A 15-year-old male presents to the school nurse with complaints of persistent itching and redness in the groin area for the past two weeks.
Upon assessment, the nurse observes a well-demarcated, erythematous rash with a scaly border extending from the inguinal folds to the upper inner thighs, sparing the scrotum and penis.
The student reports being on the school's wrestling team and frequently wearing tight-fitting athletic gear.
Which of the following interventions should the nurse prioritize?
Instruct the student to avoid all physical activity until the rash has completely resolved.
Advise the student to apply an over-the-counter topical antifungal cream to the affected area twice daily for two weeks.
Refer the student to a healthcare provider for oral antibiotic therapy to treat the infection.
Recommend the student use a topical corticosteroid to reduce inflammation and itching.
The Correct Answer is B
Choice A rationale
Instructing the student to avoid all physical activity is not the priority intervention. While reducing friction and sweating can be beneficial, completely ceasing activity may not be necessary with appropriate treatment and hygiene measures. The rash is likely a fungal infection, not exacerbated by moderate activity if properly managed.
Choice B rationale
Advising the student to apply an over-the-counter topical antifungal cream is the most appropriate initial intervention. The presentation of a well-demarcated, erythematous, scaly rash in the groin, sparing the scrotum and penis, in a wrestler wearing tight athletic gear strongly suggests tinea cruris, a fungal infection. Topical antifungals are the first-line treatment for this condition.
Choice C rationale
Referring the student for oral antibiotic therapy is not indicated at this stage. The clinical presentation is highly suggestive of a fungal infection, for which antibiotics are ineffective. Antibiotics are used to treat bacterial infections, which typically present with different characteristics such as pus or systemic symptoms.
Choice D rationale
Recommending a topical corticosteroid is not the priority. While corticosteroids can reduce inflammation and itching, they do not treat the underlying fungal infection and can sometimes worsen it by suppressing the local immune response. Antifungal treatment should be initiated first to address the cause of the rash.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The industry vs inferiority stage, according to Erik Erikson's stages of psychosocial development, occurs during middle childhood (approximately 6 to 12 years). Children in this stage focus on mastering new skills and knowledge, developing a sense of competence and industry through activities like building models and participating in team sports. Success in these endeavors leads to a feeling of accomplishment, while failure can result in feelings of inferiority.
Choice B rationale
The initiative vs guilt stage occurs during the preschool years (approximately 3 to 5 years). Children in this stage are eager to take on new tasks and activities, developing a sense of initiative. However, if their efforts are met with criticism or failure, they may develop feelings of guilt.
Choice C rationale
The autonomy vs shame and doubt stage occurs during early childhood (approximately 18 months to 3 years). Children in this stage are focused on developing independence and self-control. Success in achieving autonomy leads to feelings of confidence, while failure can result in shame and doubt about their abilities.
Choice D rationale
The identity vs role confusion stage occurs during adolescence (approximately 12 to 18 years). During this stage, individuals are exploring their sense of self and trying to establish their identity in various aspects of life. Failure to establish a clear sense of identity can lead to role confusion.
Correct Answer is A
Explanation
Choice A rationale
Cryptorchidism is the medical term for the failure of one or both testicles to descend into the scrotum. The scenario describes a 2-year-old male with one non-palpable testicle, which is the hallmark of cryptorchidism. Risk factors include prematurity and low birth weight.
Choice B rationale
An inguinal hernia is a protrusion of abdominal contents through the inguinal canal. While it can present as a swelling in the groin area, it is distinct from a missing testicle in the scrotum. Examination would typically reveal a palpable mass that may reduce with gentle pressure.
Choice C rationale
A hydrocele is a collection of fluid within the tunica vaginalis, the sac surrounding the testicle. It typically presents as a painless swelling of the scrotum. The testicle is usually palpable within the fluid-filled sac.
Choice D rationale
Testicular torsion is a medical emergency involving the twisting of the spermatic cord, which cuts off blood supply to the testicle. It presents with sudden, severe scrotal pain, swelling, and often nausea and vomiting. The examination would reveal a tender, firm, and retracted testicle. .
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