Certified Pediatric Emergency Nurse (CPEN) Practice Exam

What is a hallmark symptom of pertussis?

1. Difficulty breathing

2. Severe chest pain

3. Extended whooping cough

4. High fever

The correct answer is: Extended whooping cough

A hallmark symptom of pertussis is the extended whooping cough, which is characterized by severe coughing fits followed by a "whoop" sound as the patient inhales. This distinctive coughing pattern is a result of the irritation and inflammation of the respiratory tract caused by the Bordetella pertussis bacteria. The whooping cough is often quite prolonged, and the coughing fits can lead to exhaustion and difficulty breathing, highlighting the seriousness of the infection. The absence of other symptoms from the choices can help clarify the specificity of pertussis. While difficulty breathing can occur due to coughing fits, it is not exclusively indicative of pertussis and can be associated with other respiratory conditions. Severe chest pain can develop from intense coughing but is not a defining feature of pertussis; it's more common in other medical conditions. Additionally, a high fever may accompany many infections but is not a characteristic symptom of pertussis, where the temperature might be normal or only mildly elevated. The unique nature of the whooping cough in pertussis sets it apart from other respiratory illnesses, making it the correct choice.