An occupational health nurse is discussing health promotion with a client who has a history of obesity. Which of the following comments indicates the client is using rationalization as a coping mechanism?

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.

Choice A reason: Alerting the family members of coworkers about possible exposure to anthrax is not an action that the nurse should take. Anthrax is not contagious, and it cannot be spread from person to person. The family members of coworkers are not at risk of infection, and alerting them may cause unnecessary panic and stigma.

Choice B reason: Placing the employee under quarantine for 14 days is not an action that the nurse should take. Anthrax is not contagious, and it cannot be spread from person to person. The employee does not need to be isolated from others, and quarantine may interfere with their access to medical care and social support.

Choice C reason: Referring coworkers who might have been exposed to a provider for prophylactic antibiotics is an action that the nurse should take. Anthrax is a serious bacterial infection that can be fatal if left untreated. The coworkers who might have been exposed to the same source of anthrax as the employee should receive prophylactic antibiotics as soon as possible to prevent the infection from developing.

Choice D reason: Instructing the employee to wear a mask at work is not an action that the nurse should take. Anthrax is not contagious, and it cannot be spread from person to person. The employee does not need to wear a mask at work, and doing so may cause unnecessary discomfort and discrimination.