The nurse is evaluating a child who has been outside in the woods at camp. The child has multiple, small annular lesions without an indurated center on the arm. The nurse suspects Lyme disease.
Which stage of Lyme disease does the nurse believe that this child is exhibiting?
Fourth stage.
First stage.
Third stage.
Second stage.
The Correct Answer is B
The correct answer is choice B. First stage.
Choice A rationale:
There is no fourth stage of Lyme disease. Lyme disease typically progresses through three stages: early localized, early disseminated, and late disseminated. The symptoms mentioned in the question are more indicative of earlier stages of the disease.
Choice B rationale:
The child is likely exhibiting symptoms of the first stage of Lyme disease, known as early localized Lyme disease. This stage is characterized by the appearance of small annular (circular) lesions known as erythema migrans. These lesions are often red and have a clear center, resembling a "bull's-eye" pattern. This stage occurs within days to weeks after a tick bite and is usually accompanied by flu-like symptoms.
Choice C rationale:
There is no third stage of Lyme disease. The third stage is considered the late disseminated stage, which occurs months to years after the initial infection. It typically involves more severe symptoms, such as arthritis, neurological issues, and cardiac abnormalities.
Choice D rationale:
There is no second stage of Lyme disease. The second stage is the early disseminated stage, which occurs weeks to a few months after the tick bite. It involves the spread of the bacteria to other parts of the body, leading to symptoms such as multiple erythema migrans lesions, flu-like symptoms, fatigue, and muscle and joint pain.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The correct answer is Choice A.Choice A rationale:Vomiting is a common sign of digoxin toxicity. It occurs due to the drug's effects on the gastrointestinal system, which can lead to nausea and vomiting as the body attempts to expel the toxin. This symptom is particularly significant as it can indicate elevated digoxin levels that may require medical intervention.Choice B rationale:Tachycardia, or an increased heart rate, can occur with digoxin toxicity; however, it is more commonly associated with inadequate therapeutic levels rather than toxicity itself. Digoxin usually causes bradycardia (a slower heart rate) when at therapeutic levels, making tachycardia less indicative of toxicity.Choice C rationale:Bradypnea, or slow breathing, is not a typical sign of digoxin toxicity. While respiratory issues can arise from various conditions, they are not specifically linked to digoxin levels. Monitoring respiratory rate is essential in clinical settings but does not directly correlate with digoxin toxicity.Choice D rationale:Seizures are not a common sign of digoxin toxicity. While severe cases might lead to neurological symptoms due to electrolyte imbalances or other complications, seizures are not typically associated with digoxin overdose. Instead, they may suggest other underlying issues requiring evaluation.
Correct Answer is A
Explanation
The correct answer is choice A: Avoiding use for more than 3 days.
Choice A rationale:
Recommending avoiding the use of decongestant nose drops for more than 3 days is crucial due to the risk of rebound congestion. Decongestant nose drops work by constricting blood vessels in the nasal passages to alleviate congestion. Prolonged use can lead to a phenomenon known as rebound congestion, where the nasal passages become more congested once the medication wears off, causing the person to use the drops more frequently. This can result in a cycle of worsening congestion and overuse of the medication, which can be counterproductive and harmful. Limiting the use of decongestant nose drops to 3 days helps prevent this rebound effect and encourages the use of alternative treatments if congestion persists.
Choice B rationale:
Administering drops until nasal congestion subsides is not the recommended approach. Prolonged use of decongestant nose drops can lead to rebound congestion, as mentioned earlier. Using the drops until congestion subsides might extend their use beyond the safe period and increase the risk of adverse effects.
Choice C rationale:
Keeping drops to use again for nasal congestion is not advised. While it's important to follow the medication's storage instructions, relying on decongestant nose drops for recurring nasal congestion can lead to overuse and rebound congestion. This choice does not address the potential risks associated with prolonged use.
Choice D rationale:
Administering drops after feedings and at bedtime is not a standard recommendation for decongestant nose drops. The timing of administration is not a primary concern in the context of decongestant use. Instead, the focus should be on the duration of use and the potential for rebound congestion.
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