A public health nurse is planning a prenatal program to ensure that resources are equally available to all community members. Which of the following ethical principles is the nurse practicing?

Rationale:

A. A client who moved to an apartment located on higher ground than her previous home: Relocating to a safer area demonstrates adaptive coping and proactive problem-solving. It does not indicate symptoms of posttraumatic stress disorder (PTSD) and does not require a referral for mental health assessment.

B. A client who has frequent nightmares about the hurricane: Recurrent intrusive thoughts or nightmares about a traumatic event are hallmark symptoms of PTSD. This client should be referred for further evaluation and possible treatment.

C. A client who expresses a realization that life will not return to the way it was before the hurricane: Accepting permanent changes after a disaster reflects normal adjustment and resilience. This insight alone does not suggest PTSD.

D. A client who describes feeling disconnected from those around him following the hurricane: Emotional numbing or detachment from others is a common PTSD symptom. This client should be referred for assessment to address potential social and emotional impairments.

E. A client who describes having persistent feelings of anger about the hurricane: Persistent irritability or anger is another symptom associated with PTSD. Referral is appropriate to evaluate for underlying trauma-related disorder and provide supportive interventions.

Rationale for correct choices

• Report to the provider immediately if a dry cough develops: ACE inhibitors or similar antihypertensive medications can cause a persistent dry cough as a side effect. Early reporting allows the provider to evaluate the need for medication adjustment or substitution to prevent further complications, such as noncompliance or worsening respiratory symptoms.

• Report to the provider immediately if the client experiences muscle aches: Muscle aches or myalgia can indicate statin-induced myopathy or rhabdomyolysis, particularly with elevated LDL and prescription of statins such as rosuvastatin. Early detection prevents severe muscle breakdown, renal impairment, or other complications.

Rationale for incorrect choices

• Increase sodium intake: The client has hypertension, and increasing sodium intake would exacerbate elevated blood pressure and increase the risk of cardiovascular complications, including heart failure and stroke. Sodium restriction is essential to support blood pressure control and overall cardiovascular health.

• Take rosuvastatin only in the morning: Rosuvastatin can be taken at any time of day, unlike some other statins that are recommended in the evening. Restricting it to the morning is unnecessary and may reduce adherence if it conflicts with the client’s routine. Emphasis should be on consistent daily intake rather than timing.