A nurse is caring for a child who has red marks across his cheeks. Which of the following actions should the nurse take?
Assess the rest of the child's body for a rash.
Refer the family to child protective services.
Question the parents about how the marks occurred on the child's cheeks.
Obtain the child's temperature.
The Correct Answer is A
Choice A reason: Assess the rest of the child's body for a rash.
The child's red marks across the cheeks are characteristic of fifth disease (also known as erythema infectiosum). Fifth disease is caused by parvovirus B19 and typically presents with a bright red rash on the cheeks, often referred to as "slapped cheek" appearance. The rash may eventually spread to other areas of the body, including the arms, trunk, thighs, and buttocks. It is usually mild and self-limiting.
Choice B reason: This option is not appropriate for a rash caused by fifth disease. There is no indication of child abuse or neglect.
Choice C reason: The rash is due to a viral infection and not related to trauma or injury. Questioning the parents is unnecessary.
Choice D reason: While assessing the child's temperature is important in general nursing care, it is not specifically related to the red marks on the cheeks in this case.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Broad-spectrum antibiotics are indicated for septic shock caused by bacterial infection, as they can target a wide range of pathogens and prevent further sepsis. Fluid boluses are also essential to restore the intravascular volume and improve tissue perfusion and oxygenation.
Choice B reason: Antipyretics and oxygen therapy are not sufficient to treat septic shock, as they do not address the underlying infection or the hypovolemia. Antipyretics may lower the temperature, but they do not eliminate the bacteria. Oxygen therapy may improve the pulse oximeter reading, but it does not correct the hypoperfusion.
Choice C reason: Vasopressors and blood transfusions are not the first-line treatments for septic shock, as they may have adverse effects on the cardiovascular system and the coagulation cascade. Vasopressors may increase the blood pressure, but they may also cause vasoconstriction and reduce the blood flow to vital organs. Blood transfusions may increase the hemoglobin level, but they may also increase the risk of fluid overload, hemolysis, and transfusion reactions.
Choice D reason: Corticosteroids and antihistamines are not indicated for septic shock, as they do not have any proven benefits and may have harmful effects on the immune system and the inflammatory response. Corticosteroids may suppress the adrenal function and increase the risk of infection. Antihistamines may cause sedation and dryness of the mucous membranes.
Correct Answer is D
Explanation
Choice A reason: This is not a correct instruction for the nurse to include in the teaching plan. The parents should not remove the harness when bathing the infant, as this may interrupt the treatment and cause complications. The nurse should instruct the parents to sponge bathe the infant while wearing the harness, and to keep the harness clean and dry.
Choice B reason: This is not a correct instruction for the nurse to include in the teaching plan. The parents should not adjust the straps of the Pavlik harness by themselves, as this may affect the position and stability of the infant's hips. The nurse should instruct the parents to bring the infant to the provider's office regularly for check-ups and adjustments of the harness.
Choice C reason: This is not a correct instruction for the nurse to include in the teaching plan. The parents should not place a thin layer of clothing under the straps of the harness, as this may interfere with the proper alignment and function of the harness. The nurse should instruct the parents to dress the infant in loose-fitting clothing over the harness, and to avoid using bulky or cloth diapers.
Choice D reason: This is a correct instruction for the nurse to include in the teaching plan. The parents should check the infant's skin under the straps of the harness for redness or irritation, as this may indicate skin breakdown or infection. The nurse should instruct the parents to keep the infant's skin clean and dry, and to report any signs of redness, swelling, or drainage.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today