A nurse is caring for a client who has an acute case of cellulitis. After implementing a treatment protocol with the client, the client reports that they have had difficulty finding a job for almost a year and they sometimes skip meals to save money. Which problem is the priority for the nurse to address in the care plan?

Choice A Reason:
An older adult couple living in a community where goods and services are within walking distance is likely to experience long-term economic stability due to reduced transportation costs and increased accessibility to essential services. This setup minimizes the need for a vehicle, which can be a significant financial burden, especially for those on a fixed income. Additionally, the proximity to services can enhance their quality of life and reduce healthcare costs by promoting physical activity and social engagement.

Choice B Reason:
A single parent of two children who uses ride-share services may face financial instability due to the high costs associated with frequent ride-share usage. While ride-share services provide flexibility and convenience, they can be expensive over time, especially for a single parent managing multiple responsibilities and expenses. This choice does not offer the same level of economic stability as living in a walkable community.

Choice C Reason:
A client who has diabetes mellitus and regularly relies upon a family member for transportation may experience economic instability due to the dependency on others for mobility. This reliance can limit their ability to access employment opportunities and essential services independently. Additionally, managing a chronic condition like diabetes can be financially burdensome due to ongoing medical expenses.

Choice D Reason:
A young family regularly using public transportation services to acquire goods and services may face challenges related to the reliability and availability of public transportation. While public transportation can be cost-effective, it may not always be convenient or accessible, especially for families with young children. This can impact their ability to maintain consistent employment and access essential services, potentially affecting their long-term economic stability.

Choice A Reason:
Research indicating that a screening is not warranted at this time and may be harmful aligns with a Grade D recommendation from the USPSTF. Grade D recommendations suggest that the service has no net benefit or that the harms outweigh the benefits, and therefore, it should be discouraged.

Choice B Reason:
A Grade C recommendation from the USPSTF means that the service should be selectively offered or provided to individual patients based on professional judgment and patient preferences. There is at least moderate certainty that the net benefit is small. This means that while there is some benefit, it is not substantial enough to recommend the service for all individuals.

Choice C Reason:
The statement that there is not enough evidence to determine if a screening is helpful or not corresponds to a Grade I (Insufficient) recommendation. This grade indicates that the current evidence is insufficient to assess the balance of benefits and harms of the service. More research is needed to make a definitive recommendation.

Choice D Reason:
Research indicating that a screening exam is beneficial aligns with a Grade A or B recommendation. Grade A recommendations suggest high certainty that the net benefit is substantial, while Grade B recommendations suggest high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.