A community health nurse is reviewing the medical records of four newly diagnosed clients. The nurse should identify which of the following clients as having a nationally notifiable infectious condition?
A client who is pregnant and has cytomegalovirus (CMV)
An adolescent client who has foodborne botulism
A child who has erythema infectiosum
A young adult client who has herpes simplex virus type 1 (HSV-1)
The Correct Answer is B
Rationale:
A. Cytomegalovirus (CMV) is not nationally notifiable, though it can have significant effects, especially in pregnant women.
B. Foodborne botulism is a nationally notifiable condition due to its potential for widespread outbreaks and severe health consequences.
C. Erythema infectiosum, or fifth disease, is not a nationally notifiable disease, although it is recognized in clinical settings.
D. Herpes simplex virus type 1 (HSV-1) is common and not considered a nationally notifiable infectious disease.
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Correct Answer is ["A","C","D","E"]
Explanation
Rationale:
A. Administering methylergonovine maleate is indicated if the uterus is boggy (atonic), as it helps to contract the uterus and reduce the risk of postpartum hemorrhage.
B. Massaging a firm fundus is not appropriate; instead, the nurse should massage a boggy (soft) fundus to promote uterine contraction.
C. Documenting fundal height is a necessary action to assess uterine involution and ensure it is progressing as expected after delivery.
D. Observing the lochia during palpation of the fundus is important to assess for any abnormal findings, such as heavy bleeding, which could indicate complications.
E. Determining whether the fundus is midline is crucial; a displaced fundus may indicate bladder distention, which can affect uterine contraction.
Correct Answer is B
Explanation
Rationale:
A. Surgical asepsis (sterile technique) should be used for suctioning to prevent infection, not medical asepsis.
B. Applying suction for no longer than 10 seconds is appropriate to prevent hypoxia and trauma to the airway.
C. Advancing the catheter 2 cm after resistance is met is not advised; the catheter should not be forced beyond resistance to avoid injury.
D. The catheter should not be withdrawn if the client begins coughing; instead, it indicates the need for suctioning. If coughing occurs, the nurse should ensure the patient can breathe and may need to suction carefully.