A nurse manager in a public health clinic is reviewing the charts of five recent clients.

Exhibits

The nurse manager should identify which of the having conditions that require national notification? Select all that apply.

A. Living in a long-term care facility increases the risk for tuberculosis due to close living quarters, which facilitate airborne transmission. Older adults in these facilities may also have weakened immune systems, further elevating their susceptibility to TB infection.

B. TB treatment typically lasts 6 to 12 months, depending on the case, not a lifetime. Lifelong medication is not required unless the individual has a chronic, drug-resistant form, which is uncommon. Adherence to the full treatment course is key to curing TB.

C. Tuberculosis is not spread through direct contact. It is an airborne disease transmitted when a person inhales droplets expelled when an infected person coughs, sneezes, or speaks, particularly in enclosed or poorly ventilated environments.

D. A Mantoux skin test identifies TB exposure but does not confirm active disease. A positive result requires further evaluation with a chest x-ray and possibly sputum testing to diagnose active tuberculosis infection.

A. Consulting with the provider throughout a client's course of treatment: Consulting with providers is a collaborative practice that supports coordinated care and is a standard professional responsibility, not typically a liability concern for case managers.

B. Providing recommendations to a client about alternatives to treatments prescribed by their provider: Making treatment recommendations without proper authorization or outside the scope of practice can lead to liability issues. Case managers must avoid advising clients to alter prescribed treatments and instead facilitate communication between clients and providers.

C. Verifying a provider's licensure before referring the client to them: Verifying licensure ensures the provider’s credentials are valid and protects clients from unqualified practitioners. This is a standard safety practice and does not pose liability for the case manager.

D. Determining a client's literacy level before providing advance directive documents:
Assessing literacy helps tailor education and ensures client understanding, which supports informed decision-making and reduces liability risks related to inadequate communication. This is a prudent nursing action, not a liability concern.