A nurse is counseling a group of clients from a town that was affected by a hurricane 6 months ago. For which of the following clients should the nurse initiate a referral to assess for the presence of post-traumatic stress disorder? (Select all that apply)

Choice A reason: Red meat is high in saturated fats and sodium, which can elevate blood pressure, worsening hypertension. It is not recommended for a heart-healthy diet, as it increases cardiovascular strain. The nurse should suggest leaner proteins instead, making this an incorrect dietary choice.
Choice B reason: Cheese is often high in sodium and saturated fat, contributing to increased blood pressure and cardiovascular risk in hypertension. Low-sodium alternatives are preferred, but cheese is generally discouraged, making this an inappropriate food to recommend for this client’s diet.
Choice C reason: Canned black beans are high in sodium, which exacerbates hypertension by promoting fluid retention and vascular strain. Rinsing reduces sodium, but fresh or low-sodium options are better. This choice is less ideal than fresh produce, making it incorrect for hypertension management.
Choice D reason: Fresh spinach is rich in potassium, magnesium, and fiber, which help lower blood pressure by counteracting sodium and relaxing blood vessels. It aligns with the DASH diet, an evidence-based approach for hypertension, making it the best food to recommend for this client’s condition.

Choice A reason: Stating immunizations are required for air travel is inaccurate, as no such mandate exists for infants. This response does not address the parents’ concerns or educate them, potentially alienating them, making it ineffective and incorrect for fostering dialogue about immunization.
Choice B reason: Offering a referral to an infectious disease provider is premature and does not directly address the parents’ decision. Education and discussion are needed first to understand their concerns, making this response less effective and inappropriate as an initial approach.
Choice C reason: Suggesting no need to immunize against rare diseases is misleading, as vaccines prevent resurgences (e.g., measles). This undermines public health and dismisses the parents’ concerns, making it incorrect and potentially harmful to the infant’s health.
Choice D reason: Inviting discussion about the parents’ knowledge fosters open, non-judgmental communication, allowing the nurse to address misconceptions and provide evidence-based information. This therapeutic approach builds trust and encourages informed decision-making, making it the correct response for vaccine hesitancy.