A nurse is caring for an infant in an outpatient pediatrician's office.
Click to specify if each finding is indicative of fifth disease, measles, or rubella. Each finding may support more than 1 disease process or none at all. There must be at least 1 selection in every column. There does not need to be a selection in every row.
Red rash on the face
Koplik spots in the mouth
Fever
Lymphadenopathy
The Correct Answer is {"A":{"answers":"A,B,C"},"B":{"answers":"B"},"C":{"answers":"A,B,C"},"D":{"answers":"B,C"}}
Rationale:
- Red rash on the face: The red rash on the face is common in all three viral infections but presents differently in each. In Fifth disease, it appears as a "slapped cheek" rash, bright red on the cheeks. In Measles, the rash starts on the face, particularly behind the ears, and spreads to the body. Rubella causes a mild pinkish-red rash that begins on the face and spreads down, but it is usually less intense than in the other two diseases.
- Koplik spots in the mouth: Koplik spots are a classic feature of Measles, appearing as small white spots inside the mouth, typically on the buccal mucosa opposite the molars, and are present before the rash. Fifth disease and Rubella do not present with Koplik spots.
- Fever: Fever is common in all three diseases but varies in severity. Fifth disease usually presents with a low-grade fever. Measles often causes a high fever that spikes before the characteristic rash. Rubella typically causes a mild fever, especially in the early stages.
- Lymphadenopathy: Lymphadenopathy is prominent in Measles and Rubella, where it often affects the cervical and postauricular lymph nodes. Fifth disease does not typically cause significant lymphadenopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. “I will monitor the circulation in my baby's toes.” It is important to monitor the circulation in the toes of a child with serial casts, as the cast could cause pressure and affect blood flow. Checking for signs of poor circulation, such as color changes, temperature changes, or swelling, is crucial to ensure the cast is not too tight.
B. “I will give my baby ibuprofen for excessive crying.” Ibuprofen is not recommended for infants under 6 months of age, excessive crying should be evaluated to determine its cause. Administering ibuprofen without understanding the underlying issue could be inappropriate.
C. “My baby will need a calcium supplement with feedings.” Calcium supplements are not required for infants with clubfoot unless there is a specific indication, such as a dietary deficiency or underlying condition. Calcium is usually obtained through breast milk or formula.
D. “My baby will need to wear the casts for 4 to 6 months.” Serial casting for clubfoot treatment typically lasts longer than 4 to 6 months, depending on the severity of the condition and the child's response to treatment.
Correct Answer is D
Explanation
A. Collect a stool specimen for occult blood: A stool specimen for occult blood is typically used to check for hidden blood in the stool, which might suggest conditions like gastrointestinal bleeding or certain infections. It is not the primary test for diagnosing C. difficile infection.
B. Draw a blood culture: Blood cultures are used to identify bacteria or other pathogens in the blood, but they are not appropriate for diagnosing Clostridium difficile infection, which primarily affects the gastrointestinal system.
C. Conduct a tape test: A tape test is used for diagnosing pinworm infections, not for Clostridium difficile. It involves placing a piece of tape on the child's anal area to collect eggs for examination under a microscope. It is not relevant to the suspicion of C. difficile.
D. Obtain a stool specimen for culture: The most appropriate action is to collect a stool specimen for culture to identify C. difficile. The diagnosis of C. difficile infection is typically confirmed by stool testing, which may include testing for toxins produced by the bacteria.
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