A nurse is caring for a school-age child who has a systemic disorder and is
receiving antibiotics, immunosuppressants, and corticosteroids. Both of the child's parents have a smoking history.
The child reports soreness in his mouth and refuses to eat.
Inspection of his mouth reveals a white, milky plaque that does not come off with
rubbing.
The nurse should suspect which of the following conditions?
Dermatitis
Candidiasis
Herpes simplex
Squamous cell carcinoma.
The Correct Answer is B
The nurse should suspect candidiasis, also known as oral thrush.
Candidiasis is a fungal infection that can occur in the mouth and is characterized by the presence of a white, milky plaque that does not come off with rubbing.
The child’s use of antibiotics, immunosuppressants, and corticosteroids can increase the risk of developing candidiasis.
Choice A is incorrect because dermatitis is an inflammation of the skin and
would not present as a white plaque in the mouth.
Choice C is incorrect because herpes simplex typically presents as painful blisters or sores in the mouth.
Choice D is incorrect because squamous cell carcinoma typically presents as a firm, painless growth, or ulcer in the mouth.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C"]
Explanation
Choice A rationale: Teaching caregivers to change diapers immediately when wet is essential for preventing skin breakdown and secondary infections, especially when an infant has been experiencing high fevers or potential gastrointestinal distress.
Choice B rationale: Administering 16 oz of water to an infant after each stool is dangerous. Infants are at high risk for water intoxication and electrolyte imbalances; rehydration should involve breast milk, formula, or oral rehydration solutions.
Choice C rationale: Cleansing the diaper area with mild soap and water is a standard nursing intervention to maintain skin integrity. It removes irritants and bacteria effectively, reducing the risk of developing a secondary diaper dermatitis.
Choice D rationale: Collecting nasal drainage for culture is not indicated based on the provided vital signs. The infant's temperature has improved, and there is no specific evidence of a worsening respiratory infection requiring a culture.
Choice F rationale: Caregivers should never apply talcum powder to an infant’s skin creases. Talcum powder poses a significant aspiration risk and can lead to severe respiratory distress or chronic lung irritation if inhaled.
Choice G rationale: Using a nasal aspirator should be done before feedings, not after. Suctioning after a feeding can trigger the gag reflex and cause the infant to vomit, increasing the risk of aspiration.
Correct Answer is C
Explanation
Infants with spina bifida are at an increased risk of developing a latex allergy
due to repeated exposure to latex products during medical procedures.
Providing a latex-free environment can help prevent the development of an allergy.
Choice A is not correct because limiting visitors to immediate family members is not necessary for the care of an infant undergoing surgical closure of the myelomeningocele sac.
Choice B is not correct because maintaining the infant in the supine position is not necessary for this procedure.
Choice D is not correct because initiating contact precautions is not necessary for this procedure.
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