The nurse is providing education about the levels of prevention in the Public Health Model to a group of clients. Which of the following statements made by the client indicates an understanding of secondary prevention?

A. The pharmacological action of Ritalin causes a decrease in appetite. Methylphenidate (Ritalin) is a stimulant medication commonly prescribed for ADHD. One of its well-documented side effects is appetite suppression, which can lead to weight loss. This is the most accurate and direct explanation for the weight loss observed in the adolescent client.

B. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased. While nausea can occur with methylphenidate, it is not the primary reason for weight loss. The main mechanism is appetite suppression rather than a direct reduction in caloric intake due to nausea. This response is less accurate than option A.

C. Increased ability to concentrate allows the client to focus on activities rather than food: While methylphenidate can improve concentration, this explanation does not directly address the physiological cause of weight loss. It is the decrease in appetite due to the drug's effects on neurotransmitters that leads to weight loss, not the increased focus on activities .

D. Hyperactivity seen in ADHD causes increased caloric expenditure: Hyperactivity itself can lead to higher caloric expenditure, but this is not directly related to the weight loss caused by methylphenidate. The primary reason for the weight loss in this case is the appetite suppression due to the medication, not increased activity .

A. Follow the established protocol for reporting suspected child abuse or neglect to the appropriate authorities: This is the correct approach according to child protection guidelines. School personnel are mandated reporters and must report suspected abuse or neglect to protect the child's safety.

B. Convince the child to disclose the cause of the injuries through gentle questioning and persuasion: This approach can inadvertently pressure the child and is not recommended as it may lead to further distress or inaccurate information.

C. Respect the child's privacy and wait for them to share information about the injuries voluntarily: While respecting privacy is important, child protection takes precedence when there are signs of abuse or neglect.

D. Document and discuss the observations with the child's teacher to gather more information: While documentation is important, it should not delay reporting suspected abuse or neglect to the appropriate authorities.