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 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 C
Explanation
Choice A rationale
A high elevation in the white blood cell count, or leukocytosis, is an expected inflammatory response in appendicitis. While an elevated WBC count (normal range typically 4,500 to 11,000 cells/mcL) indicates infection or inflammation, it does not necessarily signal immediate, life-threatening complications requiring immediate intervention.
Choice B rationale
Guarding, which is the tensing of abdominal muscles upon palpation, and rebound tenderness, pain that worsens when pressure is released, are classic signs of peritoneal irritation associated with appendicitis. These findings suggest inflammation of the peritoneum but do not indicate an immediate, critical emergency in the same way as sudden pain relief.
Choice C rationale
Sudden relief of pain in a child with appendicitis, followed by a rigid abdomen and fever, is a critical sign of a ruptured appendix and subsequent peritonitis. The rupture releases the pressure causing the initial pain, but the spillage of bowel contents leads to widespread inflammation of the peritoneum, a serious and potentially life-threatening condition requiring immediate surgical intervention to prevent sepsis and other complications.
Choice D rationale
Abdominal tenderness in the right lower quadrant (RLQ), often referred to as McBurney's point, is a characteristic finding in appendicitis due to the inflammation of the appendix in this anatomical location. While it warrants investigation and treatment, localized tenderness alone does not indicate an immediate, life-threatening complication.
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