Nokea
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 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 presenting a talk on homelessness and its effect on individuals. The nurse describes the resiliency of homeless individuals based on which of the following?
- A. Strong community supports
- B. Available family resources
- C. Coping with extreme stressors
- D. Local governmental intervention
Correct Answer: C
Rationale: Resiliency in homeless individuals is often rooted in their ability to cope with extreme stressors (C), such as lack of shelter, food insecurity, and social stigma. Strong community supports (A) and family resources (B) are often limited, and local governmental intervention (D) is typically inconsistent or insufficient.
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.
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 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.