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
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 B
Explanation
Choice A rationale
Myoclonic seizures are characterized by brief, sudden, involuntary muscle jerks or twitches. These movements are typically not associated with a complete loss of postural tone leading to a fall. The child's presentation of suddenly dropping to the floor without warning indicates a loss of muscle strength.
Choice B rationale
Atonic seizures, also known as drop attacks, involve a sudden loss of muscle tone, causing the individual to fall abruptly. This loss of tone can be localized or generalized, affecting the entire body, which aligns with the description of the child suddenly dropping to the floor.
Choice C rationale
Absence seizures are characterized by brief lapses of consciousness, often appearing as a staring spell. Individuals usually do not fall during an absence seizure; instead, they may have subtle motor movements like eye blinking or lip smacking.
Choice D rationale
Tonic seizures involve a sudden increase in muscle tone, causing stiffening of the body, arms, or legs. While a person might fall due to the rigidity, the primary characteristic is muscle stiffening, not a sudden loss of tone.
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