A patient with classical heat stroke will have:

Appeared in: GMCH - 2016

Explanation

Classical (non-exertional) heat stroke is a medical emergency where the body's central temperature control system fails.
A defining characteristic of this failure is anhidrosis, which is the cessation of sweating.
Without the cooling effect of sweat evaporation, the skin becomes characteristically hot, red, and dry.
This is a critical diagnostic feature that distinguishes classical heat stroke from heat exhaustion.

Option B: Profuse sweating (diaphoresis) is the hallmark sign of heat exhaustion, where the body's cooling mechanisms are still active but are being overwhelmed.
Option C: Cool skin is characteristic of heat exhaustion, resulting from peripheral vasodilation and profuse sweating.
Option D: Heat stroke is defined by severe hyperthermia, with a core body temperature typically rising above 40°C (104°F).

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical signs of classical heat stroke to guide bedside assessment, documentation, and the next nursing action.
Recognizing dry, hot skin as a sign of classical heat stroke is critical for nurses to initiate immediate, life-saving cooling interventions and prevent irreversible organ damage or death.
What if? If the patient was a young athlete who collapsed during a marathon, the presentation could differ. This would be exertional heat stroke, where profuse sweating can still be present despite a dangerously high core temperature, making the diagnosis more challenging based on skin signs alone.

How to Approach the Question

First, identify the key terms in the question: 'classical heat stroke'. The word 'classical' (or non-exertional) is crucial.
Recall the basic pathophysiology of heat-related illnesses. The primary distinction between heat exhaustion and heat stroke is the failure of the body's central thermoregulatory (temperature control) system.
In classical heat stroke, this system fails completely, leading to a shutdown of the sweating mechanism.
Analyze the options based on this fact. If sweating stops, the skin will become dry, not profusely sweaty. This eliminates 'Profuse sweating'.
Without the cooling effect of sweat, the body's temperature will rise significantly, and the skin will feel hot, not cool. This eliminates 'Cool skin'.
By definition, heat stroke involves a dangerously high body temperature, so 'Normal body temperature' is incorrect.

Concept Tested & Keywords

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E6 Nursing Fundamentals Potter Perry 12e Part 3 p. 12-14

E6 Medicine Harrison 22e Part 2 p. 1678-1680

Practise the full GMCH - 2016

Attempt every question from this paper in a timed mock, then review the full solution for each one.