A child with type 1 diabetes is being discharged.
Which statement by the parent indicates a need for further teaching?

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. .

Choice A rationale

Cryptorchidism is the medical term for the failure of one or both testicles to descend into the scrotum. The scenario describes a 2-year-old male with one non-palpable testicle, which is the hallmark of cryptorchidism. Risk factors include prematurity and low birth weight.

Choice B rationale

An inguinal hernia is a protrusion of abdominal contents through the inguinal canal. While it can present as a swelling in the groin area, it is distinct from a missing testicle in the scrotum. Examination would typically reveal a palpable mass that may reduce with gentle pressure.

Choice C rationale

A hydrocele is a collection of fluid within the tunica vaginalis, the sac surrounding the testicle. It typically presents as a painless swelling of the scrotum. The testicle is usually palpable within the fluid-filled sac.

Choice D rationale

Testicular torsion is a medical emergency involving the twisting of the spermatic cord, which cuts off blood supply to the testicle. It presents with sudden, severe scrotal pain, swelling, and often nausea and vomiting. The examination would reveal a tender, firm, and retracted testicle. .