A nurse is assessing the mouth f a patient and during the inspection notes a black and hairy tongue. What type of infection does the patient have?

A) Glossitis: Glossitis refers to inflammation of the tongue, which can lead to redness, swelling, and sometimes a smooth appearance. It does not typically cause whitish thickening or growths in the mouth that cannot be scraped off. Glossitis is more related to the tongue's surface rather than abnormal growths or lesions.

B) Tonsillitis: Tonsillitis is an infection or inflammation of the tonsils, typically caused by viral or bacterial infections. It results in sore throat, swelling of the tonsils, and sometimes white patches. However, tonsillitis does not cause whitish thickening or growths on the oral mucosa that cannot be scraped off, making it an unlikely diagnosis here.

C) Herpes simplex: Herpes simplex virus (HSV) infections can cause oral lesions, such as cold sores or blisters. These lesions are usually painful, fluid-filled, and can be scraped off. They do not cause thick, white, non-scrapable growths like leukoplakia does.

D) Leukoplakia: Leukoplakia refers to the development of thick, white patches on the mucous membranes of the mouth, which cannot be scraped off. It is often associated with conditions like HIV, smoking, and chronic irritation. The presence of leukoplakia in an HIV-positive patient is concerning because it can be precancerous. This is the correct term for the finding described in the question.

A) Cataracts: Cataracts are a condition where the lens of the eye becomes cloudy, leading to blurred vision. While cataracts can impact vision, they do not cause fixed, dilated pupils. Cataracts would typically affect the clarity of vision rather than pupil size and response.

B) Miosis: Miosis refers to constricted pupils that are smaller than normal, typically less than 2 mm in size. The finding described in the question (fixed and 7 mm) is the opposite of miosis, which would indicate excessively small pupils.

C) Astigmatism: Astigmatism is a refractive error caused by an irregular shape of the cornea or lens, resulting in blurry vision. It is unrelated to the size or responsiveness of the pupils and does not cause fixed or dilated pupils, making it an inappropriate choice for this finding.

D) Mydriasis: Mydriasis refers to the dilation of the pupils, typically greater than 6 mm in size. When the pupils are fixed and dilated (7 mm, as described), this condition is termed mydriasis. It can occur due to various factors such as certain medications, trauma, or neurological issues. The nurse should document this finding as mydriasis and notify the healthcare provider for further assessment.