The nurse caring for a child diagnosed with rubeola (measles) notes that the pediatrician has documented the presence of Koplik's spots. On the basis of this documentation, which observation is expected?
whitish vesicles located across the chest
Small blue-white spots with a red base found on the buccal mucosa
Pinpoint petechiae noted on both legs
Petechiae spots that are reddish and pinpoint on the soft palate
The Correct Answer is B
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. "Limit your caloric intake to avoid becoming overweight."
Explanation: This statement emphasizes the importance of maintaining a healthy weight through balanced nutrition and avoiding excessive caloric intake. It promotes the prevention of overweight and obesity.
B. "Tanning beds are much safer than lying in the sun."
Explanation: This statement is incorrect. Tanning beds are not safer than natural sunlight and are associated with an increased risk of skin cancer. Adolescents should be advised to protect their skin from harmful UV radiation.
C. "Share piercing needles only with close friends you trust."
Explanation: This statement is unsafe and promotes risky behavior. Sharing piercing needles can lead to the transmission of bloodborne infections such as HIV and hepatitis. The nurse should emphasize the importance of using sterile needles and avoiding risky behaviors.
D. "Your need for sleep will increase during periods of growth."
Explanation:
During periods of growth, adolescents often experience increased physical and hormonal changes, and adequate sleep is crucial for overall health and well-being. Sleep plays a vital role in growth, immune function, and cognitive performance. Adolescents should be encouraged to prioritize getting sufficient sleep for their age group.
Correct Answer is D
Explanation
A. Administer 0.9% sodium chloride IV solution: Although IV fluids might be necessary to maintain hydration and circulation, this is not the priority over preventing the spread of infection.
B. Assist with obtaining an x-ray of the child's neck.Imaging can help confirm the diagnosis but should be done after ensuring infection control measures.
C. Initiate IV antibiotics.Antibiotics are crucial for treatment but should follow the implementation of droplet precautions to prevent the spread of infection.
D. Place the child on droplet precautions.
Epiglottitis is a medical emergency primarily caused by bacterial infections, such as Haemophilus influenzae type B (Hib). The first priority is to ensure the safety of both the patient and others by preventing the spread of infection.Placing the child on droplet precautions helps to contain the bacteria and protect healthcare workers and other patients.
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