A community health nurse is counseling a client who cares for a mentally ill parent. The client states, "I am feeling overwhelmed and exhausted." Which of the following referrals should the nurse make to provide this client with first level support?

Choice A: The Workplace Procedures and Protocols Manual
Reviewing the workplace procedures and protocols manual can provide valuable context about the standard operating procedures and safety measures in place at the factory. However, this information alone does not directly address the specifics of the employee's injury claim. It is more useful for understanding the general safety environment rather than investigating a specific incident.

Choice B: The Occupational Safety and Health Act
The Occupational Safety and Health Act (OSHA) provides guidelines and regulations for workplace safety. While it is important for ensuring compliance with safety standards, it does not contain specific information about individual employee injury claims. The nurse should be familiar with OSHA regulations but needs more detailed information about the specific incident to conduct a thorough investigation.

Choice C: The Client's Medical Record or Chart
This is the correct choice. The client's medical record or chart contains detailed information about the employee's health status, medical history, and the specifics of the injury. Reviewing this information is crucial for understanding the nature and extent of the injury, any pre-existing conditions, and the treatment provided. This data is essential for accurately assessing the validity of the injury claim and determining any potential workplace-related factors.

Choice D: The Client's Attendance Record at Health and Safety Seminars
While the client's attendance record at health and safety seminars can indicate their level of training and awareness of safety protocols, it does not provide direct information about the injury itself. This record can be useful for understanding the employee's knowledge of safety practices but is not sufficient for investigating the specifics of the injury claim.

Choice A Reason:
Autonomy refers to respecting an individual's right to make their own decisions. In the context of healthcare, it means allowing patients to make informed choices about their own care. While autonomy is an important ethical principle, it is not the primary focus when considering the balance of benefits and harms in a community-wide intervention.

Choice B Reason:
Beneficence is the ethical principle that involves acting in the best interest of others by promoting good and preventing harm. In this scenario, the nurse demonstrates beneficence by ensuring that the benefits of the physical activity program substantially outweigh any potential harms. This principle is central to public health initiatives, where the goal is to enhance the well-being of the community.

Choice C Reason:
Nonmaleficence is the principle of "do no harm." It emphasizes the importance of not causing harm to others. While nonmaleficence is closely related to beneficence, the focus in this scenario is on the positive impact of the intervention (beneficence) rather than solely avoiding harm (nonmaleficence).

Choice D Reason:
Justice refers to fairness and equality in the distribution of resources and treatment. It ensures that all individuals have equal access to healthcare and that no group is unfairly disadvantaged. Although justice is a crucial ethical principle, the scenario specifically highlights the balance of benefits and harms, which aligns more closely with beneficence.