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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
A 10-year-old child with asthma and a PCO₂ of 37 mm Hg is within the normal range for partial pressure of carbon dioxide (PaCO₂), which is typically between 35-45 mm Hg. While asthma can be serious, the given PCO₂ level does not indicate an immediate life-threatening situation.
Choice B Reason:
A 10-year-old child with sickle cell anemia reporting severe chest pain is experiencing a potentially life-threatening complication known as acute chest syndrome. This condition is a leading cause of mortality in sickle cell patients and requires immediate medical attention. Acute chest syndrome can lead to severe respiratory distress and hypoxia, making it critical to assess and treat promptly.
Choice C Reason:
A 1-year-old toddler with roseola and a temperature of 39°C (102.2°F) has a fever, which is common in viral infections like roseola. While the fever needs monitoring and management, it is not as immediately life-threatening as acute chest syndrome in sickle cell anemia.
Choice D Reason:
A 7-year-old child with diabetes insipidus and a urine specific gravity of 1.016 is within the normal range for urine specific gravity, which is typically between 1.005 and 1.030. Although diabetes insipidus requires management to prevent dehydration, the given specific gravity does not indicate an acute crisis.
Correct Answer is ["5.3"]
Explanation
Calculation Steps
Step 1: Convert the child’s weight from pounds to kilograms.
28 lb ÷ 2.2 = 12.7272 kg
Result: 12.7272 kg
Step 2: Calculate the total dose in milligrams.
10 mg/kg × 12.7272 kg = 127.272 mg
Result: 127.272 mg
Step 3: Determine the volume of acetaminophen to administer.
(127.272 mg) ÷ (120 mg/5 mL) = (127.272 × 5) ÷ 120 = 636.36 ÷ 120 = 5.303 mL
Result: 5.303 mL
Step 4: Round the answer to the nearest tenth.
5.303 mL rounds to 5.3 mL
Result: 5.3 mL
Therefore, the nurse should administer 5.3 mL of acetaminophen.
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