The practical nurse (PN) is visiting a client who has stage four colon cancer and is receiving palliative home care. The client refuses to eat and sleeps most of the day. Which intervention should the nurse ask the PN to ensure the family is providing the client?

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^).

Choice A reason: Observing the nurse for jaundice and icterus sclera is not the best action for the nurse-manager to take. These are signs of liver damage that may occur in the later stages of HVA infection. The nurse-manager should not rely on the physical appearance of the nurse to diagnose or rule out HVA. The nurse-manager should also respect the privacy and dignity of the nurse and not make any assumptions based on the skin or eye color.

Choice B reason: Reviewing the immunization status of all unit employees is an important action for the nurse-manager to take, but not the best one. The nurse-manager should ensure that all the staff are vaccinated against HVA or have received immune globulin if exposed. However, this action does not address the immediate needs and concerns of the nurse who is symptomatic and may be infected. The nurse-manager should also consider the possibility of other causes of the nurse's symptoms besides HVA.

Choice C reason: Referring the nurse to employee health for serological testing is the best action for the nurse-manager to take. The nurse-manager should facilitate the prompt and accurate diagnosis and treatment of the nurse who is symptomatic and may have HVA. The nurse-manager should also follow the infection control and reporting protocols of the facility and the health department. The nurse-manager should also provide support and counseling to the nurse and the staff.

Choice D reason: Posting an employee notice of the outbreak of HVA on the unit is not the best action for the nurse-manager to take. The nurse-manager should inform and educate the staff about the risk and prevention of HVA, but not in a way that may cause panic or stigma. The nurse-manager should also protect the confidentiality and rights of the nurse and the UAP who are diagnosed with HVA. The nurse-manager should also consult with the infection control and quality improvement teams before posting any notice.