A public health nurse is comparing mortality rates in their state to overall mortality rates in the U.S. Which of the following mortality rates should the nurse use for this comparison?

Choice A Reason:
The client reports there are bike paths or running trails in their community. This statement indicates a positive aspect of the built environment. The presence of bike paths and running trails promotes physical activity and overall well-being. It does not suggest any faults in the built environment.

Choice B Reason:
The client reports contaminants in their drinking water at home. This statement clearly indicates a faulty built environment. Contaminated drinking water poses significant health risks and reflects poor infrastructure or inadequate maintenance of water supply systems. Ensuring access to clean and safe drinking water is a fundamental aspect of a healthy built environment.

Choice C Reason:
The client reports that there is limited public parking on their street. While limited public parking can be an inconvenience, it does not directly indicate a faulty built environment. Parking availability is more related to urban planning and transportation policies rather than the overall quality of the built environment.

Choice D Reason:
The client reports a lack of community centers in their neighborhood. Although the absence of community centers can affect social interactions and community engagement, it does not necessarily indicate a faulty built environment. It highlights a gap in community resources but does not directly impact the safety or health of the environment.

Choice A Reason:
The nurse should review the state laws to determine if and how this information should be shared with the National Notifiable Disease Surveillance System. This is the correct answer because HIV is a notifiable disease, meaning that cases must be reported to public health authorities to monitor and control the spread of the infection. Each state has specific laws and regulations regarding the reporting of notifiable diseases, and it is crucial for the nurse to be aware of these requirements to ensure compliance and public health safety.

Choice B Reason:
The nurse should recognize this diagnosis as an indication that the outreach program is not successful. This statement is incorrect. A positive diagnosis does not necessarily mean that the outreach program is unsuccessful. On the contrary, identifying and linking individuals to care is a key objective of such programs. The success of the program can be measured by its ability to reach high-risk individuals, provide testing, and ensure they receive appropriate care and support.

Choice C Reason:
Outside the healthcare team, the nurse should keep this diagnosis confidential. While confidentiality is critical in healthcare, the reporting of notifiable diseases like HIV is an exception due to public health concerns. The nurse must balance confidentiality with the legal obligation to report the diagnosis to public health authorities. This ensures that appropriate measures can be taken to prevent further transmission and provide necessary public health interventions.