An infectious disease nurse is reviewing electronic medical records on a group of clients.

Exhibits

Select the 4 clients whose diagnosis should be reported to the health department.

Client 1

Client 2

Client 3

Client 4

Client 5

Client 6

Answer and Explanation

Correct Answer : A,B,D,F

A. Client 1 - Lyme disease is a reportable infectious disease in many jurisdictions due to its potential public health implications. Given that it is transmitted by tick bites, it is crucial to notify the health department to help track the incidence and potential outbreaks in the area.

B. Client 2 - Acute hepatitis C is also a reportable disease, especially given the client's history of IV substance use. Reporting aids in monitoring and controlling the spread of the disease, as it can be transmitted through blood and sharing of needles.

C. Client 3 - Clostridium difficile infections are typically not reported to the health department, as they are often linked to healthcare settings and do not pose a public health threat in the same way as other infectious diseases.

D. Client 4 - Salmonellosis is a reportable illness as it can be associated with outbreaks linked to foodborne transmission. Reporting is essential for investigating sources of infection and preventing further cases.

E. Client 5 - While Streptococcal pharyngitis is common and can cause outbreaks, it is generally not classified as a reportable disease to public health departments. Instead, treatment and monitoring are usually managed within healthcare settings.

F. Client 6 - Pertussis (whooping cough) is highly contagious and considered a reportable disease due to its potential to cause outbreaks, especially among vulnerable populations. Reporting allows for monitoring and preventive measures to be implemented in the community.

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Correct Answer is B

Explanation

A. Raising all four side rails on a confused client’s bed is considered a restraint and violates the principle of autonomy. Restraints should only be used as a last resort and require a provider’s order. Ethical practice involves finding less restrictive alternatives, such as using a sitter or bed alarms.

B. Administering opioids to a terminally ill client, even with a low respiratory rate, aligns with ethical nursing principles such as beneficence (relieving suffering) and nonmaleficence (preventing harm) when used for palliative care. In end-of-life care, the priority is comfort, and pain management is considered ethical even if it may impact respiration. This aligns with the principle of double effect, which justifies an action intended for good (pain relief) even if it has potential negative side effects (respiratory depression).

C. Electing not to care for a client due to personal beliefs is an example of bias and does not adhere to the ethical principle of fidelity, which requires nurses to provide care regardless of personal beliefs.

D. Withholding nutrition from a client with a DNR order is not ethical unless there is a clear directive regarding the client's wishes, and it may cause harm.

A. An adolescent who was admitted and refuses to speak to their parents B. A preschooler who was previously toilet trained and now requires diapers in the hospital C. A toddler who cries whenever their parent enters the examination room D. A school-age child who has several abrasions on their lower legs

Correct Answer is C

Explanation

A. Refusing to speak to parents could indicate normal adolescent behavior, stress, or other reasons unrelated to maltreatment. It does not immediately raise suspicion of abuse.

B. Regression in toilet training is a common reaction to hospitalization or stress, particularly in young children, and does not necessarily suggest maltreatment.

C. A toddler crying whenever a parent enters the examination room is concerning for maltreatment, as it could indicate fear or discomfort around the parent, which is a red flag for potential abuse.

D. Abrasions on a school-age child’s legs could be consistent with normal childhood activities, such as playing or falling, and alone do not suggest maltreatment without other indicators.

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An infectious disease nurse is reviewing electronic medical records on a group of clients. Exhibits Select the 4 clients whose diagnosis should be reported to the health department.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse provides an annual in-service for the nursing staff regarding ethical practice. Which of the following actions should the nurse include as an example of ethical practice?

Correct Answer is B

Explanation

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Correct Answer is C

Explanation

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An infectious disease nurse is reviewing electronic medical records on a group of clients.

Exhibits

Select the 4 clients whose diagnosis should be reported to the health department.