End
1 :

0930

Admission:

An adolescent was brought in with a report of headache, fever, pain with swallowing, and sore and red throat for three days.

Vital Signs:

Temperature: 38.8° C (101.8° F)

Heart rate: 110/min

Respiratory rate: 20/min

Blood pressure: 143/82 mm Hg

Oxygen saturation: 95% on room air

Laboratory Results (0945):

Throat and nose culture: Rapid antigen detection screen positive for Streptococcus pyogenes.

1000

Admission:

A preschooler was brought in for a return visit following a positive lead testing result.

Laboratory Results (One day ago):

 Metal testing: Lead 12 mcg/dL (Reference: less than 3.5 mcg/dL).

1030

Admission:

An older adult client reports to the clinic for a painful rash. A cluster of papulovesicular lesions is present on the left side of the trunk.

Provider Note (1045):

Client evaluated by provider, diagnosed with herpes zoster.

Time: 1100

 Admission:

A client reports to the clinic for reading of a tuberculin skin test administered two days ago. They reported a two-week history of fatigue, productive cough, nausea, fever, anorexia, and weight loss. They state sputum was blood-tinged this morning. The client reports recent travel to South America.

  Vital Signs:

 Temperature: 38.4° C (101.1° F)

 Heart rate: 118/min

Respiratory rate: 28/min

Blood pressure: 115/72 mm Hg

 Oxygen saturation: 93% on room air

  Laboratory Results:

Mantoux tuberculin skin testing: reddish induration greater than 10 mm (Reference: less than 5 mm).

1130

Admission:

A client reports for chlamydia testing following a positive test for a partner. They report no manifestations.

 Vital Signs:

Temperature: 37.1° C (98.8° F)

Heart rate: 72/min

Respiratory rate: 20/min

Blood pressure: 116/75 mm Hg

Oxygen saturation: 97% on room air

Laboratory Results:

Rapid chlamydia test: positive (Reference: negative).


The nurse manager should identify which of the following clients have conditions that require national notification? Select all that apply.


Answer Options

Hint : 🧾Report: Lead, TB, Chlamydia.

Correct Answers:

  • Client 2
  • Client 4
  • Client 5


Rationale :

Client 2 — Elevated Lead Level (12 mcg/dL)

💎Lead poisoning is a nationally notifiable condition because it poses serious public health risks and may indicate environmental exposure affecting other children or communities.

💎Blood lead levels above 3.5 mcg/dL are considered elevated, triggering mandatory reporting to local or state health departments.

💎Reporting allows for environmental investigations (e.g., home inspections for lead paint or contaminated water).

💎Early identification and intervention can prevent neurodevelopmental damage in children.

💎The public health department typically follows up with education, remediation, and repeat testing.

Client 4 — Tuberculosis (Active TB Suspicion)

💎The client’s positive Mantoux test, respiratory symptoms, and hemoptysis indicate active pulmonary tuberculosis, which is a reportable communicable disease.

💎TB is reported because it is highly contagious through airborne droplets and poses significant community health risks.

💎Early reporting ensures initiation of airborne isolation, sputum testing, and contact tracing.

💎Notification allows public health officials to monitor, control, and prevent further transmission.

💎Prompt reporting also facilitates treatment adherence through directly observed therapy (DOT) programs.

Client 5 — Chlamydia Infection

💎Chlamydia trachomatis infection is a sexually transmitted infection (STI) that is mandated for national notification.

💎Reporting supports contact tracing and treatment of sexual partners to prevent reinfection and spread.

💎Untreated chlamydia can lead to pelvic inflammatory disease, infertility, or neonatal conjunctivitis.

💎Public health departments use reported data to monitor infection trends and guide prevention efforts.

💎Notification helps ensure community-wide sexual health education and screening initiatives.


Distractor Analysis :

Rationale for Incorrect Options to be Available Soon

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