Situation: The public health nurse makes a home visit to a family. The father, 58, a driver, has hypertension and smokes daily. The mother, 34, is 7 months pregnant with their third child. Their eldest child, who will start school next month, missed a scheduled vaccine dose and is underweight on growth monitoring. The household stores its water in uncovered drums near the kitchen. The nurse prioritizes the uncovered water drums using the family nursing problem prioritization criteria. What score should she give for NATURE OF THE PROBLEM? Round off to two decimal places.

Uncovered water containers are a health threat (a dengue breeding site). Nature of the problem scores a health threat 2 out of a highest possible 3, with a weight of 1: 2 ÷ 3 × 1 = 0.67.

The question asks for the score assigned to the nature of the problem for uncovered water drums, using family nursing problem prioritization criteria. In this framework, each identified family health problem is scored across several dimensions—nature of the problem, modifiability, preventive potential, and salience—to determine which issue the nurse should address first.

The nature of the problem categorizes the issue as a health deficit, health threat, or foreseeable crisis. A health threat refers to a condition or situation that has not yet caused disease but increases the risk of illness or injury. Uncovered water containers stored near the kitchen are a classic environmental health threat because stagnant, exposed water provides an ideal breeding site for Aedes mosquitoes, the primary vector for dengue fever ^[2]. In this scenario, the family has not yet developed dengue, but the uncovered drums create a real and ongoing risk of vector-borne disease transmission.

In the standard prioritization scoring system, the nature of the problem is weighted with a maximum raw score of 3. A health threat receives a raw score of 2. The weight assigned to the nature of the problem is 1. Therefore, the computation is:

2 ÷ 3 × 1 = 0.67

This places the uncovered water drums at a moderate-to-high priority level based solely on the nature of the problem. The score reflects that while no illness has occurred yet, the environmental condition actively promotes a communicable disease risk that the nurse can and should address through health teaching and environmental modification.

Nature of the Problem	Raw Score	Weight	Computed Score
Health deficit (actual illness or impairment)	3	1	1.00
Health threat (risk factor present, no disease yet)	2	1	0.67
Foreseeable crisis (anticipated stressor or transition)	1	1	0.33

Key point! The uncovered water drums are scored as a health threat, not a health deficit, because no family member currently has dengue. The score of 0.67 is therefore the correct answer for the nature of the problem dimension.

The public health significance of this scoring is reinforced by evidence that environmental factors such as uncovered water storage are among the key drivers of rising dengue incidence in endemic regions ^[2]. In community health nursing, identifying and scoring such threats allows the nurse to prioritize interventions that prevent disease before it occurs, aligning with the preventive focus of home visits. The presence of an uncovered water container near the kitchen also raises concerns about water contamination and food hygiene, but the dengue breeding risk is the primary threat that the scoring system captures.

Watch out! Do not confuse the raw score with the final computed score. The raw score for a health threat is 2, but after applying the weight of 1 and dividing by the highest possible score of 3, the final score is 0.67, not 2.00.