A nurse is discussing health insurance coverage with state legislators.
Which of the following disadvantages related to health insurance should the nurse include in the discussion that is specific to clients who live in rural communities rather than urban areas?

Choice A rationale
Limited access to primary care providers is a significant disadvantage related to health insurance for clients who live in rural communities. Rural areas often have fewer healthcare providers, which can make it difficult for residents to receive the care they need. This can lead to delays in care, unmet health needs, and worsening of existing health conditions.
Choice B rationale
While the availability of managed care insurance can vary by location, this is not a disadvantage specific to rural communities. Both urban and rural areas can have limited availability of certain types of health insurance.
Choice C rationale
Financial risk that is typical of underinsured clients is not specific to rural communities. Both urban and rural residents can be underinsured, which can lead to significant out-of-pocket costs and financial strain.
Choice D rationale
Lack of government-provided health insurance is not a disadvantage specific to rural communities. Government-provided health insurance programs, such as Medicare and Medicaid, are available to eligible individuals regardless of whether they live in an urban or rural area.

Choice A rationale
The adolescent’s experimentation with drugs could be a coping mechanism to deal with the trauma of the sexual assault and the subsequent posttraumatic stress disorder (PTSD).
Substance use, including drug use, is often a maladaptive coping strategy used by individuals

who have experienced trauma to numb their feelings, escape from their reality, or attempt to regain control. This must indeed be a difficult time for both the adolescent and the parent.
Choice B rationale
While experimentation is a part of normal adolescent behavior, it is not normal or healthy for an adolescent to use drugs, especially in response to a traumatic event such as a sexual assault. Drug use can lead to addiction, health problems, and further psychological distress. Therefore, it is something to be concerned about and addressed appropriately.
Choice C rationale
While it is important to understand and address the parent’s concerns, the focus should be on the adolescent’s needs. The adolescent is dealing with the aftermath of a sexual assault and a diagnosis of PTSD, and is using drugs. These are serious issues that need to be addressed with professional help. The question of which behavior to address first should be determined based on the adolescent’s immediate safety and well-being.
Choice D rationale
It is not helpful to label the adolescent’s behavior as misbehavior or to compare them to their siblings. Each child is unique and may react differently to stress and trauma. Instead of focusing on rules and comparisons, it would be more beneficial to provide support, understanding, and appropriate professional help.