The wife of an older adult man who has had diabetes mellitus for the past 10 years reports to the home health nurse that her husband fell yesterday while taking his daily walk in the neighborhood. He has a bruised hand and a small abrasion on his left knee. The nurse assesses that his neurologic vital signs are stable. To reduce risk for future falls, which assessment is most important for the nurse to obtain?

Correct Answer: B

Rationale: In this scenario, the most important assessment for the nurse to obtain to reduce the risk of future falls for the older adult man with diabetes mellitus is the degree of paresthesia in his feet (Option B). Paresthesia, which refers to abnormal sensations like tingling or numbness, is common in individuals with diabetes and can increase the risk of falls due to decreased sensation and proprioception in the feet. Assessing the current blood sugar level (Option A) is important in managing diabetes, but in this case, the focus is on preventing falls specifically related to neuropathy. Checking the wound healing of the knee abrasion (Option C) is important for overall care but does not directly address fall prevention. A1c glycosylated hemoglobin (Option D) provides information about long-term blood sugar control but does not address the immediate risk of falls due to neuropathy. Educationally, this question highlights the importance of assessing for paresthesia in diabetic patients to prevent falls, a common complication in this population. It emphasizes the need for nurses to prioritize assessments based on the patient's specific condition and risk factors to provide targeted and effective care.

Correct Answer: A

Rationale: In this scenario, the correct action for the nurse to implement is to determine home navigational safety hazards (Option A). This is crucial because the nurse has observed the client being unsteady while ambulating, which indicates potential safety risks within the home environment. By assessing and identifying these hazards, the nurse can create a safer space for the client to move around independently and reduce the risk of falls or accidents. Option B, maintaining the client's privacy while in the bathroom, is not the most appropriate action in this situation as the primary concern is the client's safety while ambulating. While privacy is important, it is secondary to ensuring the client's physical safety. Option C, recommending that the client obtain a walker, and Option D, encouraging the client to obtain a medical alert device, are also not the most immediate actions to take. While both of these interventions may be beneficial for the client in the long run, addressing the home safety hazards is the most critical step to prevent immediate harm or injury to the client. In the context of community health nursing, it is essential for nurses to prioritize client safety and well-being during home visits. By addressing environmental safety concerns, nurses can empower clients to maintain their independence and quality of life while minimizing the risk of accidents or injuries in their home environment.

Correct Answer: C

Rationale: In this scenario, the correct action for the nurse to take is to advise the child's parents to obtain a medical evaluation of the brownish thickening on the child's neck (Option C). This is the most appropriate response as the nurse has identified a potentially concerning physical finding that requires further assessment by a healthcare provider. By recommending a medical evaluation, the nurse ensures that the child receives timely and appropriate care for any underlying condition. Option A is incorrect because reviewing the child's medical folder for a list of allergies is not relevant to addressing the brownish thickening on the neck. Option B, instructing the child's parents to begin treatment without a proper diagnosis, is inappropriate as it may not address the root cause of the issue and could potentially lead to incorrect or ineffective treatment. In an educational context, this question highlights the importance of thorough assessment and appropriate referral in community health nursing. It emphasizes the role of the nurse in recognizing abnormal findings, advocating for the well-being of the child, and collaborating with other healthcare professionals to ensure comprehensive care. By understanding the rationale behind the correct response, nursing students can develop critical thinking skills and clinical judgment necessary for effective practice in community health settings.

Correct Answer: C

Rationale: In this scenario, the correct answer is C) older females. Older females, likely grandmothers or elder women in the Somali community, hold significant influence over health decision-making for children. In many cultures, including Somali, older women are respected for their wisdom and experience, often playing a pivotal role in shaping beliefs and practices related to healthcare. They may hold traditional beliefs or have cultural values that impact the mothers' perceptions of their children's healthcare needs. Option A) husbands may have influence in decision-making, but in the context of this community, older females are typically more influential in matters related to childcare. Option B) clinic healthcare providers may have authority, but cultural beliefs and values may supersede their recommendations. Option D) tribal chief might hold authority, but in this case, it is more likely that the influence of older females within the community is stronger. Educationally, this question highlights the importance of cultural competence in community health nursing. Understanding the cultural dynamics and influencers within a specific population is crucial for providing effective and respectful care. Nurses must consider and respect the cultural beliefs and values of the community they serve to build trust and promote positive health outcomes.

Correct Answer: D

Rationale: In this scenario, option D is the most appropriate choice as an example of proficient performance criteria in professionalism for an occupational health nurse's self-evaluation. Developing policy initiatives that impact occupational health and safety demonstrates a high level of professionalism as it involves critical thinking, leadership, and advocacy for the well-being of workers. Option A, contributing money to a professional society, though commendable, does not directly reflect the nurse's professional competence in their role. Option B, maintaining chairmanship of a nursing council, is more related to leadership skills than professionalism specifically. Option C, documenting the nursing process in care management, is important but does not specifically address professionalism criteria in the context of occupational health nursing. Educationally, understanding the significance of policy development in occupational health and safety is crucial for nurses in this specialty. It not only enhances their professional growth but also contributes to creating safer work environments and promoting health outcomes for workers. Professionalism in nursing goes beyond routine tasks and encompasses actions that advance the profession and prioritize patient and worker well-being.