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 B
Explanation
A. Whitish vesicles located across the chest:
Incorrect: This description does not match the characteristic appearance or location of Koplik's spots in measles.
B. Small blue-white spots with a red base found on the buccal mucosa:
Correct Answer: Koplik's spots are small, blue-white spots with a red base that typically appear on the buccal mucosa (inner lining of the cheeks). These spots are characteristic of measles and are considered a diagnostic feature.
C. Pinpoint petechiae noted on both legs:
Incorrect: Petechiae are small, reddish-purple spots that result from bleeding under the skin. They are not characteristic of Koplik's spots in measles.
D. Petechiae spots that are reddish and pinpoint on the soft palate:
Incorrect: While petechiae can occur in various conditions, they are not characteristic of Koplik's spots in measles. Koplik's spots specifically manifest as small blue-white spots on the buccal mucosa.
Correct Answer is ["B","D","E"]
Explanation
A. Need for increased caloric intake:
Incorrect: While toddlers may have specific nutritional needs, it is important to focus on a balanced diet rather than emphasizing increased caloric intake. The emphasis should be on providing nutritious and age-appropriate foods.
B. How to encourage cooperative play:
Correct Answer: Encouraging cooperative play is important for a toddler's social development. It involves teaching sharing, taking turns, and interacting with other children.
C. Management of tantrums:
Incorrect: While guidance on managing tantrums can be part of parenting education, it may not be the primary focus in health promotion teaching. The emphasis is typically on positive guidance, effective communication, and setting age-appropriate limits.
D. Dental care:
Correct Answer: Dental care is crucial for toddlers to promote oral health. The nurse should provide information on proper oral hygiene practices, including tooth brushing, and discuss the importance of regular dental check-ups.
E. How to establish trust:
Correct Answer: Establishing trust is a vital aspect of toddler development. The nurse can provide guidance on building a secure and trusting relationship between the child and parents.
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