A nurse is preparing to perform a physical examination for a 16-year-old adolescent. Which of the following actions should the nurse plan to take?

A. Itching has subsided: While reduced pruritus indicates healing and comfort improvement, it does not correlate with viral shedding or contagiousness. Children with varicella can still transmit the virus until all lesions are fully crusted, regardless of the presence or absence of itching.

B. All vesicles have crusted over: Varicella (chickenpox) is contagious from 1–2 days before the rash appears until all lesions have formed crusts. Crusting of vesicles indicates that viral shedding has ended, and the child is no longer infectious. This is the primary clinical indicator used to determine when isolation precautions can safely be discontinued.

C. Temperature is less than 37.8° C (100° F): Fever reduction signals improvement in systemic infection and overall health but does not reflect cessation of viral shedding. Children may remain contagious despite a normal temperature until the lesions crust over.

D. The antibiotics regimen is complete: Antibiotics are not effective against varicella, a viral infection, and completing an antibiotic course does not influence contagiousness. Transmission risk is determined by lesion status, not antibiotic therapy.

A. Wearing sterile gloves when collecting a urine specimen from an indwelling urinary catheter: Sterile gloves are not required for routine urine specimen collection from an indwelling catheter unless the procedure involves breaking the closed system for insertion or manipulation. Using sterile gloves unnecessarily increases supply costs without improving safety.

B. Donning an N95 mask before caring for a client who is on contact precautions: Contact precautions require gloves and a gown, not an N95 respirator. Using an N95 inappropriately consumes a more expensive resource without providing additional protection, which is not cost-effective. Appropriate PPE selection should be based on transmission precautions.

C. Returning unopened supplies to the storage room: Returning unopened supplies for future use prevents unnecessary waste and reduces institutional costs. Supplies that remain sterile and intact can be reused for other clients, demonstrating effective resource management while maintaining safety standards.

D. Replacing a continuous feeding administration set every 8 hr: Standard guidelines recommend replacing continuous enteral feeding sets every 24 hours to prevent infection, unless otherwise indicated. Replacing them every 8 hours unnecessarily increases supply use and cost without additional safety benefit, making it a less cost-effective practice.