The nurse is assessing the client during the transfusion of O positive packed red blood cells (PRBCs) that began 15 minutes ago. The client complains of a headache and chills. Current vital signs: Blood pressure 111/58, Heart Rate 106, Respirations 22, and Temperature 100.9F.
What action(s) will the nurse take at this time? (Select all that apply).

Choice A rationale

Syphilis, caused by the bacterium Treponema pallidum, is a mandatory reportable disease in most jurisdictions. Prompt reporting is essential for public health surveillance and partner notification to prevent the spread of this multi-stage infection. If left untreated, syphilis can cause severe systemic complications, including neurosyphilis and cardiovascular damage. Health departments track these cases to ensure adequate treatment and to monitor for outbreaks within the community. Standard diagnostic tests include the RPR or VDRL followed by confirmatory treponemal assays.

Choice B rationale

Gonorrhea is a common sexually transmitted infection caused by Neisseria gonorrhoeae and is highly reportable due to its prevalence and the rising concern of antibiotic resistance. Reporting allows public health officials to monitor infection rates and implement control measures. Untreated gonorrhea can lead to pelvic inflammatory disease, infertility, and disseminated gonococcal infection. It often co-exists with chlamydia, necessitating dual screening. Reporting ensures that the healthcare system can respond effectively to emerging resistant strains of the bacteria.

Choice C rationale

Human papilloma virus (HPV) is not typically a reportable disease to public health departments for individual cases. While HPV is extremely common and is the primary cause of cervical cancer and genital warts, the sheer volume of infections makes individual reporting impractical for standard surveillance. Instead, public health efforts focus on vaccination programs and cervical cancer screening (Pap smears). Unlike syphilis or gonorrhea, the focus is on long-term prevention and clinical management rather than immediate contact tracing through the health department.

Choice D rationale

Chlamydia, caused by Chlamydia trachomatis, is the most frequently reported bacterial sexually transmitted infection. It is reportable because it is often asymptomatic, allowing it to spread easily throughout a population if not identified through screening and reported for partner follow-up. Reporting helps quantify the burden of the disease and directs resources toward screening programs for high-risk groups. Successful treatment with antibiotics is followed by reporting to ensure that the chain of transmission is broken through partner notification.

Choice E rationale

Genital warts, which are clinical manifestations of certain HPV strains, are generally not reportable to health departments. Similar to the underlying HPV infection, the management of genital warts is handled within the clinical setting through various destructive or topical treatments. While they are highly contagious, they do not carry the same public health reporting mandate as bacterial infections like syphilis or gonorrhea. Public health surveillance for warts is usually conducted through specific research studies rather than universal mandatory reporting requirements.

Choice A rationale

Encouraging a regular exercise routine is essential for improving physical functioning in patients with multiple sclerosis. Exercise helps maintain muscle tone, improves balance, and reduces the severity of fatigue, which are common challenges in MS. While the nurse must ensure the patient avoids overexertion and overheating, a tailored program focusing on stretching and strengthening can significantly enhance mobility. Physical activity also supports cardiovascular health and psychological well-being, which are critical for long-term functional independence.

Choice B rationale

Corticosteroids are typically administered to manage acute exacerbations of multiple sclerosis by reducing neuroinflammation and shortening the duration of relapses. However, they are not usually administered on a daily, long-term basis for the primary purpose of improving baseline physical functioning due to their significant side effects, such as osteoporosis and hyperglycemia. While helpful for inflammation, they do not replace the physical rehabilitation needed to improve muscle strength or coordination in a stable patient.

Choice C rationale

Turning and repositioning every 2 hours is a standard nursing intervention to prevent pressure injuries in immobile patients. While this is a necessary safety measure for a patient who is bedbound, it is not an active intervention designed to improve the physical functioning or mobility of a patient with multiple sclerosis. To improve functioning, the nurse should focus on interventions that encourage the patient to move themselves and engage in active rehabilitation rather than passive positioning.

Choice D rationale

Beta interferon 2 is an immunomodulating therapy used to reduce the frequency and severity of relapses in relapsing-remitting multiple sclerosis. While these disease-modifying therapies are crucial for slowing the progression of the disease and preventing future disability, the administration of the medication itself is a pharmacological intervention rather than a direct physical action to improve current functioning. Functional improvement is better achieved through physical therapy and active exercise programs that build strength and coordination.