While conducting a head lice screening for third-grade students, the school nurse notices a brownish thickening on the neck of one child.
What should be the nurse’s response to this observation?

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

Reporting the presence of a viral endemic at the daycare center would be premature without first confirming the diagnosis of the children sent home.

Choice B rationale

While confirming the number of children exhibiting symptoms is important, it is more crucial to first verify that the children sent home did indeed develop chickenpox.

Choice C rationale

The nurse’s initial action should be to verify that the children sent home did indeed develop chickenpox. This is because chickenpox is a highly contagious disease caused by the varicella- zoster virus. Early identification and confirmation of the disease can help in implementing appropriate control measures to prevent further spread.

Choice D rationale

Determining the number of people potentially exposed is an important step in managing a chickenpox outbreak. However, this should be done after confirming the diagnosis.

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.