A community health nurse is counseling a client who cares for a mentally ill parent. The client states, "I am feeling overwhelmed and exhausted." Which of the following referrals should the nurse make to provide this client with first level support?

Choice A Reason:
The client reports there are bike paths or running trails in their community. This statement indicates a positive aspect of the built environment. The presence of bike paths and running trails promotes physical activity and overall well-being. It does not suggest any faults in the built environment.

Choice B Reason:
The client reports contaminants in their drinking water at home. This statement clearly indicates a faulty built environment. Contaminated drinking water poses significant health risks and reflects poor infrastructure or inadequate maintenance of water supply systems. Ensuring access to clean and safe drinking water is a fundamental aspect of a healthy built environment.

Choice C Reason:
The client reports that there is limited public parking on their street. While limited public parking can be an inconvenience, it does not directly indicate a faulty built environment. Parking availability is more related to urban planning and transportation policies rather than the overall quality of the built environment.

Choice D Reason:
The client reports a lack of community centers in their neighborhood. Although the absence of community centers can affect social interactions and community engagement, it does not necessarily indicate a faulty built environment. It highlights a gap in community resources but does not directly impact the safety or health of the environment.

Choice A Reason:
Proportionate mortality refers to the proportion of deaths in a population attributable to different causes. It is expressed as a percentage of total deaths. While useful for understanding the distribution of causes of death, it does not provide a direct comparison of overall mortality rates between different populations or regions.

Choice B Reason:
Case fatality rate is the proportion of individuals diagnosed with a particular disease who die from that disease within a specified period. It is a measure of the severity of the disease rather than the overall mortality rate. This metric is not suitable for comparing general mortality rates between a state and the entire country.

Choice C Reason:
Cause-specific mortality rate refers to the mortality rate from a specific cause of death within a population. While this can provide insights into the impact of particular diseases or conditions, it does not offer a comprehensive view of overall mortality. Comparing cause-specific mortality rates would require multiple comparisons for different causes, complicating the analysis.

Choice D Reason:
Crude mortality rate is the total number of deaths in a population over a specific period, usually expressed per 1,000 or 100,000 individuals. This rate provides a straightforward measure of the overall mortality in a population, making it the most appropriate metric for comparing mortality rates between a state and the entire country. It allows for a direct comparison of the general health status and mortality burden across different regions.