A nurse is assessing a child and notes Koplik spots. In which of these communicable diseases are Koplik spots present?
Measles (rubeola)
Chicken pox
Exanthema subitum (roseola)
Rubella
The Correct Answer is A
Rationale:
A: Measles (rubeola): Koplik spots are small, bluish-white lesions with a red base that appear on the buccal mucosa, typically near the molars. They are a hallmark sign of measles and usually appear 1–2 days before the characteristic maculopapular rash develops. Their presence strongly supports a measles diagnosis in a symptomatic child.
B: Chicken pox: This viral illness caused by varicella-zoster virus is characterized by a vesicular rash in various stages of healing, beginning on the trunk and spreading outward. Oral lesions may occur but they are vesicular, not the pinpoint bluish-white lesions.
C: Exanthema subitum (roseola): Caused most often by human herpesvirus 6, roseola presents with high fever followed by a sudden pink maculopapular rash after the fever subsides. Koplik spots are not associated with this illness.
D: Rubella: Also known as German measles, rubella presents with a fine pink rash, lymphadenopathy, and mild symptoms. There are no Koplik spots; instead, enanthem is rare and nonspecific if present
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Growth of pubic hair: Pubic hair growth, or pubarche, typically occurs after the initial signs of puberty and is a secondary sexual characteristic, not the first sign.
B. Growth spurt: The rapid increase in height follows the onset of puberty but usually comes after breast development has started.
C. Breast bud development: Thelarche, or breast bud development, is the earliest visible sign of puberty in girls, marking the start of hormonal changes and sexual maturation.
D. Menarche: Menarche, the onset of menstruation, occurs later in puberty after several other physical changes, including breast development and growth spurt.
Correct Answer is B
Explanation
Rationale:
A. A high-pitched "click" is heard with hip flexion or extension: A soft or high-pitched click may occur in many healthy newborns due to ligament laxity and is not specific to developmental dysplasia of the hip (DDH). It is generally considered a benign finding.
B. A distinct "clunk" is heard with Barlow and Ortolani maneuvers: This is a hallmark finding for DDH. The “clunk” indicates the femoral head is either dislocating from or relocating into the acetabulum during these maneuvers, confirming hip instability and potential dislocation.
C. The thigh and gluteal folds are symmetric: Symmetric skin folds suggest normal hip alignment. Asymmetry of these folds is more concerning for DDH, so symmetry would not confirm the diagnosis.
D. Abduction occurs to 75 degrees and adduction to within 30 degrees (with stable pelvis): This degree of hip motion can be within normal limits, especially in the absence of instability. Restricted abduction is more consistent with DDH in older infants.
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