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":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"C"},"D":{"answers":"B"},"E":{"answers":"B"},"F":{"answers":"B"}}
Explanation
- Steatorrhea: Steatorrhea (fatty stools) is a common symptom of cystic fibrosis due to pancreatic insufficiency. It is not directly related to the current acute infection (Streptococcus pneumonia).
- Barrel chest: A barrel chest is a chronic sign of cystic fibrosis caused by long-standing lung disease and airway obstruction. It is not related to the acute infection (Streptococcus pneumonia) but reflects the long-term effects of cystic fibrosis.
- Hemoptysis 300 mL: Hemoptysis, 300 mL, is a significant and concerning sign of potential worsening condition. While blood-streaked sputum was initially noted, a large volume like 300 mL indicates significant bleeding from the lungs.
- WBC count 17,000/mm³: The initial WBC count was 22,000/mm3, indicating an active bacterial infection. A decrease to 17,000/mm3, while still elevated, suggests that the body's inflammatory response is potentially improving and that the infection IS responding to treatment.
- Oxygen saturation 95% on 1 L oxygen via nasal cannula: The oxygen saturation has improved (from 92% to 95%) with a reduction in the amount of supplemental oxygen, indicating that the patient’s respiratory status is improving.
- Respiratory rate 32/min: The respiratory rate has decreased slightly from 36/min to 32/min, indicating that the patient’s breathing is becoming more stable as the condition improves. However, respiratory rate should still be closely monitored as part of overall progress.
Correct Answer is A
Explanation
A. "Your baby has an increased risk for a heart defect.": Infants with Down syndrome have a significantly higher risk for congenital heart defects, such as atrioventricular septal defects (AVSD) and ventricular septal defects (VSD). It is important for the parents to be aware of this risk and have the infant screened by a cardiologist.
B. "Expect your baby to need factor replacement therapy every month.": Factor replacement therapy is typically associated with hemophilia, not Down syndrome. Down syndrome is a genetic condition that affects development, but it is not clotting disorders.
C. "Expect your baby to grow in height more rapidly than weight.": Infants with Down syndrome often experience growth delays, but there is no specific expectation that height will outpace weight.
D. "Your baby should have no issues with eyesight.": Children with Down syndrome are at higher risk for vision problems, including strabismus, refractive errors, and cataracts. Regular eye exams are important for early detection and management of these issues.
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