A nurse is caring for a child who received an initial dose of antibiotics 20 minutes ago.Which of the following findings is the priority to report to the provider?
Increased pulse.
Wheezing.
Maculopapular rash.
Headache.
The Correct Answer is B
Choice A rationale
An increased pulse can be a sign of many conditions and is not as immediately alarming in the context of a potential allergic reaction as respiratory symptoms.
Choice B rationale
Wheezing is the priority finding because it indicates airway constriction, a hallmark of anaphylaxis, which is a severe and potentially life-threatening allergic reaction requiring immediate treatment.
Choice C rationale
A maculopapular rash can be a sign of an allergic reaction, but it is not immediately life-threatening like airway constriction. It should be reported but is not the priority.
Choice D rationale
A headache can be a symptom of many non-emergent conditions and does not indicate an immediate risk to the child's airway or circulation. It requires attention but is not the priority in this context.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Palpating the groin area is the correct method to check for an inguinal hernia. An inguinal hernia occurs when a portion of the intestine protrudes through a weak spot in the abdominal muscles into the groin area. This area should be carefully examined to identify any bulges or abnormalities that indicate a hernia.
Choice B rationale
Palpating the abdomen may be useful for identifying other conditions, such as abdominal distension or masses. However, it is not the most appropriate site for detecting an inguinal hernia, which specifically involves the groin area.
Choice C rationale
Palpating the lower back is not relevant for detecting an inguinal hernia. The lower back is not a common site for hernias, and examining this area would not provide information about the presence of an inguinal hernia.
Choice D rationale
Palpating the upper thigh is not the correct method to check for an inguinal hernia. While the inguinal region is located near the upper thigh, the hernia itself protrudes into the groin area. The upper thigh does not provide the necessary information to identify an inguinal hernia.
Correct Answer is A
Explanation
Choice A rationale
Erythema infectiosum, or fifth disease, typically begins with a "slapped cheek" rash on the face. This is often the first noticeable sign of the disease before the rash spreads to other parts of the body.
Choice B rationale
The rash associated with fifth disease does not usually start on the arms. The initial presentation is on the cheeks, which can later spread to the trunk and extremities.
Choice C rationale
It is uncommon for the rash of erythema infectiosum to initially appear on the legs. The characteristic facial rash precedes the spread of the rash to other areas.
Choice D rationale
While the rash may eventually spread to the back, it typically starts on the face. The "slapped cheek" appearance is a hallmark sign of fifth disease.
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