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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","E","F","G"]
Explanation
O2 saturation: Directly reflects the level of oxygen in the blood.
Respiratory rate 28 bpm: Indicates increased effort to obtain oxygen.
Anxious, Restless: Neurological signs of inadequate oxygenation.
BP 145/89 mmHg: Elevated blood pressure can be a response to hypoxia.
Heart Rate 101 bpm: Increased heart rate is a compensatory mechanism for hypoxia.
Correct Answer is A
Explanation
A. Obtain a capillary glucose level: The symptoms of jitteriness and tachypnea in a newborn could be indicative of hypoglycemia, so the first action should be to assess the glucose level to determine if hypoglycemia is the cause.
B. Feed 30 mL of 10% dextrose in water: While providing dextrose may be necessary if hypoglycemia is confirmed, assessing the glucose level should be done first to guide appropriate treatment.
C. Wrap tightly in a warm blanket: While keeping the newborn warm is important, it is not the first action to take in this scenario where the newborn is displaying signs of possible hypoglycemia.
D. Encourage the mother to breastfeeD Breastfeeding may help increase the newborn's glucose level, but the priority is to assess the glucose level first to determine if hypoglycemia is present.
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