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Question

Difficulty: MediumStandard and Transmission-Based Precautions

An occupational health nurse is evaluating exposure risks in a crowded clinic waiting area. Several individuals are waiting for triage. Which individual's clinical presentation strictly necessitates immediate placement into a negative-airflow isolation room?

  1. A toddler with a high fever, coryza, and small bluish-white lesions on the buccal mucosa.Answer
  2. B
    A teenager presenting with a sudden onset of severe headache, photophobia, and nuchal rigidity.
  3. C
    An older adult with a prolonged, violent cough followed by a high-pitched inspiratory sound.
  4. D
    An infant with profuse, watery diarrhea and vomiting that has persisted for the past twenty-four hours.

Answer

The toddler with a high fever, coryza, and small bluish-white lesions on the buccal mucosa requires a negative-airflow isolation room.
The clinical presentation of a high fever, coryza, and bluish-white oral lesions (known as Koplik spots) is highly characteristic of rubeola (measles). Measles is an extremely contagious virus transmitted via aerosolized droplet nuclei that remain suspended in the air. Therefore, this client requires airborne transmission-based precautions, which necessitate an airborne infection isolation room with negative-airflow and the use of an N95 respirator.

Step-by-Step Solution

1
Analyze the stem to determine the exact requirement.
The nurse needs to identify which client requires a negative-airflow isolation room, which is a specific requirement for airborne transmission-based precautions.
Understanding that a negative-airflow room equates to airborne precautions focuses the evaluation on identifying airborne pathogens.
2
Evaluate the clinical presentation of the toddler.
The presence of fever, coryza, and Koplik spots (bluish-white lesions on the buccal mucosa) points to rubeola (measles). Measles requires airborne precautions.
Measles is transmitted via tiny droplet nuclei that remain suspended in the air, requiring specialized negative-pressure ventilation.
3
Evaluate the clinical presentations of the remaining individuals to confirm they do not require airborne isolation.
The teenager has signs of meningitis (requires droplet precautions). The older adult has signs of pertussis (requires droplet precautions). The infant has signs of gastroenteritis (requires contact precautions).
Differentiating the route of transmission for each suspected disease eliminates the distractors and confirms the correct answer.

Key Concept

Standard and Transmission-Based Precautions
Estimated Time:1m 0s
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Topics

Standard and Transmission-Based Precautions

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