The nurse observes a practical nurse (PN) placing a client on the right side with the left leg bent in preparation for a lumbar puncture. Which action should the nurse implement?

Choice A reason: Assigning the UAP to provide care for another client and assuming full care of the client is not the best action for the nurse to take. This may disrupt the continuity of care and the rapport between the UAP and the client. It may also be unnecessary and inefficient for the nurse to take over the care of the client.

Choice B reason: Reminding the UAP to apply a fitted respirator mask before entering the client's room is not the best action for the nurse to take. This may be incorrect and inappropriate for the prevention of pertussis transmission. A fitted respirator mask is used for airborne precautions, while pertussis is spread by droplet contact.

Choice C reason: Reviewing the need for the UAP to wear a face mask while in close contact with the client is the best action for the nurse to take. This can educate the UAP about the proper infection control measures for pertussis, which include droplet precautions. A face mask can prevent the UAP from inhaling or spreading the droplets that contain the bacteria.

Choice D reason: Instructing the UAP to notify the nurse of any changes in the client's respiratory status is not the best action for the nurse to take. This may be irrelevant and redundant for the situation. The UAP should already know to report any changes in the client's condition to the nurse, regardless of the diagnosis or the intervention.

Choice A reason: This is the best intervention to ensure the safety of the clients and staff. According to the [hospital fire drill requirements](^3^), the first step in a fire evacuation is to rescue persons from the room or area and move them away from where fire, smoke, or the strong smell of smoke exists. Ambulatory clients can be assisted to the nearest fire exits by the nursing staff, following the [fire safety standard operating procedure](^2^).

Choice B reason: This is not a good intervention, as it may delay the evacuation and endanger the clients and staff. Wheelchairs are not designed to be used in fire situations, and they may not fit through the fire exits or the stairwells. Non-ambulatory clients should be transferred using evacuation devices such as evacuation chairs, stretchers, or mattresses, as recommended by the [hospital evacuation checklist](^5^).

Choice C reason: This is a dangerous intervention, as it may expose the visitors to the fire and smoke. Service elevators should not be used in a fire situation, as they may malfunction or stop at the fire floor. Visitors should be instructed to use the fire exits and the stairwells to evacuate the building, following the [fire safety standard operating procedure](^2^).

Choice D reason: This is a passive intervention, as it does not ensure the safety of the clients and staff. Shutting the doors to the client rooms may help to contain the fire and smoke, but it does not guarantee that they will not spread to other areas. The charge nurse should initiate the evacuation procedures as soon as possible, following the [hospital evacuation checklist](^5^).