A client is prescribed to receive 375 mL of PRBCs to infuse over 3.5 hours on an infusion pump.

What would the nurse set the infusion pump (mL/hr) to run? (Do not use a leading zero, Round to a whole number)

Choice A rationale

Fluid-filled vesicles on the chest are not characteristic of Koplik spots. Vesicular rashes are more commonly associated with conditions like varicella (chickenpox) or herpes zoster, where the viral replication leads to the formation of small, elevated, fluid-filled lesions on the skin surface.

Choice B rationale

Koplik spots are pathognomonic for measles, appearing as small, irregular, bright red spots with bluish-white centers on the buccal mucosa, typically opposite the molars. They represent necrotic epithelial cells in the buccal mucosa and are an early diagnostic sign, often appearing 2-3 days before the generalized rash.

Choice C rationale

Enlarged parotid glands are characteristic of mumps, a viral infection affecting the salivary glands, particularly the parotid glands. This condition leads to swelling and tenderness in the areas anterior to the ears and below the jawline, distinct from the oral lesions seen in measles.

Choice D rationale

A gray pseudomembrane covering the pharynx is a hallmark sign of diphtheria, a bacterial infection caused by *Corynebacterium diphtheriae*. This pseudomembrane is a tough, adherent lesion composed of fibrin, bacteria, and necrotic cells that can obstruct the airway, unrelated to measles.

Choice A rationale

Graves' disease is an autoimmune disorder causing hyperthyroidism, characterized by excessive production of thyroid hormones (T3 and T4). These hormones increase the body's metabolic rate, leading to heightened sympathetic nervous system activity, which manifests as an increased heart rate, resulting in tachycardia.

Choice B rationale

Hyperthyroidism, as seen in Graves' disease, accelerates metabolic processes, leading to increased heat production. This typically results in warm, moist skin due to peripheral vasodilation and increased perspiration, rather than cold, clammy skin, which is more characteristic of hypothyroidism or sympathetic activation from shock.

Choice C rationale

Despite an increased metabolic rate, fatigue is a common symptom in Graves' disease. This paradox occurs because the accelerated metabolism and heightened sympathetic stimulation can lead to muscle weakness, sleep disturbances, and overall depletion of energy reserves, resulting in profound tiredness.

Choice D rationale

Hyperthyroidism significantly increases basal metabolic rate, leading to increased caloric expenditure even at rest. This heightened metabolism typically results in weight loss despite an increased appetite, as the body is burning more calories than it consumes. Weight gain is characteristic of hypothyroidism.