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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.
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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.
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 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.
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.
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.