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 B
Explanation
A. Monitor vital signs every 8 hr: Vital signs should be monitored more frequently in a child with diabetic ketoacidosis (DKA) than every 8 hours. Monitoring every 1-2 hours is typically recommended in order to detect any signs of deterioration or complications early.
B. Initiate continuous cardiac monitoring: Cardiac monitoring is important in the management of DKA because the condition can lead to electrolyte imbalances (especially hypokalemia), which can affect heart rhythm and potentially cause arrhythmias.
C. Administer subcutaneous insulin 30 min before meals: In SKA, insulin should not be administered subcutaneously until the child’s condition is stabilized, as intravenous (IV) insulin is typically used initially to correct acidosis and hyperglycemia in DKA.
D. Implement fluid restrictions: Fluid restrictions are not appropriate in DKA. Aggressive fluid resuscitation is necessary to correct dehydration and restore proper electrolyte balance. Fluid restrictions could worsen dehydration and acidosis.
Correct Answer is B
Explanation
A. "I will collect the first drop of blood by wiping it on the test strip." The first drop of blood should be wiped away with a clean cotton ball or gauze. This is because the first drop can contain interstitial fluid that may dilute the sample and lead to an inaccurate reading.
B. "I will stick the side of my finger with the lancet instead of the center." Sticking the side of the fingertip is less painful and allows for better blood flow compared to the center of the fingertip, which is often more sensitive.
C. “I will hold the lancet at a 45-degree angle when piercing my skin.” The lancet should typically be held at a 90-degree angle (straight) when piercing the skin, not at a 45-degree angle. A correct angle ensures proper blood flow and reduces discomfort.
D. “I will place my finger under cool water for a few seconds before the stick.” Using cool water before testing can cause the blood vessels to constrict. Warm water is recommended before testing, as it helps increase blood flow and makes it easier to obtain a sample.
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