A community health nurse is preparing an in-service for staff to define the conditions of causation in epidemiology studies. Which of the following descriptions should the nurse use to define a cessation of exposure to establish causation?

Choice A Reason:
The client still journaling their feelings about their sister's death 7 years ago indicates ongoing grief, which is important but may not be the immediate priority. Grieving is a natural process, and while it can impact mental health, it does not pose an immediate threat to the client's safety or daily functioning. Addressing grief can be part of a longer-term mental health support plan.

Choice B Reason:
The client experiencing cyberbullying is the priority because it can have severe and immediate impacts on mental health, including anxiety, depression, and suicidal thoughts. Cyberbullying can lead to significant emotional distress and requires prompt intervention to ensure the client's safety and well-being. Addressing this issue can help prevent further psychological harm and support the client's mental health.

Choice C Reason:
The client primarily eating fast food while living on a limited budget is a concern for long-term health, including risks of obesity, diabetes, and other chronic conditions. However, it does not pose an immediate threat to the client's safety. Nutritional counseling and support can be provided as part of a broader health plan.

Choice D Reason:
The client missing classes due to suffering from seasonal allergies is a health concern that can affect academic performance and quality of life. However, it is typically manageable with appropriate medical treatment and does not pose an immediate threat to the client's safety. Addressing allergies can be part of a comprehensive health management plan.

Choice A Reason:
Conducting a physical examination is the first step in addressing the employee's concern about hearing loss. This examination allows the nurse to assess the ear for any visible issues, such as earwax buildup, infection, or structural abnormalities. A thorough physical examination can help identify the cause of the hearing loss and determine the appropriate next steps. It is essential to rule out any immediate and easily treatable conditions before proceeding with more specialized interventions.

Choice B Reason:
Irrigating the ear to remove any obstruction, such as earwax, can be an effective treatment for hearing loss caused by cerumen impaction. However, this should only be done after a physical examination confirms that earwax is the cause of the hearing loss. Irrigation without proper assessment can potentially cause harm, especially if there is an underlying infection or perforation of the eardrum.

Choice C Reason:
Advising the client on the use of ear plugs is a preventive measure to protect hearing, particularly in noisy environments. However, this advice does not address the immediate concern of unilateral hearing loss. Ear plugs are more relevant for preventing further hearing damage rather than diagnosing or treating existing hearing issues.

Choice D Reason:
Referring the client to an audiologist is an important step if the initial physical examination does not reveal the cause of the hearing loss or if the hearing loss persists despite initial treatment. Audiologists specialize in diagnosing and treating hearing disorders and can perform comprehensive hearing tests. However, this referral should come after the nurse has conducted a preliminary assessment to rule out any obvious and treatable causes.