NCLEX® Question of the Day: Smallpox

Aug 28, 2024

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Smallpox progresses through three key stages: incubation, enanthem, and exanthem. Understanding these stages is essential for identifying symptoms such as high fever, rash development, and lesion characteristics. Nurses must differentiate between clinical findings at each stage to aid in prompt diagnosis and treatment.

The nurse in a military hospital is reviewing the signs and symptoms of smallpox. For each clinical finding, click to specify whether it is associated with the incubation, enanthem, or exanthem stage of smallpox.

Clinical Finding	Incubation period 10 to 14 days	Enanthem 2 to 4 days	Exanthem 4 to 5 days
Abdominal pain
Skin macules
High fever
Rash on the tongue and palate
Skin crusts
Severe headache

Scroll down for the correct answer!

The correct answer to today’s NCLEX-RN® Question is…

Clinical Finding	Incubation period 10 to 14 days	Enanthem 2 to 4 days	Exanthem 4 to 5 days
Abdominal pain	X
Skin macules	X
High fever	X
Rash on the tongue and palate		X
Skin crusts			X
Severe headache	X

Major Takeaway

Clinical manifestations of smallpox typically appear after an incubation period of 10 to 14 days and include high fever, severe headache, back pain, malaise and sometimes abdominal pain, vomiting, and diarrhea. In two to four days, enanthem occurs, which is a rash on the mucous membranes of the tongue and palate. This is followed by the onset of an exanthem, or a red, macular rash that typically starts at the face, distal extremities, hands, and soles of the feet and then spreads to the trunk and proximal extremities. Over the course of four to five days, the lesions evolve from macules to papules to vesicles, filled with clear fluid, which can then turn into pus, giving rise to pustules. As these pustules pop open, the pus dries out, and crusts form. An important characteristic of the smallpox rash is that all lesions are at the same stages of development at a time.

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