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A nurse is assessing a client who reports a severe headache and stiff neck. The nurse’s assessment reveals positive Kernig’s and Brudzinski’s signs. Which of the following actions should the nurse perform first?

A.

Decrease bright lights.

B.

Implement droplet precautions.

C.

Initiate IV access.

D.

Administer antibiotics.

Answer and Explanation

The Correct Answer is B

Choice A reason:

Decreasing bright lights can help alleviate discomfort for the client, especially if they are experiencing photophobia, which is common in meningitis. However, this action does not address the immediate need to prevent the spread of infection. While it is a supportive measure, it is not the first priority in managing a client with suspected meningitis.

 

Choice B reason:

Implementing droplet precautions is the first priority when a client presents with symptoms suggestive of meningitis, such as a severe headache, stiff neck, and positive Kernig’s and Brudzinski’s signs. Meningitis can be caused by bacterial infections that are highly contagious and spread through respiratory droplets. Initiating droplet precautions helps prevent the transmission of the infection to other clients and healthcare workers, making it the most critical initial action.

 

Choice C reason:

Initiating IV access is important for administering medications and fluids, but it is not the first priority. Ensuring the safety of others by implementing droplet precautions takes precedence. Once precautions are in place, the nurse can proceed with establishing IV access to facilitate further treatment.

 

Choice D reason:

Administering antibiotics is crucial in the treatment of bacterial meningitis, but it should be done after droplet precautions are in place to prevent the spread of infection. Prompt antibiotic therapy is essential, but the initial step must focus on infection control measures to protect others from exposure.


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Correct Answer is B

Explanation

Choice A reason:

Closing the school for 6 weeks is an extreme measure that is not typically warranted for managing influenza outbreaks. Public health guidelines usually recommend temporary closures or other measures to control the spread of infection, but a 6-week closure is excessive and disruptive.

Choice B reason:

Education regarding respiratory and hand hygiene is an appropriate and effective action to help control the spread of influenza. Teaching students and staff about proper handwashing techniques, respiratory etiquette, and other preventive measures can significantly reduce the transmission of the virus. This approach empowers the school community to take proactive steps in preventing further infections.

Choice C reason:

Discipline in the school setting for improper handwashing is not an appropriate response. While it is important to encourage proper hygiene practices, using disciplinary measures can create a negative environment and may not effectively promote behavior change. Education and positive reinforcement are more effective strategies.

Choice D reason:

Running a mandatory flu clinic can be beneficial, but it is not the most immediate or appropriate action in response to an outbreak. Flu clinics are typically part of broader vaccination efforts and may not address the immediate need to control the current outbreak. Education on hygiene practices is a more immediate and practical response.

Correct Answer is B

Explanation

Choice A: A negative-pressure isolation room

A negative-pressure isolation room is typically used for patients with airborne infections, such as tuberculosis or measles, to prevent the spread of infectious agents through the air. Scabies, however, is primarily transmitted through direct skin-to-skin contact and occasionally through contact with contaminated clothing or bedding. Therefore, a negative-pressure isolation room is not necessary for a scabies patient1.

Choice B: A private room

A private room is the most appropriate choice for a client with scabies. This type of room helps prevent the spread of the infestation to other patients and allows for better control of the environment. Scabies is highly contagious and can spread through direct contact with the infested person or indirectly through contaminated items. Isolating the patient in a private room minimizes the risk of transmission and allows for proper infection control measures to be implemented2.

Choice C: A semi-private room with a client who has pediculosis capitis

Placing a scabies patient in a semi-private room with another patient, even one with a different parasitic infection like pediculosis capitis (head lice), is not advisable. Both conditions are highly contagious, and cohabitation increases the risk of cross-contamination and further spread of both infestations. Each condition requires specific treatment and isolation protocols to effectively manage and prevent outbreaks3.

Choice D: A positive-pressure isolation room

A positive-pressure isolation room is designed to protect immunocompromised patients from external contaminants by ensuring that air flows out of the room rather than in. This type of room is not suitable for a scabies patient, as it does not address the primary mode of transmission for scabies, which is direct contact. The focus for scabies management should be on preventing direct and indirect contact with others4.

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