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 answers are Choices A, B, C, D, and E.

Choice A rationale

Feeding assistance may be necessary for an older adult with Parkinson’s disease due to motor symptoms like tremors or stiffness that can make self-feeding difficult. Special utensils and other dining aids can help these individuals maintain their independence during meals.

Choice B rationale

People with Parkinson’s disease can experience changes in their skin, such as becoming oily or flaky. While the term “fragile skin” is not typically used in the context of Parkinson’s, these individuals may have skin that is more susceptible to damage due to these changes.

Choice C rationale

Parkinson’s disease often leads to motor symptoms such as stiff muscles and balance impairment, which can increase the risk of falls. Therefore, measures to prevent falls should be a key part of the care plan for an older adult with Parkinson’s disease.

Choice D rationale

Chronic pain is twice as common in people with Parkinson’s disease as it is in people without the condition. This pain can be caused by various factors, including muscle stiffness and dystonia (painful muscle spasms), and should be addressed in the client’s care plan.

Choice E rationale

Depression is more common in people with Parkinson’s disease compared to the general population. It’s important to monitor for signs of depression in these individuals and provide appropriate treatment if necessary.

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

Giving a complete bed bath to further assess the client may not be the most appropriate intervention in this case. The client is semi-conscious and cries out in pain when turned or moved. A complete bed bath could potentially cause unnecessary discomfort and distress.

Choice B rationale

Removing the fentanyl patch as directed by prescription may not be the best course of action. Fentanyl is a powerful opioid used to manage severe pain. The client’s parents report that their child cries out in pain when turned or moved, suggesting that the client is experiencing significant pain. Removing the fentanyl patch could potentially exacerbate the client’s pain.

Choice C rationale

Calling for ambulance transportation to the hospital immediately may not be necessary at this time. The client’s vital signs are stable, and there is no indication of an immediate medical emergency based on the information provided.

Choice D rationale

Discussing end-of-life decisions with the client’s parents is the most appropriate intervention. The client is semi-conscious, sleeps most of the time, and is in significant pain. These symptoms suggest that the client’s condition is deteriorating. It is important to have conversations about end-of-life care preferences and decisions to ensure that the client’s wishes are respected and that the parents are prepared.