A nurse in a clinic is teaching a newly licensed nurse about sexually transmitted infections. The nurse should instruct the newly licensed nurse to report which of the following infections to the health department?

Choice A reason: Inflammation noted on the tissue edges of a client's wound is a finding that indicates wound infection, not wound healing. The nurse should monitor the wound for signs of infection, such as increased pain, swelling, warmth, odor, or purulent drainage.

Choice B reason: Increase in serosanguineous exudate from a client's wound is a finding that indicates wound deterioration, not wound healing. The nurse should assess the wound for signs of increased tissue damage, such as bleeding, necrosis, or sloughing.

Choice C reason: Erythema on the skin surrounding a client's wound is a finding that indicates wound irritation, not wound healing. The nurse should evaluate the wound for signs of inflammation, such as redness, heat, or tenderness.

Choice D reason: Deep red color on the center of a client's wound is a finding that indicates wound healing, as it shows the presence of granulation tissue. Granulation tissue is a sign of new tissue growth and blood vessel formation, which are essential for wound healing.

Choice A reason: A nurse refusing to actively participate during an elective abortion procedure scheduled for their client is not a behavior that indicates a need for further education. The nurse has the right to conscientious objection, which means they can decline to perform or assist in a procedure that violates their moral or religious beliefs. The nurse should inform the charge nurse of their objection and request to be reassigned to another client.

Choice B reason: A nurse explaining to a client's family that a DNR order includes withholding comfort measures is a behavior that indicates a need for further education. The nurse is providing false and misleading information that can cause harm and distress to the client and the family. A DNR order only means that no cardiopulmonary resuscitation (CPR) or advanced cardiac life support (ACLS) will be initiated in the event of a cardiac or respiratory arrest. A DNR order does not affect the provision of other treatments, such as pain management, hydration, nutrition, oxygen, or emotional support.

Choice C reason: A nurse informing a confused client who wants to go home that they are going to stay at the facility until they are better is not a behavior that indicates a need for further education. The nurse is using therapeutic communication and providing reassurance to the client. The nurse is also respecting the client's autonomy and right to refuse treatment, as long as the client is competent and informed. The nurse should assess the client's mental status and decision-making capacity, and involve the client's family or surrogate decision-maker if needed.

Choice D reason: A nurse giving prescribed opioids to a client who has a terminal illness and respirations of 8/min is not a behavior that indicates a need for further education. The nurse is following the principle of beneficence, which means doing good and preventing harm to the client. The nurse is also following the principle of double effect, which means that an action that has both a good and a bad effect is morally permissible if the good effect outweighs the bad effect. The nurse is providing adequate pain relief to the client, even if it may hasten their death. The nurse should monitor the client's vital signs and level of consciousness, and adjust the opioid dose as prescribed.