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 C

Explanation

A. Conversion of the PPD test from negative to positive indicates exposure to tuberculosis but does not contraindicate the administration of isoniazid. It may actually indicate the need for prophylactic treatment.

B. A history of intravenous drug abuse is not directly related to the administration of isoniazid. However, it may be important for assessing risk factors for tuberculosis transmission and adherence to treatment.

C. Isoniazid can cause hepatotoxicity, so it is essential to assess for pre-existing liver conditions such as hepatitis B before administering the medication. Hepatitis B may increase the risk of liver damage associated with isoniazid.

D. The length of time of exposure to tuberculosis is important for assessing the risk of infection and determining the need for prophylactic treatment but does not impact the administration of isoniazid.

A. An abdominal binder can be worn daily to reduce the protrusion. B. This hernia is a normal variation that resolves without treatment. C. The quarter should be secured with an elastic bandage wrap. D. Restrictive clothing will be adequate to help the hernia go away.

Correct Answer is B

Explanation

A. An abdominal binder can be worn daily to reduce the protrusion: This is not an appropriate intervention for an umbilical hernia in an infant. Abdominal binders are typically used for support after abdominal surgeries or to manage hernias in adults.

B. This hernia is a normal variation that resolves without treatment: Umbilical hernias are common in infants and typically resolve on their own without intervention by around 1 to 2 years of age. Reassuring the mother about the benign nature of the hernia is appropriate.

C. The quarter should be secured with an elastic bandage wrap: Taping a quarter over the umbilicus is not a recommended treatment for an umbilical hernia and could pose a choking hazard to the infant.

D. Restrictive clothing will be adequate to help the hernia go away: Restrictive clothing is not an effective treatment for umbilical hernias in infants and could potentially cause discomfort or complications.

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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

A client exposed to tuberculosis is scheduled to begin prophylactic treatment with isoniazid. Which information is most important for the nurse to note before administering the initial dose?

Correct Answer is C

Explanation

A mother brings her 4-month-old son to the clinic with a quarter taped over his umbilicus, and tells the nurse the quarter is supposed to fix her child's hernia. Which explanation should the nurse provide?

Correct Answer is B

Explanation

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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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