# Stage 2 — Analyze cues. For each finding, identify the conclusion it supports. More than one column may apply.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=568583&lang=en  
> language: en  
> subject: Safety and Infection Prevention and Control  
> category: SIPC

## Question

Stage 2 — Analyze cues. For each finding, identify the conclusion it supports. More than one column may apply.

|  | Supports invasive meningococcal disease | Supports close respiratory-secretion exposure | Supports neither conclusion by itself |
| --- | --- | --- | --- |
| Fever, neck stiffness, petechiae, hypotension, and confusion |  |  |  |
| Roommate shared drinks and partner had direct oral contact |  |  |  |
| Classmate attended the same 100-person lecture |  |  |  |
| Nurse provided routine care using recommended mask and eye protection without secretion contact |  |  |  |

## Explanation

The clinical cluster supports invasive disease. Direct oral or unprotected respiratory-secretion contact supports close exposure, while simply attending the same large class or providing care with correct PPE does not by itself establish such exposure.

## In-depth explanation

Quick answer
Distinguish evidence that the client has invasive disease from evidence that another person had direct secretion exposure.

Why this is correct
The clinical syndrome identifies the ill client. Close-contact follow-through focuses on household-type contact or direct exposure to oral and respiratory secretions, not casual shared space or protected care without secretion contact.

Easy analogy or mental picture
Use two maps: one maps disease inside the client, and the other maps how respiratory secretions could have reached another person. Do not merge location alone with exposure.

Memory hook
Clinical cluster diagnoses risk; secretions define exposure.

NCLEX decision rule
When meningococcal disease is suspected, isolate the client first, then identify direct secretion contacts precisely; vaccination status does not erase a qualifying exposure.

Why the other choices are wrong
A large shared lecture and correctly protected routine care do not by themselves meet the direct-exposure pattern used for prophylaxis decisions.

References
1CDC: Clinical Overview of Meningococcal DiseaseClinical syndromes, prompt treatment, reporting, vaccination, and close-contact prophylaxis
2CDC Pink Book: Meningococcal DiseasePrompt empiric antibiotics, cultures, direct secretion exposure, and chemoprophylaxis
3CDC Infection Control: Meningococcal DiseaseStandard plus Droplet Precautions and occupational-exposure follow-through

## Clinical scenario

Case update
The nurse reviews the clinical syndrome and the contact history while maintaining Droplet Precautions.

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