The partner of an older adult client who has Alzheimer's disease reports that he is not eating. The nurse observes that the client's partner refuses to assist the client with feeding. The partner insists that the client feed himself without help. Which of the following is the priority action the nurse should take?

Choice A reason: Motor vehicle safety is the topic that the nurse should give priority to, as it is the leading cause of death for adolescents. According to the World Health Organization (WHO), road traffic injuries are the top cause of death among 15- to 19-year-olds globally, accounting for 115 000 deaths in 2019¹. Adolescents are vulnerable road users, especially as drivers, passengers, pedestrians, cyclists, or motorcyclists. The nurse should educate the adolescents about the risk factors and prevention strategies for road traffic injuries, such as wearing seat belts, helmets, and reflective clothing, avoiding distractions, alcohol, and drugs, and following traffic rules and signs.

Choice B reason: Sports injury prevention is not the topic that the nurse should give priority to, as it is not the leading cause of death for adolescents. Sports injuries are common among adolescents, as they are physically active and participate in various sports and recreational activities. Sports injuries can cause pain, disability, or death, depending on the type, severity, and location of the injury. The nurse should educate the adolescents about the risk factors and prevention strategies for sports injuries, such as warming up, cooling down, stretching, using protective equipment, and seeking medical attention when needed.

Choice C reason: Substance abuse prevention is not the topic that the nurse should give priority to, as it is not the leading cause of death for adolescents. Substance abuse is the harmful use of psychoactive substances, such as alcohol, tobacco, or drugs, that can affect the health and well-being of adolescents. Substance abuse can cause acute or chronic effects, such as intoxication, overdose, addiction, organ damage, or mental disorders. The nurse should educate the adolescents about the risk factors and prevention strategies for substance abuse, such as avoiding peer pressure, coping with stress, seeking help, and accessing treatment.

Choice D reason: Gun safety is not the topic that the nurse should give priority to, as it is not the leading cause of death for adolescents. Gun safety is the practice of using firearms in a safe and responsible manner, to prevent accidental or intentional injuries or deaths. Gun safety can involve proper handling, storage, and disposal of firearms, as well as education and awareness about the dangers and consequences of gun violence. The nurse should educate the adolescents about the risk factors and prevention strategies for gun safety, such as avoiding access to firearms, reporting threats, and supporting non-violent solutions.

Choice A reason: The best first step for a community health nurse is to connect directly with the people who are most affected by the issue. Meeting with community members allows the nurse to assess their concerns, gather information on how the playground is currently used, and explore what resources and willingness the residents have to participate in solutions. This approach promotes community engagement, empowerment, and ownership of the issue, which are critical to ensuring that any interventions are both sustainable and culturally appropriate. Without this initial dialogue, actions taken may not address the true barriers or may fail to gain community support.

Choice B reason: Partnering with city officials and community members to improve the playground condition is not the first action that the nurse should take. This is a tertiary intervention that can help to restore the playground to its optimal state, but it does not address the immediate issue of the garbage accumulation.

Choice C reason: Working with local businesses to sponsor more trash receptacles in the playground is not the first action that the nurse should take. This is a secondary intervention that can help to prevent the recurrence of the problem, but it does not address the immediate issue of the garbage accumulation.

Choice D reason: Engaging families to monitor trash buildup in the playground focuses on surveillance and maintenance, but this step requires prior discussion and buy-in from the community. Asking families to monitor the site without first understanding their concerns, availability, and willingness could lead to resistance or lack of participation. This is a useful strategy after community dialogue has occurred but not as the first step.