The incidence of type 2 diabetes among Indigenous peoples (First Nations, Inuit, and Métis) is three to five times higher than in the general population. When teaching a nutrition class to a group of mostly Indigenous students, the community health nurse (CHN) incorporates into the presentation such foods as bannock and other healthy dishes familiar to Indigenous students. What level of prevention does this culturally sensitive action represent?

Correct Answer: A

Rationale: The correct answer is A: Primary prevention. This action falls under primary prevention because it aims to prevent the occurrence of type 2 diabetes in Indigenous peoples by promoting healthy eating habits through culturally sensitive foods. By incorporating familiar and healthy dishes into the nutrition class, the community health nurse is focusing on preventing the development of the disease before it occurs. This approach addresses the underlying risk factors for diabetes, such as poor diet, in a proactive manner. Summary of other choices: B: Secondary prevention involves early detection and treatment of a disease to prevent complications. This action does not focus on early detection but rather on prevention. C: Tertiary prevention focuses on managing complications and improving quality of life for those already diagnosed with a disease. This action is aimed at preventing diabetes rather than managing its complications. D: This action is primarily focused on preventing the occurrence of type 2 diabetes before it develops, making it more aligned with primary prevention than secondary prevention.

Correct Answer: D

Rationale: Positive predictive value (PPV) is the proportion of individuals with a positive test result who actually have the disease. This is crucial in determining the likelihood that a positive test accurately identifies a true positive case. By calculating PPV, we can assess the test's ability to predict the presence of the disease. In this context, the CHN (clinical history and physical examination) can help improve the accuracy of test results by enhancing the predictive value. Choice A is incorrect because it describes the negative predictive value, which is the proportion of individuals with a negative test result who are actually disease-free. Choice B is incorrect as it refers to the variability of the trait being measured, not predictive value. Choice C is incorrect as it discusses inconsistencies in the testing instrument, which are unrelated to predictive value.

Correct Answer: C

Rationale: Rationale for Choice C: The most appropriate objective for community health nursing is to ensure a high immunization rate among children to prevent the spread of diseases. Immunization is a crucial public health intervention that protects individuals and the community. Achieving a high immunization rate, such as 95%, by age 1 is a specific, measurable, achievable, relevant, and time-bound (SMART) goal that aligns with the core purpose of community health nursing. Rationale for why other choices are incorrect: A: This objective is not appropriate for community health nursing as it focuses on a specific medical intervention rather than a population-level public health goal. B: While nutrition counseling is important, this objective is not as critical for community health nursing as ensuring high immunization rates among children. D: This objective is vague and does not directly address a specific health issue or population group, making it less relevant for community health nursing.

Correct Answer: B

Rationale: The correct answer is B: Informant interviews with local community members. This method is best because it directly involves the individuals within the community who have firsthand knowledge and experience regarding immigrant access to regional health care. They can provide valuable insights and perspectives that may not be captured through other methods. A: Interviews with employees of the local health board may provide some insights, but they may not have the same level of direct experience and perspective as community members. C: Interview with a legislator or local politician may offer a broader policy perspective, but may not capture the specific experiences of community members. D: Interview with a public health official may provide valuable information, but may not offer the same depth of insights as direct interactions with community members.

Correct Answer: B

Rationale: The correct answer is B because it directly assesses the impact of the program on reducing teen injury and death related to drunk driving. By comparing statistics before and after the program, we can determine its effectiveness. A: This question focuses on participant satisfaction, not the program's impact on reducing teen injury and death related to drunk driving. C: This question focuses on the amount of alcohol intake by teens, not the program's impact on reducing teen injury and death related to drunk driving. D: This question focuses on program implementation issues, not the program's impact on reducing teen injury and death related to drunk driving.