An employee presents to an occupational health nurse with concerns that their hearing is worse on one side. Which of the following actions should the nurse take first to address the employee's concern?

Choice A Reason:
The Tuskegee Syphilis Study does not provide guidelines for the recruitment of Black and African-American research participants. Instead, it is a historical example of unethical research practices that led to significant harm and mistrust within the Black community. The study involved misleading and withholding treatment from Black men with syphilis, which has had long-lasting effects on their willingness to participate in research.

Choice B Reason:
The Tuskegee Syphilis Study did not demonstrate a correlation between coronary artery disease and syphilis. The study was focused solely on the natural progression of untreated syphilis in Black men. It did not investigate or establish any links to coronary artery disease. This choice is incorrect as it misrepresents the purpose and findings of the study.

Choice C Reason:
The Tuskegee Syphilis Study did not exclude Black men; in fact, it specifically targeted Black men for participation. The study involved 600 Black men, 399 of whom had syphilis and 201 who did not. The men were misled about the nature of the study and were not provided with adequate treatment, even after penicillin became the standard treatment for syphilis. This choice is incorrect as it inaccurately describes the study's participant selection.

Choice D Reason:
The Tuskegee Syphilis Study is indeed a source of distrust and a barrier to Black clients participating in research studies. The unethical treatment of the participants, including the lack of informed consent and the withholding of effective treatment, has led to a deep-seated mistrust of medical research within the Black community. This mistrust can make it challenging to recruit Black participants for research studies, as they may fear similar exploitation and harm.

Choice A: Impaired Transferability
Impaired transferability typically refers to an individual's difficulty in moving from one place to another, often due to physical limitations. This is a personal health diagnosis rather than a community diagnosis. Community diagnoses focus on broader issues that affect the health of the entire community rather than individual health problems.

Choice B: Disturbed Sleep Pattern
A disturbed sleep pattern is an individual health issue that affects a person's sleep quality and duration. While sleep issues can be prevalent in a community, this term is more commonly used in individual health assessments. Community diagnoses address collective health concerns that impact the community as a whole.

Choice C: Risk for Infection
Risk for infection is a term used to describe the potential for an individual to develop an infection. Although infection control can be a community health concern, this term is generally used in the context of individual health assessments. Community diagnoses would focus on factors contributing to the spread of infections within the community.

Choice D: Alteration in Family Health Management
This is the correct choice. Alteration in family health management refers to changes or challenges in how families manage their health and well-being. This can include issues such as access to healthcare, health education, and support systems. As a community diagnosis, it addresses the collective health management practices of families within the community, making it a broader public health concern.