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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.
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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 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 nurse is teaching an in-service education class about caring for homeless populations. When explaining the difference between the care provided by Safe Havens and Shelter Plus Care, which of the following would the nurse include?
- A. Shelter Plus Care offers more services to a larger population than does Safe Havens.
- B. Safe Havens provides shelter for as many as 100 people at a time.
- C. Safe Havens provides traditional support services as well as short-term housing.
- D. Shelter Plus Care offers a variety of supportive services in addition to long-term housing.
Correct Answer: D
Rationale: Shelter Plus Care provides long-term housing with supportive services (D), such as case management and healthcare, for homeless individuals with disabilities. Safe Havens offer smaller-scale, low-barrier transitional housing. Option A is incorrect, as Safe Havens target specific populations. Option B overstates Safe Havens? capacity, and option C misrepresents their focus.
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.
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.