A community health nurse is reviewing primary prevention strategies for West Nile virus with a group of clients in a rural health clinic. Which of the following instructions should the nurse include?

A. "Children are more resilient to the effects of poverty than adults": Children are particularly vulnerable to the effects of poverty due to inadequate nutrition, limited access to healthcare, and increased exposure to adverse childhood experiences, which can have long-term physical and mental health consequences.

B. "Minority groups living in poverty experience lower rates of chronic disease": Minority populations in poverty often experience higher rates of chronic illnesses such as diabetes, hypertension, and cardiovascular disease due to disparities in healthcare access, increased stress, and socioeconomic barriers to preventive care.

C. "Older adults are less likely to experience poverty due to receiving Social Security benefits": While Social Security provides financial assistance, many older adults still live in poverty due to high medical costs, inadequate retirement savings, and the rising cost of living, leading to food insecurity and difficulty affording medications.

D. "Adolescents living in poverty are more likely to be diagnosed with a conduct disorder": Poverty is associated with increased exposure to environmental stressors, family instability, and limited access to mental health resources, which can contribute to higher rates of behavioral disorders, including conduct disorder, in adolescents.

A. Provide educational in-services for staff: While staff education is an important component of a quality improvement project, it is not the first action to take. Understanding the underlying factors contributing to MRSA infections should be the priority to ensure that educational initiatives are targeted and relevant.

B. Develop a MRSA protocol for implementation: Developing a protocol is necessary for guiding practice and reducing infections. However, it is essential to first gather data on existing practices and factors contributing to MRSA infections to ensure the protocol addresses specific issues.

C. Evaluate outcomes resulting from interventions: Evaluation of outcomes is a crucial step in the quality improvement process but occurs after implementing interventions. Initial actions should focus on identifying the root causes of MRSA infections before assessing the effectiveness of any interventions.

D. Conduct a chart review to evaluate precipitating factors of clients who develop MRSA: Conducting a chart review is the first action the nurse manager should take. This step allows for the identification of patterns and factors contributing to MRSA infections, providing valuable data that will inform the development of effective protocols and interventions tailored to the facility's needs.