NORCET -4 , 2023: Which of the following clinical features would be seen in a client with dengue haemorrhagic fever, EXCEPT?

NORCET -4 , 2023

Medical & Surgical Nursing

Easy

Appeared in: NORCET -4 , 2023

Explanation

Leucocytosis, an increase in the number of white blood cells, is not a characteristic feature of dengue haemorrhagic fever.
The typical hematological finding in dengue is leukopenia, which is a decrease in the total white blood cell count (WBC ≤ 5000 cells/mm3), often appearing early in the illness.
While a rise in WBCs can occur in rare situations like severe bleeding or a secondary bacterial infection, it is not a primary manifestation of the dengue virus infection itself.

Option A: Thrombocytopenia, a platelet count below 100,000 cells/mm3, is a hallmark and a diagnostic criterion for dengue haemorrhagic fever. It contributes to the bleeding manifestations.
Option C: Lymphadenopathy, or the swelling of lymph nodes, is a common clinical finding during the febrile phase of a dengue infection.
Option D: Fever, typically of sudden onset and high-grade, is the primary and initial symptom that marks the beginning of the febrile phase of dengue.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical and laboratory findings in Dengue Haemorrhagic Fever (DHF) to guide bedside assessment, documentation, and the next nursing action.
Recognizing that leukopenia, not leucocytosis, is expected in dengue is crucial for nurses to help differentiate it from bacterial infections, which typically cause leucocytosis. This clinical judgment can prevent the inappropriate use of antibiotics.
Continuous monitoring of the complete blood count (CBC) is a vital nursing responsibility. A rapid drop in platelets and WBCs, combined with a rising hematocrit, are critical warning signs for progression to severe dengue, guiding fluid management and bleeding precautions.
What if? If a patient with confirmed dengue suddenly develops leucocytosis and a fever spike after the initial defervescence period, the nurse must suspect a secondary bacterial infection (e.g., hospital-acquired pneumonia) and escalate to the physician immediately for further investigation and possible antibiotic therapy.

How to Approach the Question

First, identify the core subject of the question, which is the clinical features of dengue haemorrhagic fever.
Recognize the negative keyword 'EXCEPT'. This signals that you must find the one option that is NOT a typical feature of the condition.
Mentally review the classic signs and laboratory findings associated with dengue: high fever, bleeding tendencies (e.g., petechiae), low platelet count (thrombocytopenia), and low white blood cell count (leukopenia).
Systematically evaluate each option against this knowledge base.
Option A (Thrombocytopenia): This is a hallmark of dengue. It is a true feature.
Option B (Leucocytosis): This means high WBC count. Dengue causes a low WBC count (leukopenia). This is a false feature.

Concept Tested & Keywords

Concept Tested: Clinical and laboratory findings in Dengue Haemorrhagic Fever (DHF).
Stem keywords: dengue haemorrhagic fever, clinical features
Lead-in keywords: EXCEPT
Negative lead-in flag: Question asks for the feature NOT present (EXCEPT).

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