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 C
Explanation
Choice A rationale
Oral contraceptive pills primarily work by suppressing ovulation and thinning the uterine lining, leading to lighter and less painful periods. While effective for dysmenorrhea, they are not typically the first-line treatment for a 12-year-old experiencing recent onset, as other less hormonally impactful options are usually tried first.
Choice B rationale
Increasing dairy intake primarily impacts bone health due to its calcium content. While calcium plays a role in muscle function, there is no strong scientific evidence directly linking increased dairy consumption to the reduction of menstrual pain caused by prostaglandins and uterine contractions in dysmenorrhea.
Choice C rationale
Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen inhibit the production of prostaglandins, which are key mediators of inflammation and pain. During menstruation, the uterus releases prostaglandins, causing contractions and pain. By blocking prostaglandin synthesis, NSAIDs effectively reduce the intensity of menstrual cramps. The medical term for severe pain during menstruation is dysmenorrhea.
Choice D rationale
Applying a heating pad to the abdomen provides localized warmth, which can help to relax the smooth muscles of the uterus and increase blood flow. This can offer symptomatic relief from menstrual cramps by reducing muscle spasms and alleviating discomfort, but it does not address the underlying physiological cause of dysmenorrhea.
Correct Answer is C
Explanation
Choice A rationale
Corn is naturally gluten-free and is generally safe for individuals with celiac disease to consume. Celiac disease is an autoimmune disorder triggered by gluten, a protein found in wheat, barley, and rye.
Choice B rationale
Rice, in all its forms (white, brown, wild), is naturally gluten-free and is a staple grain in the diet of individuals with celiac disease. It does not contain the gliadin protein that triggers the autoimmune response in celiac disease.
Choice C rationale
Wheat contains gluten, specifically the gliadin fraction, which triggers the damaging autoimmune response in the small intestine of individuals with celiac disease. Therefore, all products containing wheat, including bread, pasta, and many processed foods, must be strictly avoided.
Choice D rationale
Oats are naturally gluten-free; however, they are often processed in facilities that also handle wheat, barley, or rye, leading to cross-contamination. While certified gluten-free oats are available, regular oats may not be safe for individuals with celiac disease due to this risk of contamination.
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