Editing Infection Control and Safety – RN Practice Questions (section)

==Question 13==
A staff nurse performed unprotected suctioning of a client later confirmed to have meningococcal meningitis. Which action by the charge nurse is '''most''' appropriate?
# Reassure the nurse that wearing gloves during suctioning provided adequate protection.
# Refer the nurse to employee health for antimicrobial prophylaxis and report the case to the health department.
# Place the nurse on airborne precautions and exclude them from work for 14 days.
# Obtain a blood culture from the nurse and take no further action unless it is positive.

'''Answer:''' 2. Refer the nurse for antimicrobial prophylaxis and report the case to the health department.

''Rationale:'' ''Neisseria meningitidis'' spreads by respiratory droplets. Healthcare workers with unprotected intense exposure to respiratory secretions, such as suctioning, intubation, or mouth-to-mouth resuscitation, require prophylaxis with rifampin, ciprofloxacin, or ceftriaxone. Meningococcal disease is reportable. Gloves do not protect mucous membranes. The disease is droplet, not airborne, and prophylaxis rather than exclusion or watchful waiting is the standard, since disease onset can be fulminant.