Choice A rationale: The client’s persistent fever is a common symptom of the plague and many other infections.

Choice B rationale: The client’s statement about getting flea bites during their trip is significant because the plague is often transmitted through the bite of an infected flea.

Choice C rationale: The client’s recent travel to South Asia could have exposed them to areas where plague is endemic or there are ongoing outbreaks.

Choice D rationale: The presence of tender, inguinal lymphadenitis (swollen lymph nodes in the groin area) is a classic sign of bubonic plague.

Choice E rationale: Body aches can be a symptom of the systemic infection caused by the plague.

Choice F rationale: New onset of weakness can be a symptom of the systemic infection caused by the plague.

Choice G rationale: Headache and chills are common symptoms of the plague and many other infections.

Choice H rationale: Pruritic (itchy) lesions on the right leg could be the site of the flea bites that transmitted the plague bacteria.

Choice I rationale: Clear lungs to auscultation bilaterally does not necessarily rule out the plague. While pneumonic plague does affect the lungs, bubonic plague (the most common form) primarily causes lymphadenitis and does not typically present with respiratory symptoms in the early stages.

Choice A rationale: Herpes zoster, also known as shingles, is not a notifiable disease. It is caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person recovers from chickenpox, the virus stays dormant in the body and can reactivate years later, causing shingles.

Choice B rationale: Elevated lead levels in a child is a notifiable condition. Lead poisoning can cause serious health problems, particularly in children, and public health departments track cases to identify sources of lead and prevent further exposure.

Choice C rationale: Streptococcus pyogenes, also known as Group A Streptococcus, can cause a variety of infections, some of which are notifiable diseases. These include invasive Group A Streptococcal disease and streptococcal toxic shock syndrome.

Choice D rationale: Tuberculosis is a notifiable disease. The Mantoux tuberculin skin test is used to detect tuberculosis infection. A reddish induration greater than 10mm, especially in a client with symptoms of tuberculosis and a history of travel to an area where tuberculosis is endemic, is suggestive of tuberculosis infection.

Choice A rationale

Evaluating the effectiveness of local disaster-preparedness drills is an important step in disaster management. However, it is not the first action to take when developing a disaster- preparedness plan. This step usually comes later, after identifying the community’s risks and capabilities, assembling a team, and providing education.

Choice B rationale

Assembling an emergency disaster response team is crucial in disaster management. However, before assembling a team, it is important to first identify the community’s risks and capabilities. This will help in determining the composition and roles of the team members.

Choice C rationale

Providing education about first aid and triage is an essential part of disaster preparedness. However, this is not the first step. Before providing education, it is important to first understand the community’s risks and capabilities.

Choice D rationale

Identifying the community’s risks and capabilities is the first action to take when developing a disaster-preparedness plan. This involves determining what natural disasters the community is likely to face and the community’s capacity to respond to these disasters.

Choice A rationale

The anthrax vaccine is not ineffective following direct anthrax exposure. In fact, the vaccine is used as a preventive measure for individuals who are at high risk of exposure to anthrax.

However, in the event of widespread public exposure, the vaccine alone may not be sufficient.

Choice B rationale

Ciprofloxacin is a recommended treatment for asymptomatic individuals who were directly exposed to anthrax. It is part of the post-exposure prophylaxis (PEP) for anthrax and is used to prevent the development of the disease.

Choice C rationale

Prophylactic treatment should indeed be provided to clients following exposure to anthrax. However, the duration is not just 10 days. The recommended duration of post-exposure prophylaxis for anthrax is 60 days.

Choice D rationale

Manifestations of anthrax infection do not necessarily appear within 3 days of exposure. The incubation period for anthrax can vary widely, from a few days to several weeks, depending on the type of anthrax (cutaneous, inhalation, or gastrointestinal) and the amount of spores a person is exposed to.

Choice A rationale

HIPAA rules do not vary from state to state. They are federal laws that apply uniformly across all states. However, states may have additional laws related to health information privacy that provide further protections.

Choice B rationale

A client’s diagnosis cannot be posted on the communication board inside the client’s room. This would be a violation of HIPAA rules, which protect the privacy of a patient’s health information.

Choice C rationale

Sharing computer passwords with a manager is not in line with HIPAA regulations. Each healthcare provider should have their own unique login credentials to access electronic health records. This helps ensure the security of health information and allows for tracking of access to patient records.

Choice D rationale

HIPAA rules do indeed allow clients to receive a copy of their medical records. This is part of the patient’s right to access their own health information.

Choice A rationale

Airborne precautions are recommended for a client who has laryngeal tuberculosis. This is because tuberculosis is an airborne disease, meaning it is spread through the air when a person with active tuberculosis in their lungs or throat coughs, sneezes, speaks, or sings.

Choice B rationale

A protective environment is not specifically required for a client with laryngeal tuberculosis. This type of precaution is typically used for patients who are severely immunocompromised, such as those undergoing stem cell transplants.

Choice C rationale

Contact precautions are not necessary for a client with laryngeal tuberculosis. These precautions are used for diseases that are spread by direct or indirect contact, which is not the case with tuberculosis.

Choice D rationale

Droplet precautions are not recommended for a client with laryngeal tuberculosis. These precautions are used for diseases that are spread through droplets in the air, such as influenza or pertussis, but tuberculosis requires airborne precautions due to the smaller size and longer airborne life of the tuberculosis bacteria.

The correct answer is Choice A

Choice A rationale: The statement "I know that everything will be better soon" can indicate a risk for suicide as it may reflect a sense of hopelessness and a belief that death is the only solution to their suffering. This requires immediate attention.

Choice B rationale: Expressing a desire to maintain control over decision-making does not necessarily indicate a risk for suicide. It reflects a concern about autonomy and independence, which is common among individuals with chronic illnesses.

Choice C rationale: Relying more on a partner for support suggests that the client is seeking help and building a support system. This does not indicate a risk for suicide but rather a positive coping mechanism to manage their condition.

Choice D rationale: Fear of experiencing pain near the end is a common concern for individuals with terminal illnesses. While it indicates anxiety about the future, it does not necessarily suggest a risk for suicide. Addressing pain management can help alleviate this fear.

Choice A rationale

The first action when planning a program on early detection of breast cancer for employees at a local business should be to determine the employee’s knowledge level of breast self- examination. This is crucial because the effectiveness of the program will depend on the current understanding and practices of the employees. If the employees already have a good understanding of breast self-examination, the program can focus more on other aspects such as the importance of regular check-ups and early detection. However, if the employees have limited knowledge about breast self-examination, the program should prioritize teaching this skill.

Choice B rationale

While scheduling a guest speaker to talk about breast cancer to employees can be an effective way to provide information and motivate employees, it should not be the first action.

Understanding the employees’ current knowledge and practices should come first to tailor the program effectively.

Choice C rationale

Developing educational materials for employees is an important part of a breast cancer early detection program. However, these materials should be developed based on the needs and current understanding of the employees, which is why determining the employees’ knowledge level of breast self-examination should come first.

Choice D rationale

Having breast models available to employees during teaching sessions can be a useful tool for demonstrating breast self-examination. However, this should not be the first action. The first step should be to assess the employees’ current knowledge and practices.

Choice A rationale

The first action to take in the initial phase of planning a smoking cessation program should be to determine the prevalence of smoking in the community. This is important because it helps to understand the magnitude of the problem and the potential impact of the program. It also helps in setting realistic goals for the program and in securing funding and other resources.

Choice B rationale

While formulating objectives for the smoking cessation program is an important step, it should come after determining the prevalence of smoking in the community. The objectives should be based on the needs and characteristics of the target population, which can only be understood by first assessing the prevalence.

Choice C rationale

Gaining community support for the program is crucial for its success. However, this should come after the prevalence of smoking has been determined and objectives for the program have been formulated.

Choice D rationale

Evaluating the methods of successful smoking cessation programs can provide valuable insights for planning the program. However, this should not be the first action. The first step should be to understand the extent of the problem in the community.

Choice A rationale

Reviewing the immunization records of the child’s classmates might be a subsequent step after confirming the diagnosis and reporting to the health department. However, the immediate action should be to contact the local health department.

Choice B rationale

Advising the caregivers to increase the child’s Vitamin B intake is not relevant in this context. Koplik spots are a sign of measles, a viral infection, and increasing Vitamin B intake would not affect the course of this disease.

Choice C rationale

Examining the child’s classmates for enlargement of the parotid gland is not appropriate because enlargement of the parotid gland is a symptom of mumps, not measles.

Choice D rationale

Contacting the local health department is the correct action. Koplik spots are a characteristic sign of measles, a highly contagious and reportable disease. The local health department can provide guidance on further steps, including confirmation of the diagnosis, treatment, and measures to prevent the spread of the disease.