An 8-year-old boy presents to the nurse practitioner with acute onset of "really itchy" small erythematous plaques, predominantly on the trunk. Approximately 2 weeks ago, the boy was treated for tonsillitis. Which of the following most closely explains his condition?
Psoriasis vulgaris presents with erythematous scaly plaques on the trunk and extensor surfaces of the limbs.
Generalized pustular psoriasis presents with an acute and rapidly progressive course characterized by diffuse redness and subcorneal pustules, and is often accompanied by systemic symptoms.
This presentation is guttate psoriasis triggered by group A Streptococcal infection of tonsils.
Inverse psoriasis affects the folds of the skin.
The Correct Answer is C
Choice A reason: Psoriasis vulgaris is the most common form of psoriasis and typically affects the scalp, elbows, knees, and lower back. While it can affect the trunk, it is more chronic and less likely to be triggered by a recent infection.
Choice B reason: Generalized pustular psoriasis is a severe and rare form of psoriasis that presents with widespread pustules and systemic symptoms such as fever and malaise. The boy’s presentation lacks pustules and systemic toxicity.
Choice C reason: Guttate psoriasis is characterized by small, drop-like erythematous plaques that often appear suddenly on the trunk and proximal extremities. It is commonly triggered by a recent group A Streptococcal infection, such as tonsillitis. This matches the boy’s history and clinical findings.
Choice D reason: Inverse psoriasis affects intertriginous areas such as the axillae, groin, and under the breasts. It presents with smooth, shiny lesions and is not typically triggered by streptococcal infections. The trunk distribution and recent tonsillitis make this diagnosis unlikely.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Schizoaffective disorder is diagnosed when psychotic symptoms occur both during and outside of mood episodes. In this case, the patient had psychosis before, during, and after a major depressive episode, fulfilling the criteria for schizoaffective disorder, depressive type.
Choice B reason: Bipolar disorder with psychotic features requires the presence of manic or mixed episodes, which are not described here. The absence of mania excludes bipolar disorder from consideration.
Choice C reason: Major depressive disorder with psychotic features involves psychosis that occurs exclusively during depressive episodes. Since the patient’s psychotic symptoms persisted beyond the resolution of depression, this diagnosis is not appropriate.
Choice D reason: Schizophrenia requires at least 6 months of continuous symptoms, including 1 month of active-phase symptoms. The timeline here is insufficient for schizophrenia, and the depressive symptoms are not “unspecified”—they meet criteria for a major depressive episode.
Correct Answer is C
Explanation
Choice A reason: These factors are associated with irritable bowel syndrome and other colonic disorders, not peptic ulcer disease. PUD affects the stomach and duodenum, not the colon.
Choice B reason: This describes the pathophysiology of inflammatory bowel diseases such as ulcerative colitis and Crohn’s disease. It does not apply to PUD, which is primarily driven by gastric acid and mucosal injury.
Choice C reason: PUD results from an imbalance between aggressive factors (e.g., gastric acid, pepsin, H. pylori, NSAIDs) and protective mechanisms (e.g., mucus, bicarbonate, mucosal blood flow). H. pylori disrupts mucosal defenses, and NSAIDs inhibit prostaglandin synthesis, both contributing to ulcer formation.
Choice D reason: LES dysfunction and TLESRs are associated with gastroesophageal reflux disease (GERD), not PUD. GERD involves reflux of gastric contents into the esophagus, whereas PUD involves mucosal erosion in the stomach or duodenum.
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