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A client who is homeless and mentally ill is being discharged to an Assertive Community Treatment (ACT) program. The nurse interprets this as including which of the following services? Select all that apply.
- A. Substance abuse management
- B. Medication monitoring
- C. Counseling
- D. Living skills classes
- E. Shelter for one night
Correct Answer: A,B,C,D
Rationale: Assertive Community Treatment (ACT) programs provide comprehensive services for mentally ill individuals, including substance abuse management (A), medication monitoring (B), counseling (C), and living skills classes (D). Shelter for one night (E) is not typically part of ACT, which focuses on long-term support.
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A nurse working in an emergency homeless shelter is interviewing a woman who has just arrived with her two small children. When assessing this client, the nurse would expect the woman to report which of the following as the reason for seeking shelter?
- A. Substance abuse
- B. Domestic violence
- C. Unemployment
- D. Imprisonment
Correct Answer: B
Rationale: Domestic violence (B) is a leading cause of homelessness for women with children, as it often forces them to flee unsafe home environments. Substance abuse (A), unemployment (C), and imprisonment (D) are less common primary reasons for women with children seeking shelter.
A nurse is developing a plan of care for a male client who is homeless. Which of the following would the nurse do first?
- A. Refer the client to social services to access necessary benefits.
- B. Provide the client with a list of facilities that are safe.
- C. Discuss how the client can maintain his privacy.
- D. Stabilize the client?s physical health status.
Correct Answer: D
Rationale: Stabilizing physical health status (D) is the first priority, addressing immediate health needs that impact survival and well-being in homeless clients. Referrals (A), facility lists (B), and privacy discussions (C) are important but secondary to physical health stabilization.
A nursing instructor is preparing a class on individuals who are homeless and mentally ill for a group of nursing students. When describing the characteristics of this population, which of the following would the instructor most likely include? Select all that apply.
- A. Individuals usually receive psychiatric care in outpatient units.
- B. Their physical health is likely to be worse than that of other homeless individuals.
- C. Most have easy access to disability or other types of benefits.
- D. Individuals typically are more often involved with the legal system than other homeless people.
- E. An individual with a mental illness has the greatest risk of becoming homeless than others.
Correct Answer: B,D,E
Rationale: Homeless individuals with mental illness often have worse physical health (B) due to untreated conditions, are more involved with the legal system (D) due to behavioral issues, and have a higher risk of homelessness (E) due to social and economic challenges. Outpatient care (A) is often inaccessible, and benefits (C) are not easily accessed.
A nurse has formulated several nursing diagnoses for a homeless client after a thorough nursing assessment. Of these, which of the following would the nurse determine as the priority?
- A. Anxiety
- B. Powerlessness
- C. Imbalanced nutrition
- D. Impaired social interaction
Correct Answer: C
Rationale: Imbalanced nutrition (C) is the priority, as it addresses a basic physiological need critical for survival and health, especially in homeless individuals with limited access to food. Anxiety (A), Powerlessness (B), and Impaired social interaction (D) are important but secondary to addressing nutritional deficits.
The nurse is caring for a homeless client who has been seen in the mobile clinic every week for the past month because of a foot infection. Which nursing diagnosis would the nurse most likely identify as the priority?
- A. Social Isolation related to homelessness
- B. Ineffective Health Maintenance related to homelessness
- C. Chronic Low Self-Esteem related to foot disorder and homelessness
- D. Imbalanced Nutrition, less than body requirements, related to poor eating
Correct Answer: B
Rationale: A foot infection requiring weekly visits indicates Ineffective Health Maintenance (B) as the priority, as it addresses the immediate need to manage the infection, which poses a health risk. Social Isolation (A), Chronic Low Self-Esteem (C), and Imbalanced Nutrition (D) are relevant but secondary to treating the infection.