A teacher suspects a child is being maltreated at home and takes them to the school nurse. Which of the following findings should the nurse report as an indication of possible maltreatment?

Choice A reason: Teaching the client about appropriate food choices is an important intervention for diabetes mellitus, but it is not the first action the nurse should take. The nurse needs to assess the client's current dietary habits and preferences before providing education.

Choice B reason: Referring the client to a diabetes mellitus support group is a helpful strategy to promote coping and self-management, but it is not the first action the nurse should take. The nurse needs to address the client's immediate needs and priorities before making referrals.

Choice C reason: Identifying the client's dietary preferences is the first action the nurse should take. This is an assessment step that will help the nurse tailor the nutritional program to the client's individual needs and preferences. It will also help the nurse establish rapport and trust with the client.

Choice D reason: Developing a nutritional program is a planning step that requires assessment data. The nurse should not develop a nutritional program without first identifying the client's dietary preferences and needs.

Choice A reason: This is incorrect. Clostridium difficile is a bacterium that causes an infection of the colon, which can result in diarrhea, abdominal pain, and fever¹. Clostridium difficile is transmitted by contact with fecal matter or contaminated surfaces². Therefore, it requires contact precautions, not airborne precautions³.

Choice B reason: This is incorrect. Influenza is a viral infection that affects the respiratory tract, causing symptoms such as fever, cough, sore throat, and muscle aches⁴. Influenza is transmitted by respiratory droplets that are generated by coughing, sneezing, or talking⁵. Therefore, it requires droplet precautions, not airborne precautions³.

Choice C reason: This is correct. Disseminated herpes zoster is a widespread form of shingles that affects multiple areas of the skin and can involve the internal organs⁶. Shingles is caused by the reactivation of the varicella-zoster virus, the same virus that causes chickenpox⁷. Disseminated herpes zoster is transmitted by airborne particles that contain the virus, or by direct contact with the lesions⁶. Therefore, it requires airborne precautions, as well as contact precautions³.

Choice D reason: This is incorrect. Respiratory syncytial virus (RSV) is a common respiratory virus that causes mild to severe infections of the lungs and airways, especially in infants and young children⁸. RSV is transmitted by respiratory droplets, or by contact with contaminated surfaces or secretions⁹. Therefore, it requires contact precautions, and sometimes droplet precautions, but not airborne precautions³.