A nurse is assisting with the plan of care for an adolescent who has rheumatoid arthritis and reports difficulty feeding themselves. Which of the following referrals should the nurse recommend?

Choice A rationale:
Contact precautions are indicated when the client has a condition that can be easily transmitted through direct contact with the client or their environment. Measles, which is an airborne disease, requires more stringent precautions due to its mode of transmission.
Choice B rationale:
The correct choice. Measles is spread through airborne particles, making airborne precautions necessary. These precautions include placing the client in a negative pressure room, wearing appropriate respiratory protection (e.g., N95 mask), and ensuring that healthcare providers are properly protected from inhaling infectious particles.
Choice C rationale:
A protective environment is a specialized form of isolation used for clients with compromised immune systems, such as those undergoing stem cell transplants. It involves maintaining a sterile environment to prevent the introduction of pathogens. This level of precautions is not applicable to clients with measles.
Choice D rationale:
Droplet precautions are appropriate for diseases that are transmitted through respiratory droplets generated by coughing, sneezing, or talking. Measles, however, is transmitted through smaller airborne particles that can remain suspended in the air for longer periods, making airborne precautions the most suitable choice.

Choice A rationale:
"Provide your child with long-term goals to increase self-esteem." While setting long-term goals can indeed contribute to increasing a child's self-esteem, this choice may not be the most directly related to promoting a child's learning, especially for a child with attention deficit hyperactivity disorder (ADHD). Children with ADHD often struggle with attention and focus, and setting long-term goals might not address their immediate needs in terms of learning strategies.
Choice B rationale:
"Offer your child frequent breaks in activity during the day." Children with ADHD often benefit from frequent breaks in activities to help manage their attention and energy levels. These breaks can help prevent mental fatigue, increase focus, and enhance overall learning. This choice is appropriate for promoting the child's learning and is often recommended as part of ADHD management strategies.
Choice C rationale:
"Administer your child's medication at bedtime to prevent insomnia." This statement is not necessarily accurate for all medications used to treat ADHD. Some ADHD medications can indeed cause insomnia as a side effect, but the timing of medication administration can vary based on the specific medication and the child's individual response. It's essential for parents to follow the healthcare provider's instructions regarding medication timing.
Choice D rationale:
"Schedule a different routine for your child each day." Children with ADHD often benefit from consistent routines and schedules, as they provide structure and predictability, which can help manage their symptoms. Introducing a different routine each day could actually exacerbate symptoms and make it more challenging for the child to focus and engage in learning activities.