Pediatric ATI Practice Exam

When should the nurse advise a guardian that a child with varicella is no longer contagious?

1. When there are no new spots for 24 hours.

2. When all lesions are scabbed.

3. Once the fever resolves.

4. Three days after the rash onset.

The correct answer is: When all lesions are scabbed.

For a child with varicella (chickenpox), the appropriate time to advise a guardian that the child is no longer contagious is when all lesions are scabbed. This is important because varicella is highly contagious, and the risk of transmission is highest before the rash appears and until all lesions have crusted over. Varicella is infectious from one to two days before the onset of the rash until all the vesicles have crusted. Once the lesions have completely scabbed, the child is considered no longer contagious, which signifies that the risk of transmitting the virus to others has significantly decreased. The other options may not accurately represent the most reliable time frame for determining contagiousness. For instance, having no new spots for 24 hours does not guarantee that the child is non-contagious, as scabbing of lesions is the definitive marker. Resolution of fever can occur before the contagious period is over, and a fixed timeframe like three days after rash onset does not consider the individual progression of lesions. Thus, monitoring for scabbing provides the most accurate indication of when the child is no longer contagious.