A 6-year-old child presents to the pediatric clinic with the following (pictured) sores around the nose and mouth.
The child's parent reports that these lesions began as small red spots that quickly developed into blisters, which then ruptured and formed into what appears in the picture.
The child recently recovered from a mild cold and has been attending daycare regularly.
Based on this presentation, what is the name of the rash shown in the picture, and what bacteria is the most likely cause of the child's condition?
The rash is likely impetigo, caused by *Staphylococcus aureus*.
The rash is likely herpes simplex, caused by the herpes simplex virus.
The rash is likely ringworm, caused by a fungal infection.
The rash is likely contact dermatitis, caused by an irritant.
The Correct Answer is A
Choice A rationale
Impetigo is a highly contagious superficial skin infection commonly caused by *Staphylococcus aureus* or *Streptococcus pyogenes*. The typical presentation includes small red papules that rapidly evolve into vesicles or pustules, which then rupture, leaving behind characteristic honey-colored, crusted lesions, often around the nose and mouth, consistent with the image and the reported progression.
Choice B rationale
Herpes simplex is caused by the herpes simplex virus (HSV) and typically presents as clusters of small, painful vesicles on an erythematous base, often around the mouth (oral herpes or cold sores) or genitals. While it can cause blisters, the progression to honey-colored crusts is not characteristic of herpes simplex infections.
Choice C rationale
Ringworm, or tinea corporis or tinea faciei when on the face, is a fungal infection that typically presents as circular, scaly patches with a raised border and central clearing. It is not characterized by the formation of blisters that rupture and form honey-colored crusts.
Choice D rationale
Contact dermatitis is an inflammatory skin reaction caused by direct contact with an irritant or allergen. It can present with redness, itching, swelling, and sometimes blisters, but the lesions are typically more widespread and do not characteristically form the honey-colored crusts seen in impetigo.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Monitoring for signs of infection is crucial in children with spina bifida due to the potential for meningitis and urinary tract infections related to neurological deficits and potential openings in the spinal cord. Normal white blood cell count ranges from 4,500 to 11,000 per microliter, and fever, redness, swelling, or purulent drainage would indicate infection.
Choice B rationale
Encouraging mobility is important to promote development and prevent complications like contractures. However, in the immediate postoperative period or with significant neurological impairment, maintaining skin integrity takes precedence to prevent infection and further complications.
Choice C rationale
Providing nutritional support is essential for growth and development in children with spina bifida, who may have feeding difficulties or increased metabolic needs. Adequate nutrition supports overall health, but preventing skin breakdown in areas prone to pressure is a more immediate concern.
Choice D rationale
Maintaining skin integrity is the most important intervention because children with spina bifida often have sensory and motor deficits that make them susceptible to pressure ulcers, especially over bony prominences and the surgical site if a myelomeningocele repair has occurred. Skin breakdown can lead to serious infections and complications.
Correct Answer is C
Explanation
Choice A rationale
Gastroenteritis typically presents with vomiting, diarrhea, and abdominal pain. While a sore throat can occur with some viral gastroenteritis, excessive drooling and refusal to eat are less common primary symptoms.
Choice B rationale
A viral infection causing a sore throat can lead to refusal to eat and some difficulty swallowing, potentially causing mild drooling. However, excessive drooling and the described level of distress are less typical of a simple viral sore throat.
Choice C rationale
Excessive drooling, coughing, distress, and refusal to eat in a young child are highly suggestive of foreign body ingestion causing airway obstruction or irritation of the esophagus or trachea. The body's attempt to expel the object and the difficulty swallowing saliva lead to drooling and coughing.
Choice D rationale
An allergic reaction can cause throat swelling and difficulty breathing, but excessive drooling is not a primary symptom. Hives, itching, or other systemic symptoms would also likely be present.
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