Patient Data
The nurse is analyzing the client's symptoms. For each sign, click to indicate whether they are generally associated with chicken pox, measles, or rubella. Each column must have at least one response option selected.

Small spots with bluish-white center

Fever

Maculopapular rash

Anorexia

Cough

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A,B,C"},"C":{"answers":"A,C"},"D":{"answers":"A,B,C"},"E":{"answers":"A"}}

Rationale:

• Small spots with bluish-white center: These lesions are Koplik spots, which are pathognomonic for measles and appear on the buccal mucosa. They typically precede the rash and are described as tiny bluish-white centers on an erythematous base. Their presence strongly supports measles over other viral exanthems. Neither chicken pox nor rubella produces this oral finding.

• Fever: Measles commonly presents with a high fever that precedes and accompanies the rash. Fever is also an expected finding in rubella and chicken pox, however it is often higher than that seen with rubella and more sustained than in chicken pox. A temperature of 102.7° F aligns with the prodromal phase of measles.

• Maculopapular rash: Both measles and rubella cause maculopapular rashes that begin on the face and spread downward. In measles, the rash is typically darker and confluent, while rubella’s rash is lighter and shorter in duration. The described spread pattern fits both conditions. Chicken pox differs due to its vesicular nature.

• Anorexia: These are systemic, non-specific symptoms common to almost all viral exanthems (rash-inducing illnesses). Children often experience poor appetite due to systemic illness, fever, and upper respiratory symptoms.

• Cough: Cough is a classic prodromal symptom of measles and is part of the “three Cs”: cough, coryza, and conjunctivitis. It typically occurs before rash onset and persists during the illness. Rubella and chicken pox do not characteristically present with cough. The presence of cough strongly supports measles.

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Correct Answer is B

Explanation

Rationale:
A. "The PCA pump is designed so I can try to maintain adequate pain relief.": This statement shows understanding that the client can self-administer doses to manage pain effectively, which is the primary purpose of a PCA pump.

B. "If I am asleep, one of my visitors can push the button for me.": PCA pumps are intended for use only by the patient to prevent overdose or medication errors. Allowing others to push the button, known as "proxy dosing," is unsafe and indicates a need for further teaching.

C. "The nurse will check the PCA pump syringe to check how often I am needing a dose.": This reflects correct understanding that nursing staff monitors PCA use, including frequency and dose administration, to ensure safety and efficacy.

D. "I don't need to be afraid of overdosing because the pump has preset doses to prevent that.": This shows understanding that PCA pumps have safety mechanisms, such as lockout intervals and dose limits, to minimize the risk of overdose.

A. Position the client's head facing away from the site. B. Aspirate for the presence of a blood return. C. Prepare a saline flush in a three mL syringe. D. Initiate an infusion of 0.9% normal saline solution.

Correct Answer is B

Explanation

Rationale:
A. Position the client's head facing away from the site: While proper positioning can reduce infection risk and ensure comfort, it does not verify catheter patency or safety for medication administration.

B. Aspirate for the presence of a blood return: Before administering medication through a central venous catheter, the nurse must confirm patency by aspirating for a blood return. This ensures the catheter is in the vessel lumen and reduces the risk of extravasation or complications such as thrombosis.

C. Prepare a saline flush in a three mL syringe: While a saline flush is required, it should be administered only after patency is confirmed. Using a small syringe may reduce the risk of excessive pressure, but confirming blood return is the first step.

D. Initiate an infusion of 0.9% normal saline solution: Starting a saline infusion may maintain catheter patency, but it does not confirm that the line is safe for immediate medication administration. Patency verification must precede fluid or drug administration.

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Patient Data The nurse is analyzing the client's symptoms. For each sign, click to indicate whether they are generally associated with chicken pox, measles, or rubella. Each column must have at least one response option selected.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is providing client teaching about the use of a patient-controlled analgesia (PCA) pump. Which statement by the client indicates the need for more instruction about the PCA pump?

Correct Answer is B

Explanation

When preparing to administer an intravenous medication through a client's triple lumen central venous catheter, the nurse observes that there are no continuous intravenous fluids infusing. Which action should the nurse take?

Correct Answer is B

Explanation

A young woman with multiple sclerosis just received several immunizations in preparation for moving into a college dormitory. Two days later, she reports to the nurse that she is experiencing increasing fatigue and visual problems. Which teaching should the nurse provide?"

A client with foul smelling drainage from an incision on the upper left arm is admitted with a suspected methicillin-resistant Staphylococcus aureus (MRSA). Which nursing intervention(s) should the nurse include in the plan of care (POC)? Select all that apply.

A male client informs the nurse he has suddenly stopped taking the glucocorticoid medication without consulting the healthcare provider. The nurse should recognize the client is at risk for developing which condition?

The nurse prepares to educate the client and spouse. Click to select the 3 items that the nurse should include in the plan of care after administration of tissue plasminogen activator (tPA).

When planning care for an adolescent with anorexia nervosa, which nursing problem has the highest priority?

Patient Data The nurse is analyzing the client's symptoms. For each sign, click to indicate whether they are generally associated with chicken pox, measles, or rubella. Each column must have at least one response option selected.

The nurse is reviewing a client's prescribed medication list and notes that the client recently received alteplase. Which client outcome indicates the medication is effective? Reference Range: Prothrombin (PT) [11.0 to 12.5 seconds; 85% to 100%]

Patient Data
The nurse is analyzing the client's symptoms. For each sign, click to indicate whether they are generally associated with chicken pox, measles, or rubella. Each column must have at least one response option selected.