A father brings his preschool aged child to the clinic because of a sore throat for the past two days and currently has a temperature of 103° F (39.4°C). The child is pale around the mouth and has flushed cheeks. The nurse processes a positive rapid strep test as prescribed. Which information should the nurse provide to the child's parent? Select all that apply.

Contagious until symptoms subside.

Sandpaper-like rash.

Peeling and flaking skin in a week.

Darkening of skin under arms.

Fever lasting for 7 to 10 days.

Answer and Explanation

Correct Answer : B,C

A. Contagious until symptoms subside: Streptococcal pharyngitis is contagious until 24 hours after starting antibiotics, not until all symptoms are gone. This is important for limiting transmission to others in the household or school setting.

B. Sandpaper-like rash: A sandpaper-textured rash is a hallmark sign of scarlet fever, which is a complication of strep throat. It usually begins on the neck or chest and spreads, often feeling coarse to the touch.

C. Peeling and flaking skin in a week: Desquamation, or skin peeling, is common several days after a strep rash subsides, particularly on the hands and feet. This symptom signals the healing phase of scarlet fever.

D. Darkening of skin under arms: Darkened underarm skin is typically linked to acanthosis nigricans, associated with insulin resistance or obesity. It is not seen with streptococcal infections or fever-related conditions.

E. Fever lasting for 7 to 10 days: Fever from strep throat usually resolves quickly within 24–48 hours of initiating antibiotic therapy. Prolonged fever would be atypical and requires further evaluation for complications.

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Correct Answer is C

Explanation

A. Emollient: Emollient (stool softener) laxatives like docusate sodium help moisten stool but do not significantly increase stool volume or stimulate bowel movement. They are gentle but typically insufficient for long-term, low-frequency constipation.

B. Osmotic: Osmotic laxatives draw water into the bowel to promote peristalsis. They are effective but may cause electrolyte imbalances if used chronically. These are often reserved for when bulk-forming agents are ineffective.

C. Bulk-forming: Bulk-forming laxatives such as psyllium are typically the first-line recommendation for chronic constipation. They mimic dietary fiber by absorbing water, increasing stool bulk, and promoting regular bowel movements with minimal side effects.

D. Stimulant: Stimulant laxatives like senna or bisacodyl are stronger agents that promote bowel motility but can cause dependency if used long-term. They are not recommended as first-line therapy for chronic constipation related to diet.

A. Use standard precautions and wear a mask. B. Explain the purpose of a low bacteria diet. C. Send wound drainage for culture and sensitivity. D. Institute contact precautions for staff and visitors. E. Monitor the client's white blood cell count.

Correct Answer is ["C","D","E"]

Explanation

A. Use standard precautions and wear a mask: Standard precautions are necessary for all patients, but wearing a mask is not specifically required for MRSA unless there is suspicion of respiratory involvement. The focus should be on contact precautions rather than masking.

B. Explain the purpose of a low bacteria diet: A low bacteria diet is not necessary for a client with MRSA unless the client is immunocompromised. The main focus should be on preventing MRSA transmission and managing the infection at the wound site.

C. Send wound drainage for culture and sensitivity: Sending the wound drainage for culture and sensitivity is essential for identifying the causative organism and determining appropriate antibiotic treatment for MRSA. This helps guide therapy and ensure proper management.

D. Institute contact precautions for staff and visitors: Contact precautions are critical for preventing spread of MRSA, especially in wound care situations. The nurse should ensure all staff and visitors follow these precautions to protect others and minimize transmission risk.

E. Monitor the client's white blood cell count: Monitoring the white blood cell count is important as it helps assess the client's immune response to infection. An elevated count may indicate the presence of infection, and close monitoring helps guide treatment decisions.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client reports passing 2 to 3 small, hard stools per week since being placed on a low-residue diet three months ago. Which type of laxative should the nurse expect the healthcare provider to recommend first?

Correct Answer is C

Explanation

A client with foul-smelling drainage from an incision on the upper left arm is admitted with a suspected methicillin-resistant Staphylococcus aureus (MRSA). Which nursing intervention(s) should the nurse include in the plan of care? Select all that apply.

Correct Answer is ["C","D","E"]

Explanation

A client who sustained an L-1 spinal cord injury six months ago that resulted in paraplegia is now experiencing spastic muscle movements in the lower extremities. Which intervention should the nurse implement?

Exhibits Choose the most likely options for the information missing from the statements by selecting from the lists of options provided. The nurse monitors the client's dropdownafter administering the morphine. The nurse should include dropdownto reduce complications of the client's injury.

An adult client receives a prescription for diphenhydramine 15 mL PO every 12 hours PRN for pruritus. The bottle is labeled, "Diphenhydramine 12.5 mg/5 mL." What is the total daily dose in mg that the client receives? (Enter numerical value only.)

When should intimate partner violence (IPV) screening occur?

Exhibits Which information from the history and physical, nurses' note, and flow sheet requires further evaluation? Select all that apply.

Exhibits The client has received a medical diagnosis of rheumatoid arthritis (RA). The client should receive education about living and managing her condition and how to minimize disease complications. Which education should be given to the client by the nurse? Select all that apply.

An older adult client is referred to a rehabilitation facility following a cerebrovascular accident (CVA). The client is aphasic with left sided paresis and is having difficulty swallowing. Which intervention is most important for the nurse to include in the client's plan of care?