The nurse provides education to a client who is newly diagnosed with multiple sclerosis (MS). Which client statements indicate the need for additional teaching? SELECT ALL THAT APPLY

Choice A reason: Fluconazole (Diflucan) is an antifungal medication that is used to treat infections caused by fungi, such as candidiasis, cryptococcosis, and histoplasmosis. It is not effective against anthrax, which is a bacterial infection caused by Bacillus anthracis.

Choice B reason: Ciprofloxacin (Cipro) is an antibiotic medication that belongs to the class of fluoroquinolones. It is used to treat various bacterial infections, including anthrax. It works by inhibiting the DNA synthesis of the bacteria and preventing them from multiplying. Ciprofloxacin is one of the recommended medications for post-exposure prophylaxis and treatment of anthrax, according to the Centers for Disease Control and Prevention (CDC).

Choice C reason: Varenicline (Chantix) is a medication that is used to help people quit smoking. It works by blocking the effects of nicotine on the brain and reducing the cravings and withdrawal symptoms. It has no role in the prevention or treatment of anthrax.

Choice D reason: Potassium iodide (KI) is a medication that is used to protect the thyroid gland from radioactive iodine in the event of a nuclear or radiological emergency. It works by saturating the thyroid with non-radioactive iodine and preventing it from absorbing radioactive iodine. It has no role in the prevention or treatment of anthrax.

Choice A reason: Administering an antipyretic is not the next action that the nurse should initiate. An antipyretic is a medication that lowers fever, which is a common symptom of meningococcal meningitis. However, fever is not a life-threatening condition, and it may have some beneficial effects on fighting infection. The nurse should first prioritize other actions that are more urgent or critical for the client's safety and outcome.

Choice B reason: Decreasing environmental stimuli is not the next action that the nurse should initiate. Decreasing environmental stimuli is a nursing intervention that can help reduce agitation, confusion, or seizures in clients with meningococcal meningitis. However, it is not an immediate or essential action, and it may not be effective if the client's condition worsens or progresses to coma.

Choice C reason: Assessing the cranial nerves is the next action that the nurse should initiate. Cranial nerve assessment is a neurological examination that evaluates the function of 12 pairs of nerves that originate from the brainstem and control various sensory and motor functions, such as vision, hearing, smell, taste, facial expression, eye movement, swallowing, speech, and balance. Meningococcal meningitis is an inflammation of the meninges, which are the membranes that cover and protect the brain and spinal cord. Meningeal inflammation can compress or damage the cranial nerves, causing various signs and symptoms, such as headache, photophobia, diplopia, facial palsy, dysphagia, dysarthria, or nystagmus. Assessing the cranial nerves can help detect any neurological deficits or complications early, and guide appropriate interventions or referrals.

Choice D reason: Completing a vascular assessment is not the next action that the nurse should initiate. A vascular assessment is a physical examination that evaluates the blood flow and circulation in different parts of the body, such as the arms, legs, abdomen, or neck. It may include checking pulses, blood pressure, capillary refill, skin color, temperature, or edema. A vascular assessment may be relevant for some clients with meningococcal meningitis who develop septic shock or disseminated intravascular coagulation (DIC), which are serious conditions that affect blood vessels and clotting factors. However, these are not common or early manifestations of meningococcal meningitis, and they require more advanced or specialized assessments and treatments.