A nurse in a community health clinic reviews screening results from students in a local high school during the most recent academic year. The nurse discovers a 10% increase in the number of positive tuberculosis (TB) skin tests when comparing these numbers to the previous year. The nurse contacts the school nurse and the director of the health department. Together they begin to expand their assessment to all students and employees of the school district. The community nurse is acting in which nursing role(s)? Select all that apply

Healthy People 2030 outlines national objectives aimed at improving health and well-being by addressing social determinants of health, improving access to care, and reducing health disparities.

Rationale for correct answers:

A. Assess the health care resources within the community: This is an essential first step to understanding what services are already available and where the gaps lie.

B. Assess the existing health care programs offered by the county health department: Evaluating current programs ensures that the nurse does not duplicate services and identifies what programs can be strengthened or expanded.

C. Compare existing resources and programs with Healthy People 2030 goals: This step ensures alignment with national priorities. By comparing local services to national health goals, the nurse can identify areas that require improvement or new initiatives.

Rationale for incorrect answers:

D. Initiate new programs to meet Healthy People 2030 goals: Before launching new initiatives, a full assessment and comparison with Healthy People 2030 must be completed to ensure efforts are evidence-based and appropriately targeted.

E. Implement educational sessions in the schools to focus on nutritional needs of the children: The nurse must first assess and align goals before selecting specific interventions like school-based education.

Take-home points:

• Effective community planning starts with a comprehensive assessment of current resources and programs before implementing new interventions.
• Healthy People 2030 serves as a national guide to help public health professionals set measurable, evidence-based goals that reflect community-specific needs.

Discharge planning is a critical part of the nursing process, especially as clients transition from hospital care to home or other settings. Effective discharge planning ensures that the client is informed, prepared, and supported to continue recovery safely.

Rationale for correct answer:

D. “I have the phone numbers of the home care nurse and the therapist who will visit me at home tomorrow.” This statement shows that home services are already arranged, the client has contact information, and care continuity is in place, reflecting thorough and effective discharge planning.

Rationale for incorrect answers:

A. “As soon as I get home, the nurse will come out, look at where I live, and see what kind of care I will need.” This indicates that planning has not yet occurred. Assessment and coordination of home care needs should happen before discharge, not after the client is already home.

B. “All I need are my medications and a ride home. Then I’m all ready for discharge.” While important, this response reflects a narrow view of discharge readiness. Effective discharge involves more than transport and medications-it includes follow-up care, services, and education.

C. “When I visit my doctor in 10 days, they will show me how to change my bandages.” Waiting 10 days to learn wound care implies lack of preparation for self-care, which is unsafe and does not meet discharge criteria. Education should be provided before discharge.

Take-home points:

• Effective discharge planning includes clear arrangements for home care services.
• Nurses must verify client understanding and readiness before discharge to ensure safety, adherence, and successful recovery at home.