A nurse is working in a shelter following a disaster. Which of the following is the priority action for the nurse to take?

Choice A reason: Touching the hair of an African American client during an assessment does not demonstrate accurate cultural knowledge, as it may be considered disrespectful or intrusive. Hair is a sensitive and personal topic for many African Americans, who may have experienced discrimination or stigma based on their hair texture or style¹. The nurse should ask for permission before touching the client's hair and explain the purpose of the assessment.

Choice B reason: Offering to shake hands when meeting an Asian client of the opposite gender does not demonstrate accurate cultural knowledge, as it may be considered inappropriate or offensive. In some Asian cultures, physical contact between men and women who are not related or married is discouraged or prohibited². The nurse should observe the client's body language and follow the client's lead in greeting gestures.

Choice C reason: Maintaining eye contact when interviewing a Native American client does not demonstrate accurate cultural knowledge, as it may be considered rude or aggressive. In some Native American cultures, eye contact is a sign of disrespect or challenge, especially when talking to elders or authority figures³. The nurse should avoid direct eye contact and use a respectful tone of voice when interviewing the client.

Choice D reason: Including both hot and cold food items on a Hispanic client's menu demonstrates accurate cultural knowledge, as it reflects the concept of balance and harmony in Hispanic culture. Many Hispanics believe that health and illness are influenced by the balance between hot and cold forces in the body and the environment⁴. The nurse should respect the client's food preferences and beliefs and provide a variety of food options.

Choice A reason: Tracking rates of illness caused by infection among employees is not an action that will help the nurse detect potential physical hazards, as it is related to biological hazards. Biological hazards are living organisms or substances that can cause disease or infection, such as bacteria, viruses, fungi, or parasites. The nurse should track rates of illness caused by infection among employees to monitor the prevalence and incidence of occupational infections, such as tuberculosis, hepatitis, or COVID-19, and to implement preventive and control measures.

Choice B reason: Surveying workers about job-related emotional stress is not an action that will help the nurse detect potential physical hazards, as it is related to psychosocial hazards. Psychosocial hazards are factors that affect the mental and emotional well-being of workers, such as workload, autonomy, communication, recognition, or violence. The nurse should survey workers about job-related emotional stress to assess the level and sources of occupational stress, burnout, or fatigue, and to provide counseling, support, or referral.

Choice C reason: Identifying industrial toxins that are present in the environment is not an action that will help the nurse detect potential physical hazards, as it is related to chemical hazards. Chemical hazards are substances that can harm the health or safety of workers, such as solvents, acids, gases, or pesticides. The nurse should identify industrial toxins that are present in the environment to evaluate the exposure and risk of workers, and to implement protective measures, such as ventilation, personal protective equipment, or safe handling procedures.

Choice D reason: Measuring noise levels at various locations in the facility is an action that will help the nurse detect potential physical hazards, as noise is a common and harmful physical hazard. Physical hazards are factors that can harm the body or damage the equipment or materials, such as noise, vibration, temperature, radiation, or electricity. The nurse should measure noise levels at various locations in the facility to determine the intensity and duration of noise exposure, and to implement noise reduction measures, such as engineering controls, administrative controls, or hearing protection devices.