A school nurse is discussing stress management techniques with a group of adolescents. Which of the following activities reported by an adolescent should the nurse identify as the priority?

The correct answer is Choice A because, "I am obese because it's in my genes." The client is using rationalization as a coping mechanism by justifying their obesity as being predetermined by their genes, rather than acknowledging their personal responsibility in managing their weight. Rationalization is a defense mechanism in which a person gives a false or socially acceptable explanation for an unacceptable behavior or situation.

Choice B is wrong because, "I have difficulty resisting the items in vending machines," is not the correct answer because it is an excuse rather than a rationalization.

Choice C is wrong because, "I know you don't like me because I am obese," is not the correct answer because it is an example of projection, in which the client attributes their own feelings of dislike to others.

Choice D is wrong because, "I have lots of health problems from being obese," is not the correct answer because it is a justification, not a rationalization

The correct answer is Choice D because, "Test a client who has a family history for diabetes mellitus." Secondary prevention refers to early detection and intervention to prevent the progression of disease. Testing individuals who have a family history of diabetes mellitus is an example of secondary prevention as it allows for early detection and intervention to prevent or delay the onset of diabetes.

Choice A is wrong because, "Educate a client who has hypertension about exercises to reduce blood pressure," is not the correct answer as it is an example of primary prevention, which focuses on preventing the development of disease or injury in individuals who are at risk. Hypertension is a risk factor for cardiovascular disease, and educating individuals about lifestyle modifications, such as exercise, can prevent the development of hypertension and other comorbidities.

Choice B is wrong because, "Teach a group of school-age children about hand hygiene," is not the correct answer as it is an example of primary prevention, which aims to prevent the occurrence of disease or injury in populations that are at risk. Hand hygiene is an essential component of infection control, and teaching school-age children about it can prevent the spread of infectious diseases in schools.

Choice C is wrong because, "Provide nutrition counseling for an adolescent who is underweight," is not the correct answer as it is an example of tertiary prevention, which focuses on preventing complications and reducing the impact of established disease or injury. Nutrition counseling for an adolescent who is underweight aims to prevent complications related to malnutrition, such as growth delays, cognitive impairment, and increased susceptibility to infections.