A 15-year-old patient presents to the clinic with this rash transmitted.
They report spending time hiking in wooded areas two weeks ago.
Identify what arachnid caused this rash, and what is the name of the disease that can be.
A tick caused the rash, and the disease is Lyme disease.
A spider caused the rash, and the disease is Rocky Mountain spotted fever.
A mite caused the rash, and the disease is scabies.
A chigger caused the rash, and the disease is chigger dermatitis.
The Correct Answer is A
Choice A rationale
A tick is the arachnid responsible for transmitting Lyme disease. The characteristic rash associated with Lyme disease is erythema migrans, often described as a "bull's-eye" rash, which can appear days to weeks after a bite from an infected blacklegged tick (Ixodes scapularis or Ixodes pacificus). Spending time in wooded areas increases the risk of tick exposure.
Choice B rationale
Spiders are arachnids, but they are not the primary vector for Rocky Mountain spotted fever. Rocky Mountain spotted fever is caused by the bacterium Rickettsia rickettsii and is transmitted to humans through the bite of infected American dog ticks (Dermacentor variabilis) or Rocky Mountain wood ticks (Dermacentor andersoni). The rash associated with this disease typically starts on the wrists and ankles and spreads centrally.
Choice C rationale
Mites are arachnids, and certain types cause scabies, a contagious skin infestation characterized by intense itching and a pimple-like rash due to the burrowing of the Sarcoptes scabiei mite into the skin. While hiking in wooded areas could potentially lead to exposure to some types of mites, the rash of scabies has a distinct presentation and transmission pattern different from Lyme disease.
Choice D rationale
Chiggers are also mites (arachnids) that can be found in wooded areas. Their bites cause chigger dermatitis, characterized by intensely itchy red welts or bumps where the larvae have attached to the skin. While the history of hiking is relevant to potential exposure to chiggers, the rash and the associated disease are distinct from the erythema migrans rash of Lyme disease. .
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
For scabies treatment with topical permethrin in children, the medication should be applied from the neck down to the toes, ensuring all skin surfaces are covered because scabies mites can burrow anywhere on the body. The permethrin should be left on for the prescribed duration, typically 8-14 hours or overnight, to allow sufficient contact time to kill the mites and their eggs.
Choice B rationale
Applying permethrin only to affected areas may not be sufficient to eradicate scabies because mites can be present on areas of the skin that do not yet show visible signs of infestation or itching. Complete coverage is necessary to ensure treatment success.
Choice C rationale
Applying permethrin only to the scalp is inadequate for treating scabies, as the mites commonly infest other areas of the body. While scabies can affect the scalp, especially in infants and young children, treatment must extend to all skin surfaces from the neck down.
Choice D rationale
A hot bath should be avoided before applying permethrin. Hot water can irritate the skin and increase absorption of the medication, potentially leading to systemic toxicity or reduced effectiveness. Permethrin is typically applied to cool, dry skin.
Correct Answer is D
Explanation
Choice A rationale
Pediculosis, an infestation of lice, is highly contagious through direct contact, especially head-to-head contact. Therefore, no precautions are insufficient to prevent the spread of lice to healthcare workers and other patients. Standard precautions are necessary.
Choice B rationale
Wearing a gown and hair cover is not typically required for routine care of a child with pediculosis. Standard precautions, including gloves to prevent direct contact with the child's hair and scalp, are generally sufficient. Gowns are usually indicated when there is a risk of contact with body fluids or secretions.
Choice C rationale
Isolating the child in a negative-pressure room is reserved for airborne infections, such as tuberculosis or measles. Pediculosis is transmitted through direct contact, not airborne droplets, so isolation in a negative-pressure room is unnecessary and inappropriate.
Choice D rationale
Wearing gloves is the appropriate nursing action when treating a hospitalized child with pediculosis. Gloves prevent direct contact with the lice and their eggs (nits) during examination and treatment of the scalp and hair, thus minimizing the risk of transmission to the healthcare worker. .
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