A nurse in a public health department is caring for a client.
Which of the following data in the client’s medical record should cause the nurse to suspect the client is infected with the plague? Select all that apply.
Temperature
Client’s statement about “bites”
Travel history
Lymph node assessment
Body aches
New onset of weakness
Headache and chills
Pruritic lesions on the right leg
Clear lungs to auscultation bilaterally
Correct Answer : A,B,C,D,E,F,G,H
Choice A rationale: The client’s persistent fever is a common symptom of the plague and many other infections.
Choice B rationale: The client’s statement about getting flea bites during their trip is significant because the plague is often transmitted through the bite of an infected flea.
Choice C rationale: The client’s recent travel to South Asia could have exposed them to areas where plague is endemic or there are ongoing outbreaks.
Choice D rationale: The presence of tender, inguinal lymphadenitis (swollen lymph nodes in the groin area) is a classic sign of bubonic plague.
Choice E rationale: Body aches can be a symptom of the systemic infection caused by the plague.
Choice F rationale: New onset of weakness can be a symptom of the systemic infection caused by the plague.
Choice G rationale: Headache and chills are common symptoms of the plague and many other infections.
Choice H rationale: Pruritic (itchy) lesions on the right leg could be the site of the flea bites that transmitted the plague bacteria.
Choice I rationale: Clear lungs to auscultation bilaterally does not necessarily rule out the plague. While pneumonic plague does affect the lungs, bubonic plague (the most common form) primarily causes lymphadenitis and does not typically present with respiratory symptoms in the early stages.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Wide-angle glaucoma is a type of eye condition that can affect vision, but it is not typically associated with an increased risk of falls.
Choice B rationale
Chronic kidney disease can have many effects on the body, but it is not typically identified as a direct risk factor for falls.
Choice C rationale
Chronic obstructive pulmonary disease (COPD) can cause shortness of breath and fatigue, which could potentially contribute to instability. However, it is not one of the most common conditions associated with an increased risk of falls.
Choice D rationale
Osteoarthritis can cause pain and stiffness in the joints, which can lead to mobility issues and an increased risk of falls. Therefore, a nurse should identify osteoarthritis as a condition that increases a client’s risk for falls.
Correct Answer is D
Explanation
Choice A rationale
Reviewing the immunization records of the child’s classmates might be a subsequent step after confirming the diagnosis and reporting to the health department. However, the immediate action should be to contact the local health department.
Choice B rationale
Advising the caregivers to increase the child’s Vitamin B intake is not relevant in this context. Koplik spots are a sign of measles, a viral infection, and increasing Vitamin B intake would not affect the course of this disease.
Choice C rationale
Examining the child’s classmates for enlargement of the parotid gland is not appropriate because enlargement of the parotid gland is a symptom of mumps, not measles.
Choice D rationale
Contacting the local health department is the correct action. Koplik spots are a characteristic sign of measles, a highly contagious and reportable disease. The local health department can provide guidance on further steps, including confirmation of the diagnosis, treatment, and measures to prevent the spread of the disease.
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