adults. Option D) vocational concerns are typically more pertinent to working-age adults, not retirees, making it less relevant in this context. Educationally, understanding the unique healthcare needs of different age groups and addressing specific issues such as retirement can help community health nurses tailor their educational programs effectively, leading to better health outcomes for older adults in the community. By focusing on retirement issues, nurses can empower older adults to navigate healthcare systems, access appropriate services, and make informed decisions about their health as they age.

Correct Answer: C

Rationale: In this scenario, option C, a 60-year-old homeless person who is an alcoholic and smokes, has the highest risk for developing community-acquired pneumonia. This individual faces multiple risk factors that increase susceptibility to pneumonia, such as compromised immune function due to alcoholism and smoking, poor living conditions contributing to exposure to pathogens, and potential malnutrition which weakens the body's defenses. Option A, the 40-year-old first-grade teacher, works with children but does not have the same level of high-risk behaviors or health conditions as option C. Option B, the 75-year-old retired secretary with exercise-induced wheezing, may have asthma or another respiratory condition that predisposes them to pneumonia, but the combination of risk factors in option C is more significant. Option D, the 35-year-old aerobics instructor who skips meals and eats only vegetables, does not exhibit the same level of risk factors as the homeless alcoholic smoker in option C. Educationally, this question highlights the importance of understanding how various lifestyle factors and health conditions can impact an individual's susceptibility to infectious diseases like pneumonia. It emphasizes the need for healthcare providers to assess a patient's holistic health status when determining their risk for specific illnesses in a community health setting.

Correct Answer: B

Rationale: The correct answer to this question is B) have you started any new prescriptions. This is the most important question for the nurse to ask because the symptoms of pain, redness, and swelling in the right eye could potentially be related to a new medication that the older adult client has started recently. Medications can sometimes cause adverse effects such as eye problems, and it is crucial for the nurse to investigate this possibility to ensure the client's safety and well-being. Option A) do you have any discharge from the eye is not the most important question in this scenario as discharge from the eye, while relevant, may not directly indicate the cause of the symptoms in this case. Option C) are all of your immunizations current is not the priority question at this moment as the client's current symptoms are more indicative of a potential acute issue that needs immediate attention. Option D) how often do you wash your hands is not directly related to the client's presenting symptoms and is not as urgent or relevant in this context compared to inquiring about new medications. In an educational context, this question highlights the importance of thorough assessment and critical thinking in community health nursing. Nurses must prioritize questions based on the client's symptoms and potential causes to provide safe and effective care. Understanding the significance of medication history in assessing health issues is a key skill for nurses working in community health settings.

Correct Answer: D

Rationale: In community health nursing, obtaining information on the expressed needs of community members is crucial for effective assessment and intervention planning. This option (D) is the correct answer because it directly involves the community in identifying their own health needs, priorities, and preferences. By listening to the community members, the nurse can gain valuable insights into the specific health issues affecting them, their perceptions of health, and the resources they require for improved health outcomes. Option A, life expectancy of clients in the community, while important, is a more generalized indicator of health status and may not capture the unique health concerns of the community members. Option B, mortality rates in the community, provide retrospective data and may not reflect the current health needs and priorities. Option C, description of health problems by community leaders, is limited as it may not represent the perspectives and experiences of all community members. Educationally, this question emphasizes the importance of community engagement and participatory approaches in community health nursing practice. It highlights the significance of listening to the voices of those directly affected by health issues to inform culturally sensitive and effective interventions that address the community's specific needs.

Correct Answer: A

Rationale: The correct answer is A) client's thoughts about wanting to hurt herself. In this scenario, the most important information for the nurse to obtain is related to the client's mental health and risk of self-harm. The client's statement about not deserving to eat and not seeking help for food indicates possible depressive thoughts and feelings of worthlessness, which may escalate to suicidal ideation. Option B) medication history for antipsychotic agents is not the most important information to gather in this situation as the client's immediate safety and mental well-being take precedence over their medication history. Option C) availability of family members to provide meals, while important for assessing the client's support system, is not as critical as determining the client's mental state and risk of self-harm. Option D) community resources to provide financial aid, although relevant for addressing the client's financial concerns, is not the priority when the client's mental health and safety are in question. In community health nursing, understanding and addressing the mental health needs of clients, especially in vulnerable populations like older adults living alone, is crucial for providing holistic care and preventing adverse outcomes. Assessing for suicidal ideation and ensuring appropriate interventions are in place are essential aspects of community health nursing practice.