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. Provide disposable training pants while calming the mother: This option addresses the

immediate need to provide comfort and support to the child and mother. Offering disposable

training pants can help manage the situation while the nurse addresses the mother's distress and educates her about age-appropriate toilet training expectations.

B. Refer the mother to a community parent education program: While parent education programs can be beneficial, they are not the initial action needed in this situation, which requires
immediate intervention to support the child and mother.
C. Suggest that the mother consult a pediatric nephrologist: Referring the mother to a pediatric nephrologist may not be necessary at this point, as wetting accidents are common in young
children during the toilet training process. The nurse should first address the immediate emotional needs of the child and mother.
D. Inform the mother that toilet training is slower for boys: While it's true that toilet training can vary in timing for different children, simply providing this information to the mother may not be sufficient in addressing the distressing situation at hand.

A. Obtain a blood pressure reading before the client gets out of bed. B. Measure and record the client's urinary output every day. C. Provide the client with teaching regarding a cardiac diet. D. Obtain the client's vital signs every 4 hours when awake

Correct Answer is A

Explanation

A. Obtain a blood pressure reading before the client gets out of beD This intervention is important because the client is prescribed medications that may affect blood pressure, such as antidepressants and sedatives. Monitoring blood pressure before changes in position can help prevent orthostatic hypotension and related complications.

B. Measure and record the client's urinary output every day: While monitoring urinary output is important for overall assessment, it may not be the most immediate concern given the client's recent surgery and medication regimen.

C. Provide the client with teaching regarding a cardiac diet: While education on a cardiac diet is important for cardiovascular health, addressing immediate concerns related to medication effects and post-surgical recovery takes priority.

D. Obtain the client's vital signs every 4 hours when awake: While vital sign monitoring is essential, the timing of every 4 hours may not be necessary during sleep, and obtaining blood pressure readings before changes in position is more critical to prevent adverse events.

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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?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is A

Explanation

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