The school nurse is screening the kindergarten students. She notices many of the children are scratching their heads. Which is a common sign of head lice?

White flakes that are easily removed from hair shaft

Patchy bald spots over the scalp

Light brown colored dots attached to hair at nape of neck

Thick yellow crusts on the scalp

Answer and Explanation

The Correct Answer is C

A. White flakes that are easily removed from hair shaft: This description is characteristic of seborrheic dermatitis or dandruff rather than Pediculosis humanus capitis. Lice nits are firmly cemented to the hair shaft by a chitinous substance and cannot be flicked or blown away. Ease of removal is a primary clinical differentiator from an active infestation.

B. Patchy bald spots over the scalp: Alopecia areata or tinea capitis typically cause localized hair loss and circular bald patches. While scratching from lice can cause secondary excoriation, it does not typically result in discrete areas of hair loss. Bald spots suggest a fungal infection or an autoimmune process rather than parasites.

C. Light brown colored dots attached to hair at nape of neck: These represent nits, which are the eggs of head lice, frequently found in warm areas like the nape of the neck or behind ears. Their firm attachment to the hair shaft and proximity to the scalp are definitive diagnostic markers. Identifying these is the standard for confirming a lice infestation.

D. Thick yellow crusts on the scalp: This finding is most often associated with "cradle cap" or severe seborrheic dermatitis, which involves an overproduction of sebum. It is an inflammatory skin condition rather than a parasitic infestation. While it may cause itching, it lacks the specific presence of nits or live lice.

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Free Nursing Study Resources

Correct Answer is ["A","C","D"]

Explanation

A. The mole has patches of black, brown, and red colors within it: The C in the ABCDE mnemonic represents Color variation. Malignant melanoma often exhibits variegated pigmentation rather than a homogenous shade. Dysplastic melanocytes produce inconsistent melanin, resulting in diverse hues across the lesion.

B. The mole is 5mm in size: The D in the rule stands for Diameter, typically concerning when > 6mm. A 5mm lesion is below the standard threshold for clinical suspicion of malignancy. It does not meet the criteria for immediate reporting based on size alone.

C. The mole is asymmetrical, with one half different in shape from the other: Asymmetry, the A in the rule, suggests uncontrolled cellular proliferation. Benign nevi are usually symmetrical because growth occurs uniformly. Disparate halves indicate irregular architectural development within the epidermis or dermis, requiring further dermatologic evaluation.

D. The mole has an irregular and notched border: Border irregularity represents the B in the assessment tool. Poorly defined, scalloped, or notched edges are characteristic of cancerous lesions. This reflects the jagged horizontal growth phase of malignant cells as they invade surrounding healthy cutaneous tissue.

E. The mole is uniform in color with a light brown shade throughout: Homogenous pigmentation is a characteristic of benign melanocytic nevi. A singular shade suggests stable melanocyte activity without the chaotic pigment production seen in malignancy. This finding does not align with the ABCDE criteria for cancerous transformation.

A. Hold hands back-to-back while flexing the wrists to 90 degrees for 60 seconds B. Press the palms together for 2-3 seconds C. Interlace the metacarpals for 2-3 seconds D. Internally rotate the shoulders, pressing the hands into the back

Correct Answer is A

Explanation

A. Hold hands back-to-back while flexing the wrists to 90 degrees for 60 seconds: This position increases pressure within the carpal tunnel and compresses the median nerve against the flexor retinaculum. The test is considered positive if the patient experiences numbness or tingling in the median nerve distribution. It is a specific diagnostic maneuver for entrapment.

B. Press the palms together for 2-3 seconds: This action does not provide the necessary mechanical compression of the median nerve required for a provocative neurological test. Brief palm pressing lacks the specific anatomical positioning needed to elicit symptoms of nerve compression. It is not a recognized maneuver for carpal tunnel.

C. Interlace the metacarpals for 2-3 seconds: Interlacing the fingers or metacarpals does not put the carpal tunnel under sufficient stress to reproduce neurological symptoms. This movement does not target the median nerve at the wrist joint. It is an irrelevant action for diagnosing upper extremity nerve entrapment syndromes.

D. Internally rotate the shoulders, pressing the hands into the back: This movement assesses the internal rotation of the glenohumeral joint and the integrity of the rotator cuff. It has no diagnostic value for conditions affecting the distal upper extremity or the median nerve. It is used for shoulder rather than wrist evaluations.

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The school nurse is screening the kindergarten students. She notices many of the children are scratching their heads. Which is a common sign of head lice?

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findings align with the ABCDE rule and should be reported to the healthcare provider? Select all that apply.

Correct Answer is ["A","C","D"]

Explanation

The nurse suspects that the patient has carpal tunnel syndrome and wants to perform the Phalen test. How should the nurse instruct the patient?

Correct Answer is A

Explanation

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