A preschool-aged child who is being treated for Streptococcal pharyngitis returns to the clinic for signs of scarlet fever. Which assessment finding provides the earliest indication to the nurse that the child is experiencing a reaction to the toxins that are created by the Streptococcus bacteria?

Flaky, peeling skin.

Red bumps across chest.

White coating on tongue.

High, protracted fever.

Answer and Explanation

The Correct Answer is B

A. Flaky, peeling skin (desquamation) occurs in later stages of scarlet fever, typically after the rash begins to fade. It is not an early sign of the disease.
B. A red, sandpaper-like rash that typically begins on the chest and spreads outward is one of the earliest indications of scarlet fever. This rash is caused by exotoxins produced by Streptococcus pyogenes and is a hallmark sign of the illness.
C. A white coating on the tongue, often followed by a characteristic “strawberry tongue,” develops later in the progression of scarlet fever rather than as an early symptom.
D. While fever is a common symptom of streptococcal infections, it is not the earliest indicator of scarlet fever. The rash usually appears within 12 to 48 hours of fever onset, making it a more specific early sign.

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Correct Answer is B

Explanation

A. Measuring abdominal girth may not directly assess the condition of the suprapubic catheter insertion site.

B. Observing the insertion site is crucial for assessing for signs of infection, inflammation, or other complications related to the suprapubic catheter.

C. Assessing the perineal area may be important for clients with other types of urinary catheters, but it is not directly related to the assessment of a suprapubic catheter.

D. Palpating the flank area may be indicated for assessing kidney function or detecting flank pain, but it is not specific to monitoring a suprapubic catheter.

A. Advise the client to place one nitroglycerin tablet under his tongue as a precaution. B. Tell the client to have someone bring him to an emergency department immediately. C. Instruct the client to increase his intake of oral fluids until the skin flushing is relieved. D. Reassure the client that skin flushing is a common side effect of the medication.

Correct Answer is D

Explanation

- A: Nitroglycerin is contraindicated with tadalafil due to the risk of severe hypotension. Advising the client to take nitroglycerin could lead to a dangerous drop in blood pressure.
- B: While it is important to monitor for serious side effects, immediate emergency department care may not be necessary if the client is not experiencing chest pain or other severe symptoms.
- C: Increasing oral fluids does not address the underlying cause of the skin flushing and is not a recommended action for this symptom in relation to tadalafil use.
- D: Skin flushing is a common side effect of tadalafil and is usually self-limiting. Reassuring the client about the nature of this side effect is appropriate, as long as the client is not experiencing chest pain or other severe symptoms related to his history of stable angina.

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A preschool-aged child who is being treated for Streptococcal pharyngitis returns to the clinic for signs of scarlet fever. Which assessment finding provides the earliest indication to the nurse that the child is experiencing a reaction to the toxins that are created by the Streptococcus bacteria?

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Naxlex Comprehensive Predictor Exams

Which assessment should the home health nurse include during a routine home visit for a client who was discharged home with a suprapubic catheter?

Correct Answer is B

Explanation

A male client reports to the on-call clinic nurse that he took tadalafil 10 mg by mouth two hours ago and his skin now feels flushed. He reports a history of stable angina but denies experiencing any current or recent chest pain. Which action should the nurse take?

Correct Answer is D

Explanation

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