A client with suspected measles has Koplik spots in the mouth. Which nursing intervention is appropriate for this client?
Provide oral care with mouthwash containing alcohol.
Offer spicy and acidic foods to encourage appetite.
Rinse the mouth with warm saline solution.
Apply topical corticosteroid ointment to the spots.
The Correct Answer is C
Choice A rationale:
Providing oral care with mouthwash containing alcohol is not appropriate for a client with suspected measles and Koplik spots in the mouth. Alcohol-based mouthwashes can be irritating to the mucous membranes and may exacerbate the symptoms.
Choice B rationale:
Offering spicy and acidic foods to encourage appetite is not appropriate for a client with measles and Koplik spots. Spicy and acidic foods may cause discomfort and irritation to the oral mucosa, making the condition worse.
Choice C rationale:
Rinsing the mouth with warm saline solution is the correct nursing intervention for a client with measles and Koplik spots. Saline solution helps soothe the irritated mucous membranes and can aid in reducing discomfort.
Choice D rationale:
Applying topical corticosteroid ointment to the spots is not appropriate for a client with measles and Koplik spots. Corticosteroids can suppress the immune response, which may interfere with the body's ability to fight off the measles virus.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Nucleoprotein (N) and phosphoprotein (P) are not responsible for viral entry and fusion in measles infection. These proteins are involved in viral replication and assembly, not the initial entry into host cells.
Choice B rationale:
Matrix protein (M) and large protein (L) are not responsible for viral entry and fusion in measles infection. The matrix protein plays a role in the assembly and structure of the virus, while the large protein is involved in viral replication and transcription.
Choice C rationale:
Fusion protein (F) and hemagglutinin protein (H) are the primary proteins responsible for viral entry and fusion in measles infection. The hemagglutinin protein allows the virus to bind to specific receptors on host cells, while the fusion protein facilitates the fusion of the viral envelope with the host cell membrane, allowing the virus to enter the cell.
Choice D rationale:
Nucleoprotein (N) and matrix protein (M) are not directly involved in viral entry and fusion. Nucleoprotein plays a role in protecting the viral RNA, and the matrix protein is involved in viral assembly and budding.
Correct Answer is D
Explanation
Choice A rationale:
Chest X-ray is not a diagnostic test for measles. It may be used to assess for complications like pneumonia.
Choice B rationale:
Throat swab culture is not used to diagnose measles. It is more commonly used to detect bacterial infections such as strep throat.
Choice C rationale:
Blood glucose level is not relevant to the diagnosis of measles.
Choice D rationale:
Measles-specific IgM antibodies test is the definitive diagnostic test for measles. It detects the presence of specific antibodies produced by the immune system in response to the measles virus.
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