The caregivers of a child with a history of ear infections calls the nurse and reports that her son has just told her his urine “looks funny.” He also has a headache, and his mother reports that his eyes are puffy. Although he had a fever 2 days ago, his temperature is now down to 100 °F (37.8 °C). The nurse encourages the mother to have the child seen by the care provider because the nurse suspects the child may have:

Choice A reason: The “shortcut” scale is not a standard method for the West nomogram, which calculates body surface area (BSA) for precise dosing. Using BSA ensures accuracy for a 76-lb, 50-inch child, making this simplified approach incorrect for calculating a safe pediatric medication dosage in clinical practice.

Choice B reason: Aligning height and weight to a percentage of adult dosage is not how the West nomogram works; it calculates BSA. The correct method uses BSA relative to adult BSA, making this incorrect, as it skips the critical step of surface area calculation for accurate pediatric dosing.

Choice C reason: Multiplying height and weight and dividing the adult dosage is not a nomogram method. The West nomogram uses BSA to adjust doses, comparing child and adult surface areas, making this mathematically incorrect and inappropriate for calculating a safe pediatric medication dose for the child.

Choice D reason: The West nomogram calculates a child’s BSA using height (50 inches) and weight (76 lb), then divides by the average adult BSA (1.7 m²) to find the proportion of the adult dose (300 mg). This method ensures accurate pediatric dosing, making it the correct choice for safe administration.

Choice A reason: Perianal itching is the hallmark symptom of enterobiasis, caused by pinworms laying eggs at night, irritating the skin. This aligns with pediatric infectious disease evidence, making it the most likely history in a child admitted with pinworm infection, accurately reflecting the condition’s presentation.

Choice B reason: Malnutrition is not typically associated with pinworms, which cause localized irritation rather than systemic nutrient loss. Perianal itching is the primary symptom, making this incorrect, as it does not reflect the usual clinical history of a child with enterobiasis in a hospital setting.

Choice C reason: Bedwetting is unrelated to pinworm infection, which primarily causes perianal itching due to nocturnal egg-laying. Itching is the expected history, making this incorrect, as bedwetting does not correlate with the typical presentation of enterobiasis in a young admitted child.

Choice D reason: Restlessness may occur due to itching but is less specific than perianal itching, the defining symptom of pinworms. Itching directly ties to the diagnosis, making this less precise and incorrect compared to the primary history expected in a child with enterobiasis infection.