The nurse on the pediatric floor is taking care of a patient just diagnosed with Kawasaki Disease. On exam, the nurse can expect to find this hallmark clinical finding
The Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"A"}
Rationale for Correct Choices:
• Cracked lips and strawberry tongue are hallmark mucocutaneous changes in Kawasaki disease, reflecting widespread inflammation of mucous membranes in the acute phase. These are often accompanied by conjunctival injection and rash.
• Aspirin and IV gamma globulin are the mainstay treatments for Kawasaki disease, reducing inflammation and significantly lowering the risk of coronary artery aneurysms when given early in the illness.
Rationale for Incorrect Choices:
• Petechiae and purpura rash are more commonly seen in platelet or clotting disorders such as idiopathic thrombocytopenic purpura or meningococcemia. Kawasaki disease typically presents with diffuse erythematous rash, not pinpoint hemorrhages.
• Polyarthritis may occur in the later stages of Kawasaki disease, but chorea is a neurological manifestation linked to rheumatic fever. This combination does not fit the acute presentation of Kawasaki disease.
• Corticosteroids and antibiotics are not first-line treatments for Kawasaki disease. Antibiotics are ineffective as the cause is not bacterial, and corticosteroids are generally reserved for IVIG-resistant cases.
• ACE inhibitors and NSAIDs are not standard therapy for Kawasaki disease. ACE inhibitors are used in hypertension or heart failure, and NSAIDs are not as effective as high-dose aspirin in reducing the acute inflammatory response in this condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. "I will place number fo Poison Control on my refridgerator where it is easily visible, in case I need it.": Keeping the Poison Control number in a visible, accessible location is an important preventive measure. It allows caregivers to quickly obtain expert advice if accidental ingestion occurs, potentially preventing harm.
B. "I will lock up prescription medications so they are out of reach, but my vitamins are okay to keep in the kitchen since they cannot cause any harm.": Vitamins, especially those containing iron, can be toxic to young children. All medications and supplements should be securely stored out of reach to prevent accidental ingestion.
C. "If I suspect my child has ingested toxic substance I will not wait to get help. I will drive them to the ER immediately to be evaluated.": Immediate medical attention is important, but calling Poison Control first can provide critical guidance on emergency transport or other interventions. Driving without calling first may delay appropriate treatment.
D. "If I suspect my child has ingested a toxic substance, I will attempt to make them throw up, put them on their side and then call 911.": Inducing vomiting is dangerous and not recommended, as it may cause aspiration or worsen injury.
Correct Answer is A
Explanation
Rationale:
A: Measles (rubeola): Koplik spots are small, bluish-white lesions with a red base that appear on the buccal mucosa, typically near the molars. They are a hallmark sign of measles and usually appear 1–2 days before the characteristic maculopapular rash develops. Their presence strongly supports a measles diagnosis in a symptomatic child.
B: Chicken pox: This viral illness caused by varicella-zoster virus is characterized by a vesicular rash in various stages of healing, beginning on the trunk and spreading outward. Oral lesions may occur but they are vesicular, not the pinpoint bluish-white lesions.
C: Exanthema subitum (roseola): Caused most often by human herpesvirus 6, roseola presents with high fever followed by a sudden pink maculopapular rash after the fever subsides. Koplik spots are not associated with this illness.
D: Rubella: Also known as German measles, rubella presents with a fine pink rash, lymphadenopathy, and mild symptoms. There are no Koplik spots; instead, enanthem is rare and nonspecific if present
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