An occupational health nurse practitioner's physical assessment of a factory worker identifies an acute-onset pruritic dermatitis extending over the face, hands, neck, and forearms. The nurse's priorities should be to:

• A. Contact factory senior management, educate workers about exposure, and clean the area.
• B. Contact the Occupational Safety and Health Administration immediately and remove the offending chemical in the work environment.
• C. Immediately evacuate the worker's nearby workspace and treat the worker and other exposed workers.
• D. Treat the client and obtain a comprehensive exposure history; if an onsite environmental exposure is suspected as the cause, screen other at-risk workers and ensure that the environmental risk is identified and eliminated.

Answer: (D)

The key idea is prioritizing patient care while quickly identifying and addressing the workplace exposure that caused the dermatitis. The best approach is to treat the worker’s acute symptoms and obtain a thorough exposure history to determine what chemical or material triggered the reaction. If the history and assessment point to an onsite environmental exposure, then expand the response to protect others by screening other at‑risk workers and taking steps to identify and eliminate the environmental risk. This sequence addresses the immediate health needs of the individual and prevents a broader outbreak by removing the source.

Other options focus too much on environmental or regulatory actions without ensuring the patient is being treated or that exposure history is explored first. It’s not appropriate to evacuate or ion the workspace or to contact OSHA immediately without confirming a hazardous release, and cleaning or informing management without understanding the cause misses the needs of the patient and the broader safety action.