On assessment of a child admitted with a diagnosis of acute-stage Kawasaki disease, the nurse expects to note which clinical manifestation of the acute stage of the disease?
Cracked lips
Desquamation of the skin
Normal appearance
Conjunctival hyperemia
The Correct Answer is D
A. Cracked lips:
Incorrect: While red, cracked lips are part of the mucous membrane changes seen in Kawasaki disease, they are not specific to the acute stage. Mucous membrane changes can occur in both the acute and subacute stages.
B. Desquamation of the skin:
Incorrect: Desquamation, or peeling of the skin, is more characteristic of the subacute or convalescent stages of Kawasaki disease, particularly on the fingers and toes.
C. Normal appearance:
Incorrect: In the acute stage, the child with Kawasaki disease typically exhibits signs of illness, including fever and other clinical manifestations. A "normal appearance" would not be expected in the acute stage.
D. Conjunctival hyperemia.
Explanation: Conjunctival hyperemia, or redness of the eyes, is a common clinical manifestation of the acute stage of Kawasaki disease. Other typical signs and symptoms during this stage include fever, mucous membrane changes (such as red, cracked lips), changes in the extremities, rash, and cervical lymphadenopathy.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
A. Set the water heater at 65.6° C (150° F):
The recommended temperature for a water heater is around 49°C (120°F) to prevent burns. Setting it at 65.6°C (150°F) can lead to scald injuries.
B. Install accordion style gates: Accordion-style gates are not recommended because they can pose a strangulation risk. The safer option is to use gates with vertical or horizontal slats that are spaced closer together.
C. Fit the mattress so that it is snug against the sides of the crib: A snug-fitting mattress prevents gaps where the baby could get trapped or injured.
D. Tie plastic bags in knots before discarding them:
This prevents accidental suffocation or choking hazards that can occur if an infant gets hold of a plastic bag.
E. Serve food in small, non-circular pieces:Serving food in small, non-circular pieces reduces the risk of choking. Infants should be given age-appropriate foods to minimize the risk of choking, and cutting food into small, easy-to-manage pieces is recommended.
Correct Answer is C
Explanation
A. 9 months: By 9 months, most infants would have well exceeded doubling their birth weight.
B. 12 months: Doubling of birth weight usually occurs earlier, by around 5 to 6 months, rather than 12 months.
C. 6 months
Explanation:
The general guideline is that infants tend to double their birth weight by around 5 to 6 months of age. This doubling of birth weight is a common marker of healthy growth and development during the first few months of life.
D. 3 months: By 3 months, while infants experience significant growth, they usually haven't doubled their birth weight yet.
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