An occupational health nurse at a factory is planning upcoming health programs for employees. Which of the following actions demonstrates the use of secondary prevention strategies?

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.

Choice A reason: The anthrax vaccine is ineffective following direct anthrax exposure is not a correct piece of information to include in the protocol. The anthrax vaccine can provide some protection against anthrax if given before exposure, but it cannot prevent or treat anthrax infection after exposure¹.

Choice B reason: Manifestations of anthrax infection appear within 3 days of exposure is not a correct piece of information to include in the protocol. The incubation period of anthrax varies depending on the route of exposure, but it can range from one day to several weeks. Inhalation anthrax usually has an incubation period of one to six days, but it can be longer².

Choice C reason: Prophylactic treatment should be provided to clients for 10 days following exposure to anthrax is not a correct piece of information to include in the protocol. Prophylactic treatment, or post-exposure prophylaxis (PEP), is the use of antibiotics to prevent anthrax infection in people who have been exposed to anthrax spores but do not have symptoms. PEP should be given for at least 60 days, or until the person receives three doses of the anthrax vaccine³.

Choice D reason: Ciprofloxacin should be administered to asymptomatic clients who were directly exposed to anthrax is a correct piece of information to include in the protocol. Ciprofloxacin is one of the antibiotics recommended by the CDC for PEP of anthrax. It can prevent anthrax infection in people who have inhaled anthrax spores but do not have symptoms. Ciprofloxacin should be given as soon as possible after exposure and continued for 60 days, or until the person receives three doses of the anthrax vaccine..