NCLEX-RN : Conditions and Treatments

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #33 : Pediatric Conditions

A school nurse is holding a question and answer meeting for parents following a recent outbreak of scarlet fever. Which of the following would the nurse confirm as false? 

Possible Answers:

Children over two years of age are higher risk than children under two years of age

Scarlet fever is transmitted through the air

A child may or may not develop a rash after exposure

Scarlet fever is a viral infection

A rash develops secondary to toxin sensitivity

Correct answer:

Scarlet fever is a viral infection

Explanation:

Scarlet fever is a bacterial infection caused by group A Streptococcus that is transmitted through the air. Children who are sensitive to the bacterial toxin may develop a rash, although some will not. Infants and toddlers under the age of two are rarely seen with the disease. 

Example Question #34 : Pediatric Conditions

A 3-day-old infant is diagnosed with hyperbilirubinemia. A bilirubin test is required by capillary heel puncture. The nurse does all of the following except __________.

Possible Answers:

using an antiseptic wipe to cleanse the foot

squeezing the infants heel while collecting the sample

applying heel warmers to increase capillary blood flow

turning off the bilirubin treatment lights before collecting the sample

wiping away the first drop of blood

Correct answer:

squeezing the infants heel while collecting the sample

Explanation:

Avoid squeezing the infant's heel if possible. Squeezing causes hemolysis of the specimen. Too much pressure may also result in damage to the tissue. Turning off the bilirubin treatment lights is also important because exposure to the light may alter the bilirubin in the sample. Cleansing the site of puncture is important, and warming the area will increase the capillary blood flow.

Example Question #35 : Pediatric Conditions

A mother brings her child in for paroxysmal bouts of 10-15 coughs followed by 1-2 deep gasping breaths. It started as a simple cold and cough, which seemed to be getting better before the gasping paroxysmal coughing started. The coughing is severe enough that he has vomited several times. What is the most likely diagnosis?  

Possible Answers:

Croup

Pertussis

Pneumonia

Bronchitis

Correct answer:

Pertussis

Explanation:

The most likely diagnosis in this case is pertussis, also known as whooping cough. This is caused by Bordetella pertussis, a gram-negative encapsulated coccobacillus. It begins as a seemingly normal upper respiratory infection, which progresses two weeks after onset into paroxysms of 5-15 violent coughs followed by a forceful inspiratory gasp, often described as a "whoop." Coughing is often forceful enough to induce vomiting, nosebleeds, or subconjunctival hemorrhage. Croup, pneumonia, and bronchitis are all conditions that include cough, though none of them will generally present with this degree of gasping, vomiting, or blood vessel damage due to cough.

Example Question #111 : Conditions And Treatments

Strawberry tongue and maculopapular ("sandpaper") rash are commonly seen in what childhood exanthem?

Possible Answers:

Roseola

Impetigo

Varicella

Scarlet fever

Correct answer:

Scarlet fever

Explanation:

Strawberry tongue (glossitis) and maculopapular ("sandpaper") rash are commonly seen in scarlet fever, a condition caused by group A Streptococcus bacteria, often after a bout of strep throat. The other exanthems listed can all cause erythematous rash, though none are associated with glossitis.

Example Question #35 : Pediatric Conditions

Parotid gland enlargement, fever, myalgia, and tender salivary glands would indicate which of the following conditions?

Possible Answers:

Herpangina

Mumps

Measles

Rubella

Correct answer:

Mumps

Explanation:

Parotid gland enlargement, fever, myalgia, and tender salivary glands are all indicative of infection with the mumps virus. Symptoms typically last for 7-10 days, though sequelae such as hearing damage and testicular disorders can be long-lasting or even permanent. 

Example Question #34 : Pediatric Conditions

A nurse working in labor and delivery is responsible to assessing a newborn according to the APGAR scale. The newborn infant is noted to have a vigorous good cry, a heart rate of 97, with good reflexes, and acrocyanosis.

What is the newborn's APGAR scale according to these findings?

Possible Answers:

8

9

7

6

3

Correct answer:

8

Explanation:

The APGAR score is 8, the child has received a score of 2 under respiration for good cry, a score of 2 under cry reflex for vigorous crying, a score of 2 under reflexes for good reflexes, a score of 1 for heart rate of 97 (under 100 bpm), and and score of 1 for color for acrocyanosis (blue limbs, pink body).

Example Question #41 : Pediatric Conditions

You are the nurse taking care of a 19-year old patient at a primary care clinic who complains of fever, tonsillar exudates, tender anterior cervical lymph nodes, and a sore throat without a cough. How many of the Centor criteria for streptococcal pharyngitis does this patient exhibit?

Possible Answers:

Four

One

Three

Two

None of these

Correct answer:

Four

Explanation:

The correct answer is "4." This is correct because the patient exhibits four out of the four Centor criteria for streptococcal pharyngitis. The Centor criteria are as follows:

1) Tonsillar exudates

2) Lack of cough

3) Fever

4) Tender anterior cervical lymphadenopathy

The Centor criteria are used to generate a score based upon the patient's age and number of positive criteria. This score can then be used to assess the likelihood that the patient's condition is due to streptococcal pharyngitis, and therefore to guide the decision of whether or not to treat with antibiotics for streptococcal pharyngitis. In this patient's case, since they are older than 14 and younger than 45, they do not gain or lose points for their age. They get four points total for having all of the positive criteria. Therefore, it is highly likely that they are infected with streptococcal pharyngitis and should be treated empirically with antibiotics.

Example Question #112 : Conditions And Treatments

The pediatric nurse is counseling a mother/baby couplet who are having trouble breastfeeding. The baby is showing poor suck and falling asleep at the breast. Which of the following is not an appropriate intervention?

Possible Answers:

Unswaddle and undress the baby prior to placing at breast

Feed the infant according to infant's cues

Feed the baby every three hours until they become in-sync with the pattern

Gently caress or rub the head of the infant

Play with the feet of the newborn while feeding

Correct answer:

Feed the baby every three hours until they become in-sync with the pattern

Explanation:

When presented with an infant showing poor suck, it is important to feed when cues are given. The infant will suck best when hungry. However, a breast-fed infant should not go more than 3 hours between routine feedings in order to establish healthy weight gain. Feeding every 3 hours regardless of cue is less advisable. Unswaddling, undressing, and stimulating the infant can sometimes aid in keeping them awake and sucking well at the breast.

Example Question #922 : Nclex

Individuals who contracted varicella zoster (chicken pox) in childhood may experience which of the following if the virus is reactivated later in life?

Possible Answers:

Orchitis

Scarlet fever

Rheumatic fever

Shingles 

Correct answer:

Shingles 

Explanation:

A common sequela of varicella is shingles, a painful rash caused by reactivation of the varicella zoster virus along the single dermatome that corresponds with the site of initial infection. Rheumatic fever and scarlet fever are both possible sequelae of streptococcus infection, and orchitis is a potential sequela or co-morbidity of infection with the mumps virus.

Example Question #923 : Nclex

At what point is a child with varicella no longer contagious?

Possible Answers:

By the time the lesions are visible, the child is no longer contagious

After the last lesion has broken open and crusted over

After the last lesion is no longer visible

7 days after the initial presentation

Correct answer:

After the last lesion has broken open and crusted over

Explanation:

Varicella is a highly contagious infectious disease of childhood. It is no longer contagious when the last lesion has broken open and crusted over. Until then the virus can be spread via respiratory droplets, by contact with the saliva of an infected child, or by touching an unbroken blister or the fluid within a blister. 

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