A nurse prepares to apply topical permethrin for a child with scabies.
What should be included in the instructions?
Apply from neck to toes and leave on overnight.
Apply to affected areas only.
Apply only to the scalp.
Apply after a hot bath.
The Correct Answer is A
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
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.
Correct Answer is D
Explanation
Choice D rationale
Hirschsprung disease is characterized by the absence of ganglion cells in a segment of the colon, leading to impaired peristalsis and difficulty passing stool. Monitoring bowel movements is crucial to assess the effectiveness of treatment, identify signs of obstruction, and guide further interventions.
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