A hospice nurse is planning care for a patient who is near death.
Which of the following actions should the nurse include in the patient’s plan of care to promote the patient’s comfort?

The correct answer is Choice B

Choice A rationale: Community-wide tuberculosis screenings are not the first-line response to a confirmed active case. While targeted screening may be appropriate for close contacts or high-risk groups, indiscriminate testing lacks cost-effectiveness and may overwhelm public health resources. Screening is a secondary prevention strategy, not an immediate containment measure. The priority is to initiate contact tracing and isolate the source. Therefore, this action is premature and not scientifically aligned with outbreak control protocols.

Choice B rationale: Tuberculosis is a notifiable disease under global public health regulations due to its airborne transmission and potential for outbreaks. Reporting to the public health department enables contact tracing, isolation protocols, and surveillance. This aligns with WHO and CDC guidelines for communicable disease control. Timely reporting activates epidemiological response systems and ensures legal compliance. It is the most immediate and scientifically justified action to prevent community spread and initiate containment measures.

Choice C rationale: Ensuring medication adherence is critical for individual treatment success and preventing drug resistance, especially with multidrug-resistant TB. However, this is a longitudinal management strategy rather than an immediate public health containment action. Directly observed therapy (DOT) is often used to support adherence, but it does not substitute for mandatory reporting or contact tracing. While essential for long-term control, it is not the first step in preventing community transmission.

Choice D rationale: Community education enhances awareness and reduces stigma, but it is a tertiary prevention strategy. It does not directly interrupt transmission or initiate containment. Education is valuable for long-term public health outcomes, but it lacks immediacy in halting spread from an active case. Scientific protocols prioritize identification, isolation, and reporting before educational outreach. Therefore, while beneficial, this action is not the most urgent or scientifically prioritized response.

Choice A rationale

While seeking assistance from local spiritual leaders can be helpful in understanding a community’s culture, it is not the only or necessarily the best way to assess a group’s culture. Cultural assessment involves a broader range of activities.

Choice B rationale

Collecting all data on the first visit may not be feasible or appropriate. Cultural assessment is an ongoing process that involves building trust and rapport with the community.

Choice C rationale

Incorporating one’s implicit bias into planned delivery of care is not appropriate. Nurses should strive to provide culturally competent care, which involves recognizing and addressing their own biases.

Choice D rationale

Interviewing community leaders can provide valuable insights into community life and culture. This is an important part of cultural assessment and can help inform the planning of culturally appropriate care.