An 8-year-old presents to the emergency room with burns to both legs. During assessment, the nurse notes that the burn on his right foot is dry in appearance with eschar tissue. The dermal elements are not present. When asked about sensation, the patient does not express pain at the site of the burn. The nurse knows that this burn is most likely classified as which type of burn?

Choice A reason: Antibiotics for otitis media do not contraindicate MMR vaccination, as antibiotics treat bacterial infections and do not interfere with the immune response to this live attenuated vaccine. The MMR can be safely administered in children with mild bacterial infections, making this an incorrect contraindication.

Choice B reason: Congenital immunodeficiency (e.g., severe combined immunodeficiency) is a contraindication for MMR, a live attenuated vaccine. Such conditions impair the immune system’s ability to control the attenuated virus, risking severe infection. Avoiding MMR in these children prevents life-threatening complications, making this the correct contraindication for the vaccine.

Choice C reason: A mild cough and temperature of 37.7°C (99.9°F) indicate a minor illness, which is not a contraindication for MMR vaccination. Live vaccines like MMR can be safely given during mild infections, as they do not significantly impair the immune response, making this an incorrect choice.

Choice D reason: A fever of 38.3°C (101°F) after previous immunizations is a common, transient reaction and not a contraindication for MMR. It does not indicate an immune deficiency or hypersensitivity that would prevent future vaccinations, making this an incorrect choice for withholding the MMR vaccine.

Choice A reason: Partial thickness burns affect the epidermis and part of the dermis, preserving some nerve endings and dermal structures like hair follicles, resulting in pain, redness, and blisters. The described burn, with no sensation, dry eschar, and absent dermal elements, indicates deeper tissue damage beyond the dermis, making partial thickness incorrect.

Choice B reason: Subcutaneous burn is not a standard term in burn classification systems. Burns are categorized by depth as superficial, partial thickness, or full thickness. Subcutaneous refers to tissues beneath the dermis, but the described burn’s features—dry eschar and no sensation—align with full thickness burns, making this choice inappropriate.

Choice C reason: Scalding burn refers to the cause of injury, specifically hot liquids or steam, not the depth of tissue damage. Scalds can result in superficial, partial, or full thickness burns. The clinical findings of dry eschar and no sensation indicate a full thickness burn, not the mechanism, rendering scalding burn incorrect.

Choice D reason: Full thickness burns extend through the entire dermis into subcutaneous tissue, destroying nerve endings and dermal elements, leading to dry, leathery eschar and no pain sensation. The described burn’s characteristics—dry appearance, eschar, and lack of sensation—match this classification, requiring debridement to remove necrotic tissue for healing.