NORCET 2 - 2021 (shift-1)
Medical & Surgical Nursing
Easy
In the following image, this type of fever graph is seen in which disease?
Appeared in: NORCET 2 - 2021 (shift-1)
Explanation
- The image displays a 'step-ladder' fever pattern, a classic clinical sign of typhoid (enteric) fever.
- This pattern is characterized by a gradual, stepwise increase in body temperature, where each day's peak temperature is higher than the previous day's, typically occurring over the first week of the illness.
- The graph shows this progressive rise from 37°C to over 41°C, which is highly characteristic of typhoid fever before treatment is initiated.
Why Other Options Were Wrong
- Option A: Malaria typically causes an intermittent fever, not a step-ladder pattern.
- Option C: Dengue fever is associated with a biphasic or 'saddleback' fever pattern.
- Option D: COVID-19 does not have a characteristic step-ladder fever pattern. Its fever presentation is variable.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Identifying diseases based on characteristic fever patterns to guide bedside assessment, documentation, and the next nursing action.
- Accurate temperature charting is a fundamental nursing responsibility that provides vital diagnostic clues, as different fever patterns are hallmarks of specific diseases.
- In a patient with suspected typhoid fever, nurses must monitor for relative bradycardia (Faget's sign), where the pulse rate does not increase proportionately with the high fever.
- Patient education on hygiene, safe drinking water, and food handling is a key nursing role in preventing the spread of typhoid, which is transmitted via the fecal-oral route.
How to Approach the Question
- First, carefully analyze the image provided. Identify the key feature, which is the label 'Step Ladder fever' and the visual representation of the temperature rising in distinct steps.
- Next, access your knowledge of medical-surgical nursing regarding infectious diseases and their clinical manifestations.
- Associate the 'step-ladder' pattern with its corresponding disease. This pattern is a classic, textbook sign of typhoid fever.
- Systematically eliminate the other options by recalling their characteristic fever patterns: Malaria (intermittent), Dengue (biphasic/saddleback), and COVID-19 (variable/remittent).
- Confirm your answer based on this direct and strong association between the visual evidence and known pathophysiology.
Concept Tested & Keywords
- Concept Tested: Identifying diseases based on characteristic fever patterns.
- Stem keywords: fever graph, disease, temperature
- Lead-in keywords: which disease
- Clinical cues: The image explicitly labels the graph as 'Step Ladder fever', which is the primary clue.
Question ID
QMcbc1JpI_O1F_VLVsDwPs
Reference Book
E6 Nutrition Kumud Khanna 2e p. 196-198
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1642-1644
E6 Ghai Essential Pediatrics(pp 26-904 of 913) p. 220-222
Practise the full NORCET 2 - 2021 (shift-1)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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