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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.
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A nurse is assessing a 49-year-old homeless male client. The nurse fashions the assessment process based on the understanding that the client would most likely demonstrate which of the following?
- A. Cooperation and talkativeness to share his ideas
- B. Agreement to allow a complete physical examination
- C. Desire for in-depth discussion of his condition
- D. Resistance and caution about the interaction
Correct Answer: D
Rationale: Homeless individuals often exhibit resistance and caution (D) during assessments due to mistrust from past experiences or stigma. Cooperation (A), agreement to physical exams (B), or desire for in-depth discussion (C) are less likely due to barriers like fear of judgment or lack of trust in healthcare providers.
The nurse is working in a shelter for homeless men. When planning the care for these clients, the nurse integrates understanding that men who have been homeless for a long period of time often feel a sense of which of the following?
- A. Depersonalization
- B. Strong coping skills
- C. Self-efficacy
- D. Fear of failure
Correct Answer: A
Rationale: Long-term homelessness often leads to depersonalization (A), a sense of disconnection from self or identity, due to chronic social isolation and marginalization. Strong coping skills (B) and self-efficacy (C) are less likely, as prolonged homelessness often erodes these. Fear of failure (D) may be present but is less specific than depersonalization.
The nurse is helping a 56-year-old homeless woman develop a plan for after discharge. Which of the following would be most appropriate to include?
- A. Contacting the woman?s daughter as a possible source of support after the client?s discharge
- B. Contacting the woman?s parents as a possible source of support after the client?s discharge
- C. Providing the woman with a three-ring binder full of resources that will promote independent living
- D. Providing the woman with telephone numbers of various local health care insurance companies
Correct Answer: A
Rationale: Contacting the woman?s daughter (A) is most appropriate, as it leverages potential family support to aid post-discharge stability. Contacting parents (B) is less likely, given the client?s age. A binder of resources (C) may be overwhelming without guidance, and insurance company numbers (D) are less immediate for a homeless individual.
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.