NBCSN Nationally Certified School Nurse Practice Exam

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Which symptom indicates the presence of Group A streptococcal infection in relation to scarlet fever?

  1. Bright red rash covering most of the body

  2. Swollen lymph nodes only

  3. Severe joint pain

  4. Persistent cough

The correct answer is: Bright red rash covering most of the body

The presence of a bright red rash covering most of the body is a key indicator of Group A streptococcal infection associated with scarlet fever. This rash, often described as having a sandpaper-like texture, typically appears 12 to 48 hours after the onset of fever and presents in stages, often starting in the neck and then spreading to the trunk and extremities. Scarlet fever is characterized not just by the rash but also by additional signs such as a high fever, a red and swollen tongue (often referred to as a "strawberry tongue"), and other systemic symptoms. The bright red rash serves as a distinct and visible symptom that healthcare providers look for when diagnosing scarlet fever, emphasizing the link between the rash and the underlying streptococcal infection. While swollen lymph nodes and severe joint pain can be associated with infections, they do not specifically indicate scarlet fever. A persistent cough is more commonly linked to respiratory illnesses rather than scarlet fever, which is primarily identified by the rash and fever in conjunction with throat symptoms. The specificity of the bright red rash makes it the most identifiable symptom of Group A streptococcal infection in the context of scarlet fever.