A school nurse is assessing a school-age child and notices silver specks that resemble dandruff but don’t brush off the hair. The child continuously scratches at the nape of their neck. The nurse should suspect which of the following disorders?

Impetigo contagiosa

Folliculitis

Tinea capitis

Pediculosis capitis

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Impetigo contagiosa is a highly contagious bacterial skin infection that primarily affects children. It typically presents as reddish sores on the face, especially around the nose and mouth, which quickly rupture, ooze for a few days, and then form a honey-colored crust. While impetigo can cause itching, it does not produce silver specks that resemble dandruff or cause persistent scratching at the nape of the neck.

Choice B Reason:

Folliculitis is an infection of the hair follicles, often caused by bacteria, fungi, or viruses. It presents as small red bumps or white-headed pimples around hair follicles. Folliculitis can cause itching and discomfort, but it does not typically produce silver specks that resemble dandruff. The symptoms are more likely to include clusters of small red bumps or pus-filled blisters rather than dandruff-like specks.

Choice C Reason:

Tinea capitis, also known as scalp ringworm, is a fungal infection of the scalp. It can cause patches of hair loss, dry scaly rashes, severe itchiness, and sometimes swollen lymph nodes. While tinea capitis can cause flaking that resembles dandruff, it does not typically present with silver specks that do not brush off. The primary symptoms are more likely to include red, inflamed patches and hair loss.

Choice D Reason:

Pediculosis capitis, or head lice infestation, is characterized by the presence of lice and their eggs (nits) on the scalp and hair. The nits are often mistaken for dandruff but do not brush off easily. The primary symptoms include intense itching, especially at the nape of the neck and behind the ears, and the presence of small, white or silver specks (nits) attached to the hair shafts. This matches the description provided in the question, making pediculosis capitis the most likely diagnosis.

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Correct Answer is A

Explanation

Choice A Reason:

Aspirin is strongly associated with an increased risk of Reye syndrome in children, especially when given during a viral illness like influenza or chickenpox. Reye syndrome is a rare but serious condition that causes swelling in the liver and brain. The use of aspirin in children with viral infections can lead to this condition, making it crucial to avoid aspirin and instead use alternatives like acetaminophen or ibuprofen for fever and pain relief.

Choice B Reason:

Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that is generally considered safe for use in children to relieve pain and reduce fever. Unlike aspirin, ibuprofen does not carry the same risk of causing Reye syndrome. Therefore, giving ibuprofen to a child with influenza for muscle aches does not increase the risk of Reye syndrome.

Choice C Reason:

Using a humidifier in a child’s room can help alleviate symptoms of respiratory infections by keeping the air moist, which can soothe irritated airways and reduce congestion. This practice does not increase the risk of Reye syndrome and is generally considered a safe and supportive measure for children with influenza.

Choice D Reason:

Encouraging a child to drink grapefruit juice can be beneficial for hydration and providing essential vitamins. However, it has no direct connection to the risk of Reye syndrome. While grapefruit juice can interact with certain medications, it does not increase the risk of developing Reye syndrome in children with influenza.

A. “We will restrict the amount of salt in our child’s food.” B. “We will give our child pancreatic enzymes with snacks and meals.” C. “We will limit our child’s fluid intake.” D. “We will prepare low-fat meals with limited protein for our child.”

Correct Answer is B

Explanation

Choice A Reason:

The statement “We will restrict the amount of salt in our child’s food” is incorrect. Children with cystic fibrosis often lose more salt through their sweat than other children, especially in hot weather or during exercise. Therefore, they may need extra salt in their diet to compensate for this loss. Restricting salt intake can lead to hyponatremia, a condition characterized by low sodium levels in the blood, which can be dangerous.

Choice B Reason:

The statement “We will give our child pancreatic enzymes with snacks and meals” is correct. Most children with cystic fibrosis have pancreatic insufficiency, meaning their pancreas does not produce enough enzymes to digest food properly. Taking pancreatic enzyme supplements with all meals and snacks helps ensure that the child can absorb nutrients effectively, which is crucial for growth and overall health.

Choice C Reason:

The statement “We will limit our child’s fluid intake” is incorrect. Adequate hydration is essential for children with cystic fibrosis to help thin the mucus in their lungs and aid in its clearance. Limiting fluid intake can lead to dehydration, which can exacerbate respiratory symptoms and other complications associated with cystic fibrosis

Choice D Reason:

The statement “We will prepare low-fat meals with limited protein for our child” is incorrect. Children with cystic fibrosis require a high-calorie diet that includes adequate amounts of fat and protein to meet their increased energy needs. A diet low in fat and protein can lead to malnutrition and poor growth. Instead, a high-fat, high-protein diet is recommended to support their nutritional requirements.

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A school nurse is assessing a school-age child and notices silver specks that resemble dandruff but don’t brush off the hair. The child continuously scratches at the nape of their neck. The nurse should suspect which of the following disorders?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a child who has influenza. The nurse should identify which of the following statements by the parent indicates the child has an increased risk for Reye syndrome?

Correct Answer is A

Explanation

A nurse is providing discharge teaching about nutrition to the parents of a child who has cystic fibrosis (CF). Which of the following responses by the parents indicates an understanding of the teaching?

Correct Answer is B

Explanation

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