A preschool-aged child who is being treated for Streptococcal pharyngitis returns to the clinic for signs of scarlet fever. Which assessment finding provides the earliest indication to the nurse that the child is experiencing a reaction to the toxins that are created by the Streptococcus bacteria?

Flaky, peeling skin.

Red bumps across chest.

White coating on tongue.

High, protracted fever.

Answer and Explanation

The Correct Answer is B

A. Flaky, peeling skin (desquamation) occurs in later stages of scarlet fever, typically after the rash begins to fade. It is not an early sign of the disease.
B. A red, sandpaper-like rash that typically begins on the chest and spreads outward is one of the earliest indications of scarlet fever. This rash is caused by exotoxins produced by Streptococcus pyogenes and is a hallmark sign of the illness.
C. A white coating on the tongue, often followed by a characteristic “strawberry tongue,” develops later in the progression of scarlet fever rather than as an early symptom.
D. While fever is a common symptom of streptococcal infections, it is not the earliest indicator of scarlet fever. The rash usually appears within 12 to 48 hours of fever onset, making it a more specific early sign.

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Correct Answer is A

Explanation

A. A quiet, non-stimulating environment helps reduce sensory overload and agitation, which are common in alcohol withdrawal delirium.
B. While hydration and nutrition are important, they are not as immediately critical as managing environmental stimuli.
C. Confronting the client's denial is a part of psychological therapy but not the most immediate concern during acute withdrawal delirium.
D. Group participation may be too stimulating for a client in acute withdrawal and can exacerbate symptoms.

A. Remind the UAP to apply a fitted respirator mask before entering the client's room. B. Instruct the UAP to notify the nurse of any changes in the client's respiratory status. C. Review the need for the UAP to wear a face mask while in close contact with the client. D. Assign the UAP to provide care for another client and assume full care of the client.

Correct Answer is C

Explanation

A. Remind the UAP to apply a fitted respirator mask before entering the client's room: While respiratory protection is important when caring for a client with influenza, the situation described does not warrant the use of a fitted respirator mask for the UAP. Standard precautions, including wearing a face mask, gloves, and gown, are typically sufficient for influenza.
B. Instruct the UAP to notify the nurse of any changes in the client's respiratory status: This instruction is important for overall client monitoring but does not directly address the issue of appropriate personal protective equipment (PPE for the UAP.

C. Review the need for the UAP to wear a face mask while in close contact with the client: Correct! The nurse should remind the UAP of the importance of wearing a face mask when providing care to a client with influenza. Face masks help prevent the spread of respiratory droplets and protect both the client and healthcare workers from infection.
D. Assign the UAP to provide care for another client and assume full care of the client: While reassigning the UAP is an option if they are not following proper infection control procedures, it's important to address the issue directly by reminding them of the need for appropriate PPE.

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A preschool-aged child who is being treated for Streptococcal pharyngitis returns to the clinic for signs of scarlet fever. Which assessment finding provides the earliest indication to the nurse that the child is experiencing a reaction to the toxins that are created by the Streptococcus bacteria?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which nursing intervention is most important for the nurse to include in the plan of care for a client with alcohol withdrawal delirium?

Correct Answer is A

Explanation

A client with influenza needs help in transferring to the bedside commode. The nurse observes the unlicensed assistive person (UAP) donning gloves and a gown to assist the client. Which action should the nurse take?

Correct Answer is C

Explanation

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