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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Elevated heart rate and BP may indicate stress or pain, but Kussmaul respirations are more typical of metabolic acidosis (e.g., DKA), not increased ICP.

B. Bradycardia, widening pulse pressure (increased systolic with stable diastolic), and irregular respirations are signs of Cushing’s triad, a late but classic indicator of increased ICP requiring immediate reporting.

C. Vital signs here are stable and within expected ranges; shallow respirations may be related to sedation or fatigue but not increased ICP.

D. This pattern suggests hypotension and compensatory tachycardia, more consistent with hypovolemia or shock than increased ICP.

A. "Risk for self-directed violence as evidenced by feelings of hopelessness." B. "Chronic low self-esteem as evidenced by feelings of worthlessness." C. "Anxiety as evidenced by abdominal discomfort secondary to depression." D. "Imbalanced nutrition as evidenced by 25 lb (11 kg) weight loss in four months."

Correct Answer is A

Explanation

A. "Risk for self-directed violence as evidenced by feelings of hopelessness": The client’s feelings of hopelessness, combined with significant weight loss and loss of interest in activities, suggest possible depression. Hopelessness is a key symptom of depression, which can increase the risk for self-harm or suicide.

B. "Chronic low self-esteem as evidenced by feelings of worthlessness": Feelings of worthlessness are part of the larger picture of the client’s depression. The priority is to address the immediate risk of harm, which takes precedence over chronic low self-esteem.

C. "Anxiety as evidenced by abdominal discomfort secondary to depression": While abdominal discomfort can be a symptom of depression, it is secondary to the more immediate concern of the client’s potential risk for self-directed violence.

D. "Imbalanced nutrition as evidenced by 25 lb (11 kg) weight loss in four months": The significant weight loss is concerning, but it is likely a result of the client’s depression. The focus should first be on addressing the client’s safety, followed by nutrition and weight restoration.

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Naxlex Comprehensive Predictor Exams

Which client's vital signs indicating increased intracranial pressure (ICP) should the nurse report to the healthcare provider?

Correct Answer is B

Explanation

Correct Answer is A

Explanation

Exhibits For each assessment finding, click to indicate whether the findings from the client's assessment are generally associated with rotator cuff injury and/or humeral fracture. Each column must have at least one response selected.

The nurse implements a tertiary prevention program for type 2 diabetes mellitus in a rural health clinic. Which outcome indicates that the program was effective?

The nurse is setting up the equipment to assist with a sigmoidoscopy while the practical nurse (PN) positions the client in a flat prone position. Which action should the nurse implement?

The nurse is caring for a client who receives a prescription for parenteral lidocaine. Prior to administering the medication, the nurse should review the medical record for which condition?

The nurse is caring for a one-week-old infant who has a ventriculoperitoneal (VP) shunt that was placed 2 days after birth. Which finding(s) indicate a postoperative complication? Select all that apply. Reference Range: White blood cells (WBC) [9,000 to 10,000/mm3 (9 to 10 x 10^9 /L)]

The nurse is reviewing the plan of care for a newly admitted client who is intoxicated on admission. Which findings should the nurse include as indicators to begin implementing the detoxification medication protocol?