A nurse is assessing a child with suspected measles. Which statement made by the child's parent indicates an understanding of the characteristic rash?
"The rash starts on the extremities and spreads to the face.”
"The rash usually fades in the opposite order it appeared.”
"The rash is accompanied by high fever and intense itching.”
"The rash is usually only present on the face and trunk.”
The Correct Answer is B
Choice B rationale:
The statement "The rash usually fades in the opposite order it appeared" indicates an understanding of the characteristic rash of measles. In measles, the rash typically follows a specific pattern, starting on the face and spreading downward to the extremities. As the rash resolves, it fades in the reverse order, disappearing first from the extremities and then from the face.
Choice A rationale:
This statement is incorrect. The rash of measles starts on the face and then spreads to the extremities.
Choice C rationale:
This statement is also incorrect. The rash of measles is not typically associated with intense itching. It is a maculopapular rash, which means it consists of flat red spots and raised bumps, but itching is not a prominent feature.
Choice D rationale:
This statement is incorrect. The rash of measles is not limited to the face and trunk; it affects the entire body.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice B rationale:
The statement "The rash usually fades in the opposite order it appeared" indicates an understanding of the characteristic rash of measles. In measles, the rash typically follows a specific pattern, starting on the face and spreading downward to the extremities. As the rash resolves, it fades in the reverse order, disappearing first from the extremities and then from the face.
Choice A rationale:
This statement is incorrect. The rash of measles starts on the face and then spreads to the extremities.
Choice C rationale:
This statement is also incorrect. The rash of measles is not typically associated with intense itching. It is a maculopapular rash, which means it consists of flat red spots and raised bumps, but itching is not a prominent feature.
Choice D rationale:
This statement is incorrect. The rash of measles is not limited to the face and trunk; it affects the entire body.
Correct Answer is D
Explanation
The correct answer is choice d. Airborne precautions.
Choice A rationale:
Standard precautions are the basic level of infection control that should be used in the care of all patients all of the time. These precautions are designed to reduce the risk of transmission of microorganisms from both recognized and unrecognized sources. However, they are not sufficient to prevent the transmission of measles, which is an airborne virus.
Choice B rationale:
Droplet precautions are used for diseases that are transmitted by large droplets that are expelled into the air and travel 3 to 6 feet from the patient. Measles is not primarily transmitted by large droplets and therefore, droplet precautions are not the most effective measure for preventing measles transmission.
Choice C rationale:
Contact precautions are used for infections, diseases, or germs that are spread by touching the patient or items in the patient’s room. Measles is highly contagious and can be spread through the air by breathing, coughing, or sneezing, so contact precautions alone would not prevent the spread of measles.
Choice D rationale:
Airborne precautions are required for diseases that are transmitted by smaller droplets, which remain in the air for long periods of time and can be spread over long distances when the infected person breathes, coughs, or sneezes. Measles is known to be highly contagious and can remain airborne for up to two hours in an airspace after the infected person leaves an area. Therefore, airborne precautions, which include the use of a high-efficiency particulate air (HEPA) filter and special respiratory protection, are necessary to prevent the spread of measles.
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