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A nurse in a public health department is caring for a client.

Exhibits

Which of the following data in the client’s medical record should cause the nurse to suspect the client is infected with the plague? Select all that apply.

Temperature

Client’s statement about “bites”

Travel history

Lymph node assessment

Body aches

New onset of weakness

Headache and chills

Pruritic lesions on the right leg

Clear lungs to auscultation bilaterally

Answer and Explanation

Correct Answer : A,B,C,D,E,F,G,H

Choice A rationale: The client’s persistent fever is a common symptom of the plague and many other infections.

Choice B rationale: The client’s statement about getting flea bites during their trip is significant because the plague is often transmitted through the bite of an infected flea.

Choice C rationale: The client’s recent travel to South Asia could have exposed them to areas where plague is endemic or there are ongoing outbreaks.

Choice D rationale: The presence of tender, inguinal lymphadenitis (swollen lymph nodes in the groin area) is a classic sign of bubonic plague.

Choice E rationale: Body aches can be a symptom of the systemic infection caused by the plague.

Choice F rationale: New onset of weakness can be a symptom of the systemic infection caused by the plague.

Choice G rationale: Headache and chills are common symptoms of the plague and many other infections.

Choice H rationale: Pruritic (itchy) lesions on the right leg could be the site of the flea bites that transmitted the plague bacteria.

Choice I rationale: Clear lungs to auscultation bilaterally does not necessarily rule out the plague. While pneumonic plague does affect the lungs, bubonic plague (the most common form) primarily causes lymphadenitis and does not typically present with respiratory symptoms in the early stages.

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Correct Answer is C

Explanation

Choice A rationale

Down syndrome does not typically require a modification in the standard immunization schedule. Children with Down syndrome should receive all recommended vaccinations according to the standard schedule.

Choice B rationale

Failure to thrive does not typically require a modification in the standard immunization schedule. Children with failure to thrive should receive all recommended vaccinations according to the standard schedule.

Choice C rationale

This is the correct answer. Children with leukemia or other cancers that weaken the immune system may require modifications to the standard immunization schedule. These children may need to avoid certain vaccines or delay vaccination until their immune system is stronger.

Choice D rationale

Sickle cell disease does not typically require a modification in the standard immunization schedule. Children with sickle cell disease should receive all recommended vaccinations according to the standard schedule.

A. Administer oxygen therapy. B. Establish a triage area. C. Notify the parents of the students. D. Contact the local health department.

Correct Answer is B

Explanation

Choice A rationale

Administering oxygen therapy is a specific medical intervention that may not be immediately necessary or appropriate depending on the cause of the symptoms. It would be more appropriate to first establish a triage area to assess the severity of the students’ conditions.

Choice B rationale

Establishing a triage area is the correct immediate action. This allows the nurse to quickly assess the severity of each student’s condition, prioritize care, and determine the appropriate next steps.

Choice C rationale

Notifying the parents of the students might be a subsequent step after assessing the students and determining the cause of the symptoms. However, it should not be the immediate action.

Choice D rationale

Contacting the local health department would be appropriate if there was a suspicion of a public health emergency, such as an outbreak of a communicable disease. However, the immediate action should be to assess the students and provide necessary care.

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A nurse in a public health department is caring for a client. Exhibits Which of the following data in the client’s medical record should cause the nurse to suspect the client is infected with the plague? Select all that apply.

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A nurse in a public health department is caring for a client.

Exhibits

Which of the following data in the client’s medical record should cause the nurse to suspect the client is infected with the plague? Select all that apply.