A nurse is collecting data from a child who has pertussis. Which of the following manifestations should the nurse expect?
Peeling of the hands and feet
Fever
Beefy, red tongue
Facial erythema
The Correct Answer is B
The correct answer is choice B. Fever.
Choice A rationale:
Peeling of the hands and feet is not a typical manifestation of pertussis. This symptom is more commonly associated with conditions like Kawasaki disease.
Choice B rationale:
Fever is a common symptom in the early stages of pertussis, along with a mild cough and runny nose.
Choice C rationale:
A beefy, red tongue is not associated with pertussis. This symptom is more characteristic of scarlet fever.
Choice D rationale:
Facial erythema is not a typical symptom of pertussis. Pertussis primarily affects the respiratory system, causing severe coughing fits.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "If you are allergic to gluten you should not receive this vaccine."Gluten allergy is not a contraindication for the MMR vaccine. The vaccine does not contain gluten, and an allergy to gluten would not prevent someone from safely receiving the vaccine. However, individuals with severe allergies to neomycin or gelatin (which are components of the vaccine) should not receive it.
B. "Avoid pregnancy for at least 28 days after receiving the vaccine."The MMR vaccine contains live attenuated viruses, and there is a theoretical risk to the fetus if a woman becomes pregnant shortly after vaccination. Therefore, it is recommended that women avoid becoming pregnant for at least 28 days after receiving the MMR vaccine to reduce any potential risks.
C. "Avoid breastfeeding for 3 days after receiving the vaccine."The MMR vaccine is safe for breastfeeding mothers and does not require any interruption in breastfeeding. The vaccine viruses are not transmitted through breast milk in a way that would harm the infant.
D. "Your partner should also receive the MMR vaccine."While it is important for all individuals to be up-to-date on their vaccinations, the partner's vaccination status is unrelated to the postpartum administration of the MMR vaccine to the client. This instruction does not address a specific concern related to the postpartum period or the MMR vaccine's administration at this time.
Correct Answer is A
Explanation
A. Correct. An incident report should be completed for any unintended event or situation that could have resulted or did result in harm to a patient. Administering the wrong dose of medication falls under this category.
B. Incorrect. The nursing care plan is a comprehensive outline of a patient's care needs and interventions and is not the appropriate place to document a medication error.
C. Incorrect. The provider's progress notes are meant to document the patient's condition, care, and progress, but they are not used to document medication errors.
D. Incorrect. The controlled substance inventory record is used to track the dispensing and administration of controlled substances, not to document medication errors.
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