A nurse is collecting data from a child who has pertussis. Which of the following manifestations should the nurse expect?

Pertussis, also known as whooping cough, is a highly contagious respiratory infection caused by Bordetella pertussis. It is characterized by inflammation of the upper respiratory tract leading to severe, uncontrollable coughing episodes. The illness typically progresses through stages, with the paroxysmal stage being most clinically distinctive. Recognition of hallmark symptoms is essential for early diagnosis, isolation, and prevention of transmission, especially in pediatric populations. Rationale: A. Koplik spots are small bluish-white lesions on an erythematous base found on the buccal mucosa and are a classic early sign of measles (rubeola), not pertussis. Their presence indicates a viral exanthem rather than a bacterial respiratory infection. They are not associated with pertussis. B. A beefy, red tongue is commonly associated with conditions such as scarlet fever or vitamin deficiencies. It reflects mucosal inflammation or systemic infection affecting the oral cavity. This finding is not characteristic of pertussis, which primarily affects the respiratory tract rather than oral mucosa. C. Peeling of the hands and feet is typically seen in conditions such as Kawasaki disease, where vasculitis leads to desquamation during the subacute phase. This manifestation is unrelated to pertussis, which does not involve systemic vasculitis or skin desquamation as a primary feature. D. A paroxysmal cough is the hallmark manifestation of pertussis, characterized by sudden, intense coughing fits that may end with a whooping sound during inspiration. These episodes can be followed by vomiting or exhaustion due to increased intrathoracic pressure. This symptom results from toxin-mediated damage to the respiratory epithelium caused by Bordetella pertussis.