A nurse suspects that a three-year-old child may have rubella based on presenting symptoms. Which of the following questions asked by the nurse (directed at the parents) will be most effective in determining how the child was exposed to the virus?
Whom has the child come into contact with over the last three weeks?
Are your child's immunizations up to date?
What medications have you given your child?
When did you first notice the rash?
The Correct Answer is A
Choice A reason: This statement is correct, as asking about the child's contacts over the last three weeks can help the nurse identify the possible source of infection and the risk of transmission. Rubella is a viral infection that spreads through respiratory droplets or direct contact with an infected person. The incubation period of rubella is 14 to 21 days, meaning that the child could have been exposed to the virus up to three weeks before developing symptoms.
Choice B reason: This statement is incorrect, as asking about the child's immunizations is not the most effective way to determine how the child was exposed to the virus. Although immunization can prevent rubella infection, it is not 100% effective, and some children may still get the disease despite being vaccinated. The nurse should also consider other factors, such as the child's medical history, travel history, and exposure to other people with rash or fever.
Choice C reason: This statement is incorrect, as asking about the medications given to the child is not the most effective way to determine how the child was exposed to the virus. Medications can help relieve the symptoms of rubella, such as fever, rash, or joint pain, but they do not affect the transmission or the course of the infection. The nurse should focus on the epidemiological aspects of the disease, such as the mode of transmission, the incubation period, and the contagious period.
Choice D reason: This statement is incorrect, as asking about the onset of the rash is not the most effective way to determine how the child was exposed to the virus. The rash of rubella usually appears 14 to 17 days after exposure, and lasts for about three days. However, the child can be contagious from seven days before to seven days after the rash appears, meaning that the child could have been exposed to the virus up to four weeks before or after the rash. The nurse should ask about the child's contacts during this period, not just the rash.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Murmur, tachycardia, and low erythrocyte sedimentation rate are not specific signs of Kawasaki disease. They may indicate other cardiac or inflammatory conditions.
Choice B reason: Abdominal pain, vomiting, and restlessness are not typical signs of Kawasaki disease. They may suggest other gastrointestinal or neurological problems.
Choice C reason: Coarse breath sounds, abnormal ECG, and joint pain are not common signs of Kawasaki disease. They may indicate other respiratory, cardiac, or rheumatic disorders.
Choice D reason: This is the correct choice. Fever, "strawberry tongue" and peeling palms and soles are characteristic signs of Kawasaki disease, which is a rare but serious condition that causes inflammation of the blood vessels. Other signs include red eyes, swollen lips, rash, and swollen lymph nodes.
Correct Answer is A
Explanation
Choice A reason: This statement is correct, as most infants are ready to start solid foods when they are 4 to 6 months old, depending on their individual growth and readiness. The nurse should explain to the parents that some signs of readiness include being able to hold the head up, sit with support, show interest in food, and move food from the spoon to the throat.
Choice B reason: This statement is incorrect, as 2 to 3 months is too early to introduce solid foods to infants, as their digestive system and swallowing skills are not mature enough to handle them. The nurse should advise the parents to avoid giving solid foods before 4 months of age, as it can increase the risk of choking, allergies, obesity, and iron deficiency.
Choice C reason: This statement is incorrect, as 1 year is too late to introduce solid foods to infants, as they need more nutrients and calories than breast milk or formula alone can provide. The nurse should inform the parents that delaying solid foods beyond 6 months of age can lead to growth faltering, micronutrient deficiencies, and feeding difficulties.
Choice D reason: This statement is incorrect, as 10 to 11 months is too late to introduce solid foods to infants, as they need more nutrients and calories than breast milk or formula alone can provide. The nurse should inform the parents that delaying solid foods beyond 6 months of age can lead to growth faltering, micronutrient deficiencies, and feeding difficulties.
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