A community health clinic nurse manager is reviewing the incidence rate of chlamydia in the state. In a given year, 3,144 new cases were reported and the population was estimated at 325,986. Which of the following is the incidence rate in the state for the year?

Choice A reason: Koplik spots are small, white, bluish-gray spots that appear on the inner cheeks, gums, or roof of the mouth before the rash develops. They are a characteristic sign of measles and can help to distinguish it from other viral infections.

Choice B reason: Persistent low-grade temperature is not a finding that the nurse should expect in a client who has measles. Measles typically causes a high fever that can reach up to 40°C (104°F) and lasts for four to seven days. The fever may spike when the rash appears and subside when the rash fades.

Choice C reason: Muscle aches and tenderness are not findings that the nurse should expect in a client who has measles. Measles mainly affects the respiratory system and the skin, and does not cause significant muscle involvement. The client may experience fatigue, weakness, or malaise, but not muscle pain or soreness.

Choice D reason: Rash confined to the trunk of the body is not a finding that the nurse should expect in a client who has measles. Measles causes a red, blotchy rash that usually starts on the face and spreads to the rest of the body, including the arms, legs, and feet. The rash may last for up to a week and may cause itching or peeling of the skin.

Choice A reason: Organizing an influenza immunization clinic with the American Red Cross is a service that the nurses should plan to provide to the congregation, as it is consistent with the role and scope of parish nursing. Parish nurses, or faith community nurses, are registered nurses who provide education, counseling, referral, advocacy, and volunteer coordination within the context of their faith community¹. They focus on holistic healing and prevention of illness, rather than hands-on care². Organizing an influenza immunization clinic is an example of a preventive and educational service that can benefit the health of the congregation and the community.

Choice B reason: Performing wound care in the home of members is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as wound care, medication administration, or blood pressure monitoring². They may refer members to other health care providers or agencies for these services, or teach members how to perform self-care³.

Choice C reason: Providing end of life care for members who are terminal is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide direct clinical care, such as pain management, symptom control, or palliative care². They may provide spiritual and emotional support, counseling, and advocacy for members who are terminal, or refer them to hospice or other end of life care services³.

Choice D reason: Facilitating discharge from the facility to the home is not a service that the nurses should plan to provide to the congregation, as it is outside the role and scope of parish nursing. Parish nurses do not provide case management, discharge planning, or home health care². They may collaborate with other health care professionals or community agencies to ensure continuity of care and smooth transition for members who are discharged from the facility to the home³.