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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.
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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 group of nurses is in a discussion about the homeless population in their community as a means for developing appropriate programs for this group. Which statement by one of the members indicates a need for the group to address the nurse?s stereotypical thinking?
- A. Homeless individuals must be creative in figuring out ways to survive.
- B. People who are homeless come from all walks of life.
- C. If the person lives on the street, he will not accept services.
- D. Most people are homeless for a relatively short period of time.
Correct Answer: C
Rationale: The statement that street-living individuals will not accept services (C) reflects a stereotype, assuming unwillingness without evidence. Options A, B, and D are accurate, recognizing creativity, diversity, and the transient nature of homelessness, respectively.
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 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 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.