A nurse is working with a care manager for a client who participates in a health maintenance organization. The nurse should identify that a health maintenance organization provides which of the following payment structures?

Choice A reason: Helping the client apply for Medicare is not the best action by the nurse, as Medicare is a federal health insurance program for people who are 65 or older, disabled, or have end-stage renal disease. The client does not meet any of these criteria and may not be eligible for Medicare.

Choice B reason: Exploring options for alternative therapies is not the best action by the nurse, as alternative therapies may not be effective or safe for treating tuberculosis. Tuberculosis is a serious bacterial infection that requires specific antibiotics to cure. Alternative therapies may also interfere with the prescribed medication or cause adverse effects.

Choice C reason: Arranging for medication through local agencies is the best action by the nurse, as it ensures that the client receives the appropriate treatment for tuberculosis. Local agencies may have programs or resources that can help the client access free or low-cost medication. The nurse should also educate the client about the importance of adhering to the medication regimen and completing the course of treatment.

Choice D reason: Sending the client to the nearest facility for further evaluation is not the best action by the nurse, as it may delay the initiation of treatment and increase the risk of transmission of tuberculosis to others. The client already has a diagnosis of tuberculosis and needs to start the treatment as soon as possible. The nurse should also advise the client to wear a mask and avoid close contact with others until the infection is no longer contagious.

Choice A reason: A humidifier should be placed beside the child's bed is not the information that the nurse should include, as it is not relevant to pertussis. Pertussis, or whooping cough, is a bacterial infection that causes severe coughing spells, difficulty breathing, and a characteristic whooping sound. A humidifier may help with other respiratory conditions, such as bronchitis or asthma, but it does not affect pertussis.

Choice B reason: Household contacts will receive prophylactic antibiotics is the information that the nurse should include, as it is an important measure to prevent the spread of pertussis. Pertussis is highly contagious and can be transmitted through respiratory droplets from coughing or sneezing. Household contacts, especially those who are not fully vaccinated or have a weakened immune system, are at risk of contracting pertussis from the child. Prophylactic antibiotics, such as azithromycin or erythromycin, can reduce the risk of infection and complications.

Choice C reason: Transmission will be prevented because of herd immunity is not the information that the nurse should include, as it is not true for pertussis. Herd immunity is the protection that occurs when a large proportion of the population is immune to a disease, either through vaccination or natural infection. Herd immunity can reduce the transmission of some diseases, such as measles or polio, but it is not effective for pertussis. This is because pertussis immunity wanes over time, and the current vaccines do not provide long-lasting protection. Therefore, even vaccinated people can get or spread pertussis.

Choice D reason: The child is most contagious after the rash develops is not the information that the nurse should include, as it is not true for pertussis. Pertussis does not cause a rash, unlike some other childhood diseases, such as measles or chickenpox. The child is most contagious during the first two weeks of the illness, when the symptoms are similar to a common cold. The coughing spells usually start after the first week and can last for several weeks or months.