A father brings his preschool aged child to the clinic because of a sore throat for the past two days and currently has a temperature of 103° F (39.4°C). The child is pale around the mouth and has flushed cheeks. The nurse processes a positive rapid strep test as prescribed. Which information should the nurse provide to the child's parent? Select all that apply.
Contagious until symptoms subside.
Sandpaper-like rash.
Peeling and flaking skin in a week.
Darkening of skin under arms.
Fever lasting for 7 to 10 days.
Correct Answer : B,C
A. Contagious until symptoms subside: Streptococcal pharyngitis is contagious until 24 hours after starting antibiotics, not until all symptoms are gone. This is important for limiting transmission to others in the household or school setting.
B. Sandpaper-like rash: A sandpaper-textured rash is a hallmark sign of scarlet fever, which is a complication of strep throat. It usually begins on the neck or chest and spreads, often feeling coarse to the touch.
C. Peeling and flaking skin in a week: Desquamation, or skin peeling, is common several days after a strep rash subsides, particularly on the hands and feet. This symptom signals the healing phase of scarlet fever.
D. Darkening of skin under arms: Darkened underarm skin is typically linked to acanthosis nigricans, associated with insulin resistance or obesity. It is not seen with streptococcal infections or fever-related conditions.
E. Fever lasting for 7 to 10 days: Fever from strep throat usually resolves quickly within 24–48 hours of initiating antibiotic therapy. Prolonged fever would be atypical and requires further evaluation for complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Heart rate 100 beats/minute: A compensatory increase in heart rate (tachycardia) is expected in orthostatic hypotension. It helps maintain cerebral perfusion when blood pools in the lower extremities after standing quickly.
B. Blood pressure 125/65 mm Hg: This BP shows a slight systolic increase, which is not typical after orthostatic stress. A decrease in BP, not an increase, would be expected if symptoms like dizziness are present.
C. Heart rate 70 beats/minute: A decreased heart rate is not physiologically expected when someone experiences postural hypotension. Bradycardia would worsen cerebral perfusion and is inconsistent with dizziness.
D. Blood pressure 115/70 mm Hg: This change is too minor to explain dizziness. In orthostatic hypotension, we usually expect a drop of ≥20 mm Hg systolic or ≥10 mm Hg diastolic after position change.
Correct Answer is ["A","D","E"]
Explanation
A. Ask the client if she has any alcohol in the room at this time: This is an essential step in assessing for immediate safety and contraband that may impact her treatment plan, especially considering her symptoms and possible withdrawal risk.
B. Administer a PRN prescription for an antianxiety drug: This could mask symptoms of alcohol withdrawal or interact negatively with alcohol. Medication should be given only after thorough assessment and consultation.
C. Inform the family that they are enabling the client: While family education is important, using accusatory language like "enabling" can damage therapeutic relationships. A nonjudgmental, supportive approach is better.
D. Observe for signs to determine if client is inebriated: Monitoring for inebriation supports accurate clinical assessment and decisions about withdrawal protocols, safety, and medication timing.
E. Schedule a conference with the client and family members: A joint meeting allows open discussion, identifies care goals, and promotes understanding and support from all parties involved.
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