The nurse assesses a 15-year-old client who shows some signs of possible drug use. Which key indicators in the client's record should the nurse be prepared to discover to confirm the existence of an increased risk for substance use disorder?

Rationale:
A. Next-door neighbor is incorrect because while neighbors may observe certain behaviors, they typically do not have consistent access to comprehensive information about a child’s health, behavior, or social risk factors, making them less reliable for identifying at-risk children.

B. Parent is incorrect because although parents provide valuable insight, they may not always recognize signs of victimization or aggressive behavior in their child, and relying solely on parental reporting can lead to underestimation of risk.

C. School nurse is correct because the school nurse regularly interacts with children in a structured environment, has access to health records, observes social interactions, and can identify early warning signs of both victimization and aggression. School nurses are uniquely positioned to help public health departments target prevention and intervention efforts effectively.

D. Pediatric primary care provider is incorrect because although they monitor children’s overall health and development, they may see the child infrequently and have limited observation of day-to-day social interactions and behaviors that indicate risk for violence in the school or community setting.

Rationale:

A. Cholera is caused by the bacterium Vibrio cholerae and is a classic example of a waterborne disease. Transmission occurs when individuals consume water or food contaminated with fecal matter containing the bacteria. Cholera primarily spreads in areas with poor sanitation, inadequate sewage systems, or contaminated drinking water. The disease can lead to profuse watery diarrhea, severe dehydration, and electrolyte imbalances, which can be fatal if untreated. Public health measures such as ensuring safe drinking water, proper sanitation, and hygiene education are essential to prevent outbreaks.

B. Malaria is a vector-borne disease, transmitted through the bite of an infected female Anopheles mosquito. The mosquito carries Plasmodium parasites, which enter the human bloodstream. Malaria is not spread through water consumption, although mosquito breeding often occurs in stagnant water. Preventive strategies focus on mosquito control, use of insecticide-treated nets, and prophylactic medications.

C. Influenza spreads via airborne droplets, generated when an infected person coughs, sneezes, or talks. It can also be spread by touching surfaces contaminated with the virus. Influenza is not transmitted through water, so preventive strategies include vaccination, hand hygiene, and respiratory etiquette.

D. Chickenpox (varicella) is another airborne disease, transmitted through respiratory droplets or direct contact with lesion fluid from an infected person. It does not spread through contaminated water. Prevention relies on varicella vaccination and isolation of infected individuals.