A nurse is making a follow-up call to client who has a new prescription for ACE inhibitor to treat hypertension. The client reports lightheadedness upon standing. Which of the following statements should the nurse make?

A) Beefy, red tongue: The beefy, red tongue is typically associated with scarlet fever, a bacterial infection caused by group A Streptococcus. This condition can lead to a red, "strawberry" tongue, often accompanied by a rash. While measles can involve a variety of symptoms, including a red rash, conjunctivitis, and cough, the beefy red tongue is not characteristic of measles. In measles, the more notable symptoms are a high fever, cough, runny nose, and the development of Koplik spots inside the mouth.

B) Paroxysmal cough: Paroxysmal cough, which is a sudden, severe, and uncontrollable cough often followed by a "whooping" sound, is more characteristic of pertussis (whooping cough). While a cough is indeed present with measles, it is generally not paroxysmal. In measles, the cough is more persistent and associated with other typical symptoms such as fever and a characteristic rash. The coughing in measles may also be dry and harsh but does not tend to occur in violent, paroxysmal episodes like those seen in pertussis.

C) Peeling of the hands and feet: Peeling of the skin, particularly of the hands and feet, is more commonly observed in conditions such as scarlet fever, Kawasaki disease, or after a viral infection like hand-foot-and-mouth disease. It is not a classic finding of measles. In measles, the skin rash usually starts as maculopapular spots on the face and spreads down the body. While some skin sloughing can occur after the rash resolves, especially in severe cases, it is not the characteristic sign of measles, and it is not typically seen on the hands and feet.

D) Fever: Fever is one of the earliest and most prominent symptoms of measles. It typically appears about 2-4 days before the characteristic measles rash. The fever in measles can be quite high, often exceeding 104°F (40°C), and is associated with other symptoms such as cough, conjunctivitis, and photophobia. The fever usually persists for several days, and it is one of the critical signs that lead to the diagnosis of measles, particularly when combined with the characteristic rash and other respiratory symptoms.

A) "I get nervous when I'm in a large group": Social anxiety or nervousness in large groups is common, especially during adolescence. While it can indicate discomfort in social situations, it is not necessarily a warning sign of suicidal ideation.

B) "My partner and I had our first argument last night": Relationship conflicts are a normal part of adolescent development, and although they can cause emotional distress, a single argument does not typically indicate a risk for suicide. It’s important to assess the client’s overall emotional state and coping mechanisms, but this statement alone does not suggest suicidal thoughts.

C) "I am not interested in anything anymore.": This statement is a red flag for depression and potential suicidal ideation. A loss of interest or pleasure in activities that were once enjoyable (anhedonia) is a core symptom of depression, which can be a significant risk factor for suicide. This warrants further exploration and immediate attention from the nurse.

D) "I'm not sleeping much because of all the homework I have.": While lack of sleep can be a concern and may affect an adolescent’s overall health and well-being, it is more likely related to stress or academic pressure rather than suicidal thoughts. Sleep disturbances in adolescents are common, particularly when facing high academic expectations, but this is not an immediate sign of suicide risk.