NCLEX-RN Exam - Topic 2 Question 8 Discussion

Actual exam question for NCLEX's NCLEX-RN exam

Question #: 8
Topic #: 2

An 8-year-old child comes to the physician's office complaining of swelling and pain in the knees. His mother says, ''The swelling occurred for no reason, and it keeps getting worse.'' The initial diagnosis is Lyme disease. When talking to the mother and child, questions related to which of the following would be important to include in the initial history?

AA decreased urinary output and flank pain

BA fever of over 103F occurring over the last 2--3 weeks

CRashes covering the palms of the hands and the soles of the feet

DHeadaches, malaise, or sore throat

Show Suggested Answer

Suggested Answer: D

(A) Urinary tract symptoms are not commonly associated with Lyme disease. (B) A fever of 103F is not characteristic of Lyme disease. (C) The rash that is associated with Lyme diseasedoes not appear on the palms of the hands and the soles of the feet. (D) Classic symptoms of Lyme disease include headache, malaise, fatigue, anorexia, stiff neck, generalized lymphadenopathy, splenomegaly, conjunctivitis, sore throat, abdominal pain, and cough.

by Cristina at Jul 14, 2025, 02:40 AM

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Tammy

5 months ago

What about headaches? Do they matter in this case?

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Kip

5 months ago

Wait, how can they be sure it's Lyme? Could be something else.

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Billy

6 months ago

Definitely need to check for rashes, that's classic Lyme!

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Mariann

6 months ago

Fever is a big sign too, can't overlook that!

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Tresa

6 months ago

Lyme disease can cause joint pain, especially in kids.

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Sheldon

6 months ago

I’m confused about the decreased urinary output option; I don’t recall it being a typical symptom of Lyme disease.

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Nadine

7 months ago

I practiced a similar question about Lyme disease, and I think asking about headaches or malaise could help assess if there’s more systemic involvement.

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Rickie

7 months ago

I’m not entirely sure, but I feel like rashes on the palms and soles might be more related to other conditions, not Lyme disease specifically.

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Reena

7 months ago

I remember discussing Lyme disease in class, and I think fever could be a key symptom, especially if it’s been persistent.

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Melynda

7 months ago

This is a good one. I'd make sure to ask about any recent tick bites or outdoor activities, since that can help point to Lyme disease. And of course, I'd want to get details on the joint swelling and pain the patient is experiencing.

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Gracie

7 months ago

Okay, for this type of question, I think it's important to really zero in on the key symptoms associated with Lyme disease. Based on the information provided, I'd be sure to ask about fever, rashes, and any other systemic symptoms the patient may be experiencing.

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Detra

8 months ago

Hmm, I'm a bit unsure about this one. I know Lyme disease can cause joint swelling, but I'm not sure which specific symptoms would be most important to ask about in the initial history. I'll have to think this through carefully.

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Lenita

8 months ago

This seems like a pretty straightforward question. I'd focus on gathering information about any recent fever, rashes, or other symptoms that could point to Lyme disease.

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Margery

9 months ago

Yes, rashes could also be a symptom of Lyme disease, so that's an important question to include in the history.

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Irene

10 months ago

But what about rashes? Shouldn't we ask about any rashes on the hands and feet?

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Leslee

10 months ago

I agree, a fever could indicate an infection like Lyme disease.

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Doug

10 months ago

Hmm, I'm torn between B and D. Maybe the kid's just really excited about the swelling and can't decide which symptom to complain about first. Classic Lyme move.

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