Which is the primary factor in how a hospice nurse makes decisions while giving care in the client's home, surrounded by the client's family?

Correct Answer: D

Rationale: Although the nurse tries to do everything possible for the client, the caregiver, and the whole family, the nurse must prevent a decline in the caregiver's health. Although the dying patient is the focus of all skilled nursing care, the experienced home care nurse knows that a careful assessment of the caregiver's mental and physical health is important. The spouse, lover, children, friends, and neighbors who have made the commitment to stay until the end need the nurse's time and attention as much as, if not more than, the patient. Although the patient's wishes are important, all decisions regarding care are made considering the health of the caregivers. Encouragement of the family to grieve and confront the reality of the client being terminal would not be a primary factor in how the nurse makes decisions.

Correct Answer: A

Rationale: The correct answer is A: Being a minority group member. Migrant farmworkers often belong to marginalized minority groups, facing discrimination, language barriers, and limited access to resources and information, leading to disenfranchisement. Choice B is incorrect as religious practices are not directly related to disenfranchisement. Choice C is incorrect as previous physical abuse may not necessarily lead to disenfranchisement. Choice D is incorrect as the length of time in the community does not determine disenfranchisement, but rather the social status and treatment of minority group members.

Correct Answer: A

Rationale: The correct answer is A. Beginning tests to determine the cause of the bleeding while asking about other family concerns is appropriate because it addresses the immediate health issue while also considering the family's holistic needs. By conducting tests, the nurse can identify the underlying cause of the bleeding and provide necessary treatment. Additionally, inquiring about other family concerns such as nutrition and shelter shows a comprehensive approach to care, considering social determinants of health. Choice B is incorrect because referring the man to a urologist bypasses the initial assessment and testing that should be done at the clinic. Choice C is incorrect as suggesting urgent care does not address the immediate need for assessment and testing. Choice D is incorrect because assuming a urinary infection without proper assessment can lead to incorrect treatment.

Correct Answer: A

Rationale: The correct answer is A because directing clients to English-as-second-language courses can empower new immigrants by improving their language skills, facilitating communication, enhancing social integration, and increasing access to resources. Learning English is crucial for obtaining employment, accessing healthcare, and navigating daily life in a new country. Providing money (choice B) may offer temporary relief but does not address the root cause of resilience. Identifying affordable housing (choice C) is important but does not directly build resilience. Soliciting donations (choice D) may help with immediate needs but does not promote self-sufficiency and long-term resilience like language skills.

Correct Answer: A

Rationale: The correct answer is A: Call all homeless clients 48 hours after TB skin testing to remind them to return to the clinic for test interpretation. This approach ensures proactive follow-up and increases the likelihood of clients returning for test interpretation. Calling clients directly allows for immediate communication and personalized reminders, addressing the issue of non-compliance among the homeless population. Option B is not ideal as relying on homeless individuals to read and mail in their TB skin test results may lead to inaccuracies, lack of follow-up, and potential privacy breaches. Option C is not recommended as re-administering the TB skin test may not be necessary and can lead to unnecessary testing and costs. Option D of routinely referring all homeless clients for chest x-rays is excessive and not warranted without first interpreting the TB skin test results.