Choice A reason: Reporting the incident to local authorities is an important action, but it is not the first priority. The nurse should first assess the child's physical condition and provide any necessary care.

Choice B reason: Checking the child for injuries is the first action the nurse should take, as the child may have sustained physical harm from the abuse. The nurse should document any findings and report them to the appropriate authorities.

Choice C reason: Referring the parent to a social service agency is a helpful action, but it is not the first priority. The nurse should first ensure the child's safety and well-being.

Choice D reason: Enrolling the parent in anger management classes is a potential intervention, but it is not the first priority. The nurse should first address the immediate needs of the child and the family.

Choice A reason: Giving positive feedback to students who make appropriate choices is a good strategy to reinforce healthy eating, but it is not the first action that the nurse should take. The nurse should first assess the students' readiness to learn and their motivation to change their behavior.

Choice B reason: Helping students recognize the value of making healthy food choices is an important goal of the program, but it is not the first action that the nurse should take. The nurse should first determine the students' current knowledge, attitudes, and beliefs about healthy eating and tailor the program accordingly.

Choice C reason: Providing students with resources about making wise choices independently is a useful way to support their learning, but it is not the first action that the nurse should take. The nurse should first identify the barriers and facilitators that influence the students' food choices and address them in the program.

Choice D reason: Determining students' motivation to learn about healthy food choices is the first action that the nurse should take. This is based on the principle of learner-centered education, which states that the nurse should assess the learners' needs, interests, and readiness to learn before planning and implementing the program.

Choice A reason: Investigating potential health and environmental issues is a key function of community-oriented nursing, as it helps to identify and address the factors that affect the health of the population.

Choice B reason: Initiating support groups for parents of autistic children is not a specific task of community-oriented nursing, as it focuses on a particular subgroup rather than the whole population. This is more aligned with community-based nursing, which provides care to individuals and families in their natural settings.

Choice C reason: Providing wound care for clients in their homes is not a specific task of community-oriented nursing, as it focuses on individual needs rather than population needs. This is also more aligned with community-based nursing, which provides direct care to clients in their homes.

Choice D reason: Participating in local health surveillance activities is a key function of community-oriented nursing, as it helps to monitor and evaluate the health status and trends of the population.

Choice E reason: Providing health-related education to community groups is a key function of community-oriented nursing, as it helps to promote health and prevent disease among the population.

Choice A reason: Scheduling bone density screening is an appropriate outcome for the program, as it helps to detect and prevent osteoporosis, a common condition among postmenopausal women. Bone density screening is recommended for women aged 65 years and older, or younger women with risk factors.

Choice B reason: Arranging for mammograms every 3 years is not an appropriate outcome for the program, as it does not follow the current guidelines for breast cancer screening. The American Cancer Society recommends that women aged 45 to 54 years should have mammograms every year, and women aged 55 years and older should have mammograms every 2 years, or continue yearly screening if they prefer.

Choice C reason: Starting hormone replacement therapy is not an appropriate outcome for the program, as it is not a universal recommendation for postmenopausal women. Hormone replacement therapy may have benefits and risks depending on the individual's health history, symptoms, and preferences. It should be discussed with a health care provider before starting.

Choice D reason: Significantly decreasing caloric intake is not an appropriate outcome for the program, as it may lead to nutritional deficiencies and other health problems. Postmenopausal women should maintain a balanced diet that meets their nutritional needs and supports their weight management. A moderate reduction in caloric intake may be advised for overweight or obese women, but not a drastic one.

Choice A reason: A fee-for-service health care insurance program is not a payment structure of a health maintenance organization. In a fee-for-service program, the client pays a premium to the insurer, and the insurer pays the provider for each service rendered, regardless of the outcome or quality of care.

Choice B reason: A fixed sum payment for the client on a monthly or yearly basis is a payment structure of a health maintenance organization. In this structure, the provider receives a set amount of money per client per period of time, regardless of the number or type of services provided. This encourages the provider to deliver preventive and primary care, and to avoid unnecessary or costly procedures.

Choice C reason: A percentage of the total costs for each service rendered by the provider is not a payment structure of a health maintenance organization. This is a type of cost-sharing arrangement, where the client pays a portion of the expenses and the insurer pays the rest. This may result in higher out-of-pocket costs for the client and higher utilization of services by the provider.

Choice D reason: A predetermined percentage of the cost of services is not a payment structure of a health maintenance organization. This is a type of discounted fee-for-service arrangement, where the provider agrees to accept a lower fee than the usual charge for each service. This may reduce the costs for the insurer, but not necessarily for the client or the provider.

Choice A reason: Providing the client with a printed recipe is not the first action that the nurse should take when assisting this client. The nurse should first assess the client's current dietary practices and preferences, and then provide culturally appropriate and individualized education and guidance.

Choice B reason: Observing the client during preparation of traditional foods is the first action that the nurse should take when assisting this client. This will help the nurse to understand the client's cultural values and beliefs, as well as the ingredients and methods used in preparing the foods. The nurse can then offer suggestions on how to modify the recipes to fit the client's meal plan.

Choice C reason: Using cookbooks to include traditional foods in meal plans is not the first action that the nurse should take when assisting this client. The nurse should first observe the client's food choices and cooking techniques, and then collaborate with the client to find cookbooks that are suitable for the client's culture and health condition.

Choice D reason: Explaining diabetes exchange list is not the first action that the nurse should take when assisting this client. The nurse should first observe the client's eating habits and patterns, and then educate the client on how to use the exchange list to plan balanced meals that include traditional foods.

Choice A reason: This comment does not indicate rationalization, but rather a recognition of the consequences of obesity. The client may be expressing a need for help or motivation to change their lifestyle.

Choice B reason: This comment indicates rationalization, which is a defense mechanism that involves making excuses or justifying one's behavior or situation. The client may be avoiding personal responsibility or denying the possibility of change by blaming their obesity on their genes.

Choice C reason: This comment does not indicate rationalization, but rather a challenge or barrier that the client faces in achieving their health goals. The client may be acknowledging their weakness or seeking support to overcome their temptation.

Choice D reason: This comment does not indicate rationalization, but rather a projection or displacement of the client's negative feelings onto others. The client may be feeling insecure or rejected because of their obesity, and assuming that others share the same opinion.

Choice A reason: Demographic data is not part of the windshield survey, but rather a secondary source of information that the nurse can obtain from census reports, health statistics, or other documents. Demographic data includes information such as age, gender, race, ethnicity, income, education, and occupation of the community members.

Choice B reason: Mortality rate is not part of the windshield survey, but rather a secondary source of information that the nurse can obtain from vital records, health reports, or other documents. Mortality rate is a measure of the number of deaths in a given population, usually expressed as deaths per 1000 or 100,000 people.

Choice C reason: Informant interviews are not part of the windshield survey, but rather a primary source of information that the nurse can obtain by talking to key informants or community leaders who have knowledge and insight about the community. Informant interviews can help the nurse to identify the community's strengths, needs, problems, and resources.

Choice D reason: Housing quality is part of the windshield survey, which is a direct observation of the community by driving or walking through it. Housing quality includes information such as the type, age, condition, size, and value of the houses, as well as the availability and accessibility of utilities, sanitation, and safety features. Housing quality can reflect the socioeconomic status, health status, and environmental risks of the community.

Choice A reason: One dose of the immunization does not give children lifelong protection from hepatitis B. The immunization requires a series of three or four doses, depending on the vaccine type, to provide long-term immunity. The first dose is usually given at birth, followed by the second dose at 1 to 2 months of age, and the third dose at 6 to 18 months of age. Some children may need a fourth dose at 4 to 6 years of age.

Choice B reason: Hepatitis B does not spread easily among children through casual contact. Hepatitis B is a blood-borne infection that is transmitted through exposure to infected blood or body fluids, such as through sexual contact, sharing needles, or from mother to child during birth. Casual contact, such as hugging, kissing, or sharing food, does not pose a risk of transmission.

Choice C reason: Many people who acquire acute hepatitis B develop chronic hepatitis. Chronic hepatitis is a condition where the infection persists for more than six months and causes inflammation and scarring of the liver. Chronic hepatitis can lead to serious complications, such as cirrhosis, liver failure, or liver cancer. About 90% of infants, 25% to 50% of children aged 1 to 5 years, and 5% to 10% of adults who get infected with hepatitis B will develop chronic hepatitis.

Choice D reason: People who have had a hepatitis B infection do not need the immunization. The immunization is only effective in preventing the infection, not treating it. People who have had a hepatitis B infection will develop natural immunity, which means they will not get infected again. However, they should still be monitored for any signs of liver damage or complications.

Choice A reason: A client who has superficial partial-thickness burn injuries over 5% of his body is not the highest priority for treatment. This type of burn injury affects only the epidermis and the upper layer of the dermis, and causes pain, redness, and blisters. The client may need fluid replacement, pain management, and wound care, but is not in immediate danger of life-threatening complications.

Choice B reason: A client who has a femur fracture with a 2+ pedal pulse is not the highest priority for treatment. This type of fracture involves the breakage of the thigh bone, which is the largest and strongest bone in the body. The client may experience severe pain, swelling, deformity, and bleeding. A 2+ pedal pulse indicates that the blood flow to the lower extremity is adequate, but not optimal. The client may need immobilization, traction, surgery, and infection prevention, but is not in immediate danger of life-threatening complications.

Choice C reason: A client who is ambulatory and exhibits manic behavior is not the highest priority for treatment. This type of behavior involves a state of elevated mood, energy, and activity, which may be caused by stress, trauma, or a mental disorder. The client may experience euphoria, irritability, impulsivity, and poor judgment. The client may need psychological support, medication, and safety measures, but is not in immediate danger of life-threatening complications.

Choice D reason: A client who has a rigid abdomen with manifestations of shock is the highest priority for treatment. This type of condition involves a severe injury to the abdominal organs, such as the liver, spleen, or intestines, which may cause internal bleeding, inflammation, and infection. The client may experience pain, tenderness, distension, and guarding of the abdomen, as well as signs of shock, such as hypotension, tachycardia, pallor, and confusion. The client may need fluid resuscitation, blood transfusion, surgery, and antibiotics, and is in immediate danger of life-threatening complications.