A nurse is caring for a child who has bacterial meningitis. Which of the following findings should indicate to the nurse that the child can be removed from droplet precautions?

A. Negative cerebrospinal fluid culture: A negative CSF culture does not immediately indicate that the child is no longer infectious, as cultures can be affected by prior antibiotic therapy or sampling timing. Droplet transmission risk is based on organism viability rather than culture results alone. B. Absent nuchal rigidity: Improvement or resolution of meningeal signs reflects clinical recovery but does not determine infectiousness. A child may still harbor and transmit the causative bacteria despite reduced neurological symptoms. C. Antibiotics initiated 24 hr ago: Children with bacterial meningitis are considered noninfectious after receiving at least 24 hours of appropriate antibiotic therapy. At this point, droplet precautions can be safely discontinued according to infection control guidelines. D. Temperature below 37.4° C (99.3° F): Normalization of temperature indicates improvement but does not correlate with the elimination of transmission risk. Fever resolution alone is insufficient to determine when isolation precautions can be stopped.