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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.
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After describing the various legislative efforts to address the issue of homelessness in the United States, a nursing instructor determines that the teaching was successful when the students identify which of the following as addressing the need for a continuum of care approach?
- A. Bringing Home America Act
- B. Affordable Care Act
- C. American Recovery and Reinvestment Act
- D. McKinney-Vento Homeless Assistance Act
Correct Answer: D
Rationale: The McKinney-Vento Homeless Assistance Act (D) addresses homelessness through a continuum of care approach, funding services like housing, healthcare, and support for homeless individuals. The Bringing Home America Act (A) is not a recognized law, the Affordable Care Act (B) focuses on healthcare access, and the American Recovery Act (C) targets economic recovery.
A nursing instructor is preparing a teaching plan for a group of nursing students who will be working with homeless populations. As part of the class, the instructor will be including information about barriers to successful treatment of homeless clients who are mentally ill. Which reason would the instructor include as contributing to lack of compliance with psychotropic medications?
- A. Mistrust of medical personnel
- B. Lack of proper medication storage
- C. Chemical dependence on prescription medications
- D. Lack of motivation and literacy skills
Correct Answer: B
Rationale: Lack of proper medication storage (B) is a significant barrier for homeless individuals, as they often lack secure, stable environments to store psychotropic medications. Mistrust (A), chemical dependence (C), and lack of motivation/literacy (D) may contribute but are less specific to medication compliance than storage issues.
A new graduate nurse is considering taking a job that focuses on meeting the mental health needs of homeless populations. During the graduate nurse?s pre-employment interview, the graduate nurse asks the interviewer what characteristics are common in this population. Which response by the interviewer would be most likely?
- A. Most of them have very little education and, consequently, they work in menial jobs when they can get them.
- B. They come from a variety of backgrounds, and they often experience chronic illness and are unemployed.
- C. They have often squandered their financial resources, and most are from poorer rural and urban backgrounds.
- D. Most are frail elderly people, and many are mentally ill. However, very few are addicts or alcoholics.
Correct Answer: B
Rationale: Homeless populations are diverse, coming from various backgrounds, and often face chronic illness and unemployment (B), reflecting the complexity of their challenges. Option A stereotypes education and job type, option C assumes financial mismanagement, and option D incorrectly limits the population to frail elderly and minimizes addiction issues.
A nurse is working for a mobile homeless treatment program. Which method would the nurse most likely use to provide follow-up care to clients?
- A. Seeing them by appointment at a clinic office
- B. Riding a bicycle to wherever the client happens to be
- C. Meeting the client in a public place easily accessible by taxi
- D. Using the telephone to determine how well the clients are doing
Correct Answer: C
Rationale: Meeting in a public place accessible by taxi (C) is practical for a mobile homeless treatment program, balancing accessibility and safety. Clinic appointments (A) are challenging due to transportation issues, riding a bicycle (B) is impractical, and telephone follow-up (D) is unreliable due to limited phone access among homeless clients.
The nurse is developing a plan of care for a client who has been admitted to the inpatient unit after being brought to the emergency department by law enforcement. Assessment in the emergency department revealed that the client is homeless and has been diagnosed with posttraumatic stress syndrome. The client also has a history of substance abuse. When reviewing the client?s medical record, which of the following would the nurse identify as contributing to the client?s homelessness? Select all that apply.
- A. Diagnosis of posttraumatic stress syndrome
- B. Involved participation of family members
- C. Part-time employment as a custodian
- D. History of substance abuse
- E. Recent loss of public assistance support
Correct Answer: A,D,E
Rationale: Posttraumatic stress syndrome (A), substance abuse (D), and loss of public assistance (E) are significant contributors to homelessness due to their impact on mental health, stability, and resources. Family involvement (B) typically mitigates homelessness, and part-time employment (C) is less directly causative.