A nurse is caring for a client who is homeless. Which of the following actions should the nurse take first?
Determine the client's understanding of her living situation.
Assist the client to develop goals for obtaining shelter.
Discuss the risks of being homeless with the client.
Develop client teaching using a variety of strategies.
The Correct Answer is A
Choice A reason: Determining the client's understanding of her living situation is the first action that the nurse should take. This is based on the principle of client-centered care, which states that the nurse should respect the client's values, preferences, and needs, and involve the client in the decision-making process. The nurse should assess the client's perception of her homelessness, the factors that contributed to it, and the resources that are available to her.
Choice B reason: Assisting the client to develop goals for obtaining shelter is not the first action that the nurse should take. This is an important intervention, but it should be done after the nurse has assessed the client's understanding of her living situation and explored the client's readiness and motivation to change.
Choice C reason: Discussing the risks of being homeless with the client is not the first action that the nurse should take. This is an important intervention, but it should be done after the nurse has assessed the client's understanding of her living situation and established a trusting relationship with the client. The nurse should avoid being judgmental or paternalistic, and instead use a harm reduction approach that focuses on minimizing the negative consequences of homelessness.
Choice D reason: Developing client teaching using a variety of strategies is not the first action that the nurse should take. This is an important intervention, but it should be done after the nurse has assessed the client's understanding of her living situation and identified the client's learning needs and preferences. The nurse should use strategies that are appropriate for the client's literacy level, language, culture, and cognitive ability.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Creating diversionary activities for children is not the priority action for the nurse to take. This is a supportive intervention that can help the children cope with the stress and trauma of the disaster, but it should be done after the nurse has ensured the safety and well-being of the clients.
Choice B reason: Addressing the physical needs of clients is the priority action for the nurse to take. This is based on the principle of Maslow's hierarchy of needs, which states that the nurse should prioritize the most basic and essential needs of the clients, such as food, water, shelter, clothing, and medical care. The nurse should assess the clients for any injuries, illnesses, or chronic conditions, and provide appropriate interventions or referrals.
Choice C reason: Helping clients gather needed supplies is not the priority action for the nurse to take. This is a helpful intervention that can assist the clients to obtain the resources and materials they need to survive and recover from the disaster, but it should be done after the nurse has addressed the physical needs of the clients.
Choice D reason: Exploring feelings the clients are experiencing is not the priority action for the nurse to take. This is a therapeutic intervention that can facilitate the emotional and psychological healing of the clients, but it should be done after the nurse has addressed the physical needs of the clients. The nurse should also respect the clients' readiness and willingness to share their feelings, and avoid forcing or rushing the process.
Correct Answer is D
Explanation
The correct answer is D.
Caffeinated beverages should be replaced with caffeine-free beverages. High levels of caffeine can cause low birth weight and may increase the chance of miscarriage. Pregnant women metabolize caffeine more slowly, which can affect the fetus.
Choice A reason: The need for supplemental folic acid is greatest during the first trimester to prevent neural tube defects. The recommended daily dose is 600 mcg.
Choice B reason: Adolescent pregnancy is associated with a higher risk of low birth weight infants, not high birth weight.
Choice C reason: Pregnant adolescents generally need to gain an appropriate amount of weight, similar to adult mothers, to support the growth and development of the fetus. The weight gain recommendations during pregnancy are based on the mother's pre-pregnancy BMI.
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