The public health nurse is investigating a report of several chickenpox (varicella virus) cases at a daycare center.
The daycare worker mentions that five children have been sent home over the past two weeks with fever and itchy blisters.


What should be the nurse’s initial action?

Answer and explanation

The correct answer is Choice A.

Choice A rationale

Primary prevention includes measures that prevent the occurrence of a specific disease or health condition. In the context of sexually transmitted infections (STIs), primary prevention would involve education on safe sex practices. This could include information on the use of condoms, the importance of regular STI testing, and the risks associated with having multiple sexual partners. Given the client’s history of multiple sexual partners and recurrent symptoms suggestive of STIs, education on safe sex practices would be an appropriate preventive strategy.

Choice B rationale

Secondary prevention involves early detection and intervention to prevent the progression of a disease or health condition. Regular screenings for STIs fall under this category. However, given that the client has visited the clinic three times in the past 12 months with similar concerns but no STIs were diagnosed, secondary prevention may not be the most appropriate focus for this client.

Choice C rationale

Tertiary prevention involves managing disease post diagnosis to slow or stop disease progression through measures such as medication management and lifestyle changes. Education regarding prescribed treatments for STIs would fall under this category. However, since the client has not been diagnosed with an STI in her previous visits, tertiary prevention would not be the most appropriate focus for this client.

Choice D rationale

Quaternary prevention involves strategies to reduce or avoid unnecessary interventions in the health care system. This could include avoiding unnecessary diagnostic tests or treatments.

Given the client’s history and current symptoms, focusing on quaternary prevention would not be appropriate as it is important to identify the cause of her symptoms and provide appropriate treatment.

Answer and explanation The correct answer is C. Choice A rationale

While applying antibiotic ointment to the sores might help prevent infection, it does not address the underlying issue causing the sores and poor healing.

Choice B rationale

Although a diet rich in nutrients can promote wound healing, it is not the most immediate need for this client. The client’s symptoms suggest a serious underlying condition that requires medical evaluation.

Choice C rationale

The client’s symptoms of pale, bluish feet and sores on both lower extremities that are healing poorly suggest a severe and untreated medical condition, possibly related to circulation or skin integrity. Therefore, the nurse should refer the client to a healthcare provider for a complete evaluation.

Choice D rationale

Sending the client to the emergency department for treatment might be necessary in some cases, but it is more appropriate to first refer the client to a healthcare provider for a complete evaluation.