A nurse is assessing factors that affect a client's health. Which of the following should the nurse identify as a social determinant of health that directly affects the client's physical safety?

A. Teaching a class about the risks of cigarette smoking: This is a primary prevention activity focused on educating children to prevent the initiation of smoking and related health problems before they occur.

B. Recommending a seating arrangement for a child in a body cast: This is a tertiary prevention activity that involves managing existing health conditions and preventing complications, not primary prevention.

C. Creating a plan of care for children who have a diagnosis of diabetes mellitus: This is tertiary prevention since it deals with managing an existing chronic illness to reduce complications.

D. Organizing a program to promote skateboard safety: This is primary prevention, aiming to prevent injuries associated with skateboarding by teaching safe practices before accidents happen. It targets a behavior to prevent harm.

E. Lobbying for funding for health promotion efforts: This supports primary prevention. By securing resources for health promotion, the nurse is contributing to initiatives that aim to prevent illness and promote well-being across the school community before health problems arise.

A. A durable medical power of attorney designates a trusted person to make healthcare decisions on behalf of the client if they become unable to do so. While important, it focuses on decision-making authority rather than specific treatment preferences.

B. A do-not-resuscitate (DNR) prescription specifically addresses whether resuscitation efforts should be initiated but does not cover broader end-of-life care preferences or wishes. It is one component of advance care planning but not the comprehensive document for overall wishes.

C. An organ donation card expresses the client’s wishes regarding donation of organs after death. Although valuable, it does not address broader end-of-life care decisions or treatments.

D. A living will is a legal document that details the client’s preferences for end-of-life care, including treatments they want to accept or refuse. It ensures that their wishes are honored when they cannot communicate, making it the most appropriate document for this purpose.