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Female Reproductive System NCLEX RN Questions Questions

Extract:

The nurse in the emergency department (ED) is caring for a 10-year-old client.
Item 2 of 5
Nurses' Notes
1322: 10-year-old client and his parents report an 8-day history of a brownish-raised lesion over the back of his left leg. The parents report that the size of the rash has increased. The parents report returning from a one-week camping trip three weeks ago. The parents deny efficacy with over-the-counter antihistamine creams. The client's parents deny that the child has had a fever but has felt 'warm' occasionally and endorsed an intermittent headache. They report an area of firmness in the child's groin. On assessment, there was an erythematous, raised, nonpainful, oval patch on the back of his left leg. This was an enlargement of an inguinal lymph node. The child is alert and fully oriented and denies any pain. Peripheral pulses palpable 2+. No cyanosis or edema in the extremities. Lung sounds clear bilaterally. The parents report that the child did not receive the seasonal influenza vaccine. He currently takes a multivitamin for iron deficiency anemia and was hospitalized one year ago for an appendectomy. The parents state that the child’s sibling had influenza one month ago. Vital signs: T 98.8°F (37.1°C); HR 78 beats/min; RR 16 breaths/min; BP 110/76 mm Hg. SpO2 97% on room air.


Question 1 of 5

The nurse considers if the client may have an infection caused by a tick. Click to specify if the features are consistent with the disease process of Rocky Mountain spotted fever (RMSF) or Lyme Disease.

Feature Rocky Mountain spotted fever Lyme Disease
Fever
Petechial rash that becomes diffuse
Erythema migrans (bullseye rash)
Myalgia
Causative agent Rickettsia rickettsii
Causative agent Borrelia burgdorferi

Correct Answer: C (Lyme Disease), F (Lyme Disease)

Rationale: The bullseye rash and Borrelia burgdorferi are specific to Lyme disease. Fever and myalgia can occur in both RMSF and Lyme disease, but the petechial rash and Rickettsia rickettsii are specific to RMSF.

Extract:


Question 2 of 5

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