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 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 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.