A community health nurse is working in a rural area where there are many homes built before the 1970s. To promote good health, which of the following actions should the nurse take?

Choice A: Make a Report to Child Protective Services (CPS)
This is the correct action for the nurse to take. Nurses are mandated reporters, meaning they are legally required to report any suspected cases of child abuse or neglect to the appropriate authorities. Child Protective Services (CPS) is the agency responsible for investigating reports of child abuse and ensuring the safety and well-being of children. Reporting to CPS ensures that the case is handled by professionals trained to investigate and intervene in such situations.

Choice B: Call the Police and Report the Suspected Abuse
While calling the police may seem like a logical step, it is not the primary action a nurse should take in this situation. The police may become involved later in the process, especially if there is an immediate threat to the child's safety. However, the initial report should be made to CPS, as they are the designated agency for handling child abuse cases.

Choice C: Call the Child's Guardian to Have the Child's Pediatrician Confirm the Suspected Abuse
This action is not appropriate because it could potentially place the child in further danger. If the guardian is the abuser, notifying them could lead to retaliation against the child or attempts to cover up the abuse. Additionally, it is not the role of the pediatrician to confirm abuse; this is the responsibility of CPS and law enforcement.

Choice D: Alert the School Principal of the Situation
While it is important to keep school officials informed, the nurse's primary responsibility is to report the suspected abuse to CPS. The school principal can be informed after the report has been made, but the immediate priority is to ensure the child's safety by contacting the appropriate authorities.

Choice A: Proportionate Mortality
Proportionate mortality refers to the proportion of deaths in a specified population over a period of time attributable to different causes. It is expressed as a percentage of the total number of deaths. While this measure can provide insight into the relative importance of different causes of death, it does not give the actual mortality rate for each cause. Therefore, it is not the best measure for identifying the top three causes of death in a county.

Choice B: Crude Mortality Rate
The crude mortality rate is the total number of deaths from all causes per 1,000 or 100,000 population in a given year. This measure provides an overall picture of the mortality level in a population but does not specify the causes of death. It is useful for general mortality trends but not for identifying specific causes of death.

Choice C: Cause-Specific Mortality Rate
The cause-specific mortality rate is the number of deaths from a specific cause per 100,000 population in a given year. This measure is the most appropriate for identifying the top three causes of death because it provides detailed information on the mortality rate for each specific cause. By calculating the cause-specific mortality rates, the nurse can determine which causes are the most significant contributors to mortality in the county.

Choice D: Case Fatality
Case fatality refers to the proportion of individuals diagnosed with a particular disease who die from that disease within a specified period. It is usually expressed as a percentage. While case fatality provides information on the severity of a disease, it does not give the overall mortality rate for the population or help identify the top causes of death.