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 Reason:
The need for social support to abstain from smoking is an important factor in tobacco cessation. Social support can significantly influence an individual's ability to quit smoking by providing encouragement and accountability. However, according to the Health Belief Model, the focus is more on perceived benefits and barriers, perceived severity, and perceived susceptibility. While social support is crucial, it is not the primary focus of the Health Belief Model in this context.

Choice B Reason:
The benefits of not smoking when engaging in sports and other activities is a key aspect of the Health Belief Model. This model emphasizes the importance of perceived benefits in motivating behavior change. Highlighting the positive outcomes of not smoking, such as improved athletic performance and better overall health, can effectively encourage high school students to avoid tobacco use. This approach aligns with the model's focus on perceived benefits as a motivator for behavior change.

Choice C Reason:
The school's no smoking policy is an important regulatory measure to prevent tobacco use among students. However, the Health Belief Model focuses more on individual perceptions and motivations rather than institutional policies. While the policy is essential for creating a smoke-free environment, it does not directly address the personal beliefs and attitudes that the Health Belief Model targets.

Choice D Reason:
The local town ordinance regarding smoking bans in certain public spaces is another regulatory approach to control tobacco use. Similar to the school's no smoking policy, this ordinance is important for public health but does not align directly with the Health Belief Model. The model is more concerned with individual perceptions of risk and benefit, rather than external regulations.

Choice A: Quaternary
Quaternary prevention focuses on identifying patients at risk of over-medicalization and protecting them from unnecessary medical interventions. It aims to prevent harm from excessive or inappropriate medical care. This level of prevention is not applicable to the scenario of tube feeding, which is a necessary and appropriate medical intervention for the student's condition.

Choice B: Primary
Primary prevention aims to prevent the onset of disease or injury before it occurs. This includes measures such as vaccination, health education, and lifestyle modifications to reduce risk factors. Tube feeding does not fall under primary prevention, as it is not aimed at preventing the initial occurrence of a health issue but rather managing an existing condition.

Choice C: Tertiary
This is the correct choice. Tertiary prevention involves managing and improving the quality of life for individuals with chronic or long-term health conditions. It focuses on rehabilitation, treatment, and support to prevent complications and improve functional abilities. Helping a special needs student with tube feeding is an example of tertiary prevention, as it involves ongoing care and support to manage a chronic condition and enhance the student's well-being.

Choice D: Secondary
Secondary prevention aims to detect and treat disease or injury at an early stage to prevent progression. This includes screening programs, early diagnosis, and prompt treatment. Tube feeding is not a form of secondary prevention, as it is not focused on early detection or intervention but rather on managing an established health condition.