A home health nurse is planning the initial home visit for a client who has dementia and lives with his adult son's family. Which of the following actions should the nurse take first during the visit?

Choice A reason: Tracking rates of illness caused by infection among employees is not an action that will help the nurse detect potential physical hazards, as it is related to biological hazards. Biological hazards are living organisms or substances that can cause disease or infection, such as bacteria, viruses, fungi, or parasites. The nurse should track rates of illness caused by infection among employees to monitor the prevalence and incidence of occupational infections, such as tuberculosis, hepatitis, or COVID-19, and to implement preventive and control measures.

Choice B reason: Surveying workers about job-related emotional stress is not an action that will help the nurse detect potential physical hazards, as it is related to psychosocial hazards. Psychosocial hazards are factors that affect the mental and emotional well-being of workers, such as workload, autonomy, communication, recognition, or violence. The nurse should survey workers about job-related emotional stress to assess the level and sources of occupational stress, burnout, or fatigue, and to provide counseling, support, or referral.

Choice C reason: Identifying industrial toxins that are present in the environment is not an action that will help the nurse detect potential physical hazards, as it is related to chemical hazards. Chemical hazards are substances that can harm the health or safety of workers, such as solvents, acids, gases, or pesticides. The nurse should identify industrial toxins that are present in the environment to evaluate the exposure and risk of workers, and to implement protective measures, such as ventilation, personal protective equipment, or safe handling procedures.

Choice D reason: Measuring noise levels at various locations in the facility is an action that will help the nurse detect potential physical hazards, as noise is a common and harmful physical hazard. Physical hazards are factors that can harm the body or damage the equipment or materials, such as noise, vibration, temperature, radiation, or electricity. The nurse should measure noise levels at various locations in the facility to determine the intensity and duration of noise exposure, and to implement noise reduction measures, such as engineering controls, administrative controls, or hearing protection devices.

Choice A reason: Presenting community education programs about stress management is not an example of tertiary prevention, but rather an example of primary prevention. Primary prevention aims to prevent violence from occurring in the first place by addressing the underlying causes and risk factors. Stress management is one of the strategies that can help reduce the potential for violent behavior.

Choice B reason: Developing resources for victims of abuse is an example of tertiary prevention. Tertiary prevention aims to reduce the consequences and complications of violence by providing treatment and rehabilitation for the survivors. Resources for victims of abuse may include counseling, shelter, legal aid, and support groups.

Choice C reason: Urging community leaders to make nonviolence a priority is not an example of tertiary prevention, but rather an example of secondary prevention. Secondary prevention aims to detect and intervene in violence as early as possible by identifying and responding to the warning signs and symptoms. Community leaders can play a role in promoting a culture of nonviolence and enforcing policies and laws that protect the victims and punish the perpetrators.

Choice D reason: Assessing for risk factors of intimate partner abuse during health examinations is not an example of tertiary prevention, but rather an example of secondary prevention. Secondary prevention aims to detect and intervene in violence as early as possible by identifying and responding to the warning signs and symptoms. Health examinations can provide an opportunity for screening and counseling the clients who may be at risk of or experiencing intimate partner abuse.