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: Slightly crooked teeth may complicate oral hygiene but are not a primary cause of cavities, which depend more on brushing and diet. Malocclusions affect chewing efficiency, making this less accurate and incorrect compared to the functional impact of misaligned teeth noted during the assessment.

Choice B reason: Malocclusions do not directly cause infections or tooth loss unless severe and untreated. Slight cross-over primarily impacts chewing and jaw function, not infection risk, making this exaggerated and incorrect for the primary reason to seek orthodontic consultation for the teenager’s teeth.

Choice C reason: Social impacts like dating or hiring are speculative and not the primary clinical concern for slight malocclusions. Chewing and jaw efficiency are direct functional issues, making this psychosocial focus less relevant and incorrect for the orthodontic referral rationale in this clinical scenario.

Choice D reason: Slight malocclusions, like crossed front teeth, can impair chewing and jaw function, leading to inefficient mastication or strain. This functional concern justifies orthodontic evaluation, aligning with dental health principles, making it the correct reason to recommend seeing an orthodontist for the teenager.

Choice A reason: Rubbing the nose upward and backward, known as the "allergic salute," is a common response in allergic rhinitis to relieve nasal itching and congestion. This action temporarily opens air passages and alleviates discomfort, aligning with pediatric allergy evidence, making it the correct explanation for the child’s behavior observed in clinical settings.

Choice B reason: Drawing attention to the nose is not a typical response in allergic rhinitis. The "allergic salute" is a reflexive action to relieve itching and congestion, not a deliberate attempt to gain attention. This choice misinterprets the physiological basis of the behavior, making it incorrect for the child’s action in the context of allergic rhinitis symptoms.

Choice C reason: Nasal discharge may occur in allergic rhinitis, but rubbing upward and backward aims to relieve itching and open airways, not prevent discharge. This action is not primarily about controlling runny nose, making this choice less accurate compared to addressing the itching and congestion relief central to the child’s behavior.

Choice D reason: Preventing a sneeze is not the purpose of the "allergic salute." Rubbing the nose upward and backward relieves itching and congestion, common in allergic rhinitis. Sneezing is a separate reflex, and this action does not address it, making this incorrect for the child’s observed behavior in the context of allergy symptoms.