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A nurse is checking a school-age child for pediculosis capitis. Which of the following findings is a definitive indication of this condition?
- A. Firmly attached white particles on the hair
- B. Itching and scratching of the head
- C. Thick, yellow-crusted lesions on a red base
- D. Patchy areas of hair loss
Correct Answer: A
Rationale: Firmly attached white particles on the hair: Firmly attached white particles on the hair are characteristic of nits, which are the eggs of lice. While this finding supports the diagnosis of pediculosis capitis, it is not a definitive indication on its own. Itching and scratching of the head: Itching and scratching of the head are common symptoms of pediculosis capitis. However, they are also common symptoms of various other scalp conditions, so they are not definitive indications. Thick, yellow-crusted lesions on a red base: This description is more characteristic of impetigo, a bacterial skin infection, rather than pediculosis capitis. Impetigo typically presents with yellow-crusted lesions on a red base, but it does not involve lice infestation. Patchy areas of hair loss: Patchy areas of hair loss are not typically associated with pediculosis capitis. This finding is more suggestive of conditions like alopecia areata or fungal infections.
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A nurse is caring for a child who has atopic dermatitis. Which of the following findings should the nurse expect?
- A. Maculopapular lesions between fingers and toes
- B. Inflamed area with white exudate
- C. Nonpruritic erythematous papule
- D. Rash with thick skin
Correct Answer: D
Rationale: Maculopapular lesions between fingers and toes: This finding is not typically associated with atopic dermatitis. Maculopapular lesions between the fingers and toes are more commonly seen in conditions like scabies or fungal infections. Inflamed area with white exudate: This finding is also not characteristic of atopic dermatitis. An inflamed area with white exudate may indicate a bacterial infection rather than atopic dermatitis. Nonpruritic erythematous papule: Atopic dermatitis often presents with erythematous (red) papules (small raised bumps) that are pruritic (itchy). However, the presence of nonpruritic lesions is less typical of atopic dermatitis. Rash with thick skin: This finding is consistent with atopic dermatitis. Chronic scratching and rubbing of the affected areas can lead to thickening of the skin (lichenification) in individuals with atopic dermatitis.
A nurse is preparing to administer vaccines to a 4-month-old infant. Which of the following vaccines should the nurse plan to administer?
- A. Influenza
- B. Rotavirus
- C. Measles, mumps, rubella (MMR)
- D. Varicella (VAR)
Correct Answer: B
Rationale: Influenza: The influenza vaccine is typically administered annually starting at 6 months of age. It helps protect against seasonal influenza viruses and is usually recommended during the fall or winter months. Rotavirus: The rotavirus vaccine is routinely administered to infants starting at 2 months of age, with additional doses given at 4 and 6 months of age. It helps prevent rotavirus infection, which can cause severe diarrhea and vomiting in infants and young children. Measles, mumps, rubella (MMR): The MMR vaccine is typically administered around 12-15 months of age, with a second dose given at 4-6 years of age. It helps protect against measles, mumps, and rubella, which are contagious viral infections that can cause serious complications. Varicella (VAR): The varicella vaccine, also known as the chickenpox vaccine, is usually administered around 12-15 months of age, with a second dose given at 4-6 years of age. It helps prevent chickenpox, a highly contagious viral infection characterized by a rash and fever.
A nurse is caring for a child who has Hirschsprung disease. Which of the following findings should the nurse expect?
- A. Ridged abdomen
- B. Ribbonlike, foul-smelling stools
- C. Projectile vomiting
- D. Chronic hunger
Correct Answer: B
Rationale: Ridged abdomen - This finding is not typically associated with Hirschsprung disease. Instead, the abdomen may appear distended or bloated due to the accumulation of stool in the colon. Ribbonlike, foul-smelling stools - This is a characteristic finding in Hirschsprung disease. Because the affected portion of the colon lacks nerve cells (ganglion cells) responsible for peristalsis, stool movement is impaired, leading to the passage of narrow, ribbonlike stools. These stools may also have a foul odor due to bacterial overgrowth in the affected area. Projectile vomiting - Projectile vomiting is not a common finding in Hirschsprung disease. It is more commonly associated with conditions such as pyloric stenosis or gastroesophageal reflux. Chronic hunger - Chronic hunger is not a typical finding in Hirschsprung disease. Instead, affected infants may experience feeding difficulties, constipation, and failure to thrive due to the obstruction of stool in the colon. They may also exhibit symptoms such as abdominal distention, vomiting, and refusal to feed.
A nurse is collecting data from an infant who has otitis media. The nurse should expect which of the following findings?
- A. Increase in appetite
- B. Tugging on the affected ear lobe
- C. Erythema and edema of the affected auricle
- D. Bluish-green discharge from the ear canal
Correct Answer: B
Rationale: Increase in appetite: Otitis media, an infection or inflammation of the middle ear, typically causes discomfort and pain in infants. As a result, they may experience a decrease in appetite rather than an increase. Tugging on the affected ear lobe: Tugging or pulling on the affected ear lobe is a common sign of ear pain in infants with otitis media. It occurs because the pain from the middle ear extends to the outer ear canal. Erythema and edema of the affected auricle: Otitis media primarily affects the middle ear, so erythema (redness) and edema (swelling) are not typically observed on the outer ear (auricle). Instead, these symptoms are more commonly seen in external ear infections, such as otitis externa. Bluish-green discharge from the ear canal: Bluish-green discharge from the ear canal is not a typical finding in otitis media. It may suggest a secondary bacterial infection or another underlying condition, but it is not a characteristic feature of otitis media.
A nurse is caring for an infant who has gastroesophageal reflux. The nurse should place the infant in which of the following positions after feeding?
- A. Left side
- B. Upright
- C. Right side
- D. Prone
Correct Answer: B
Rationale: Left side: Placing the infant on the left side after feeding is not typically recommended for managing gastroesophageal reflux. This position may not provide optimal support for digestion and may not effectively reduce reflux symptoms. Upright: This is the correct answer. Placing the infant in an upright position after feeding can help reduce gastroesophageal reflux. Gravity helps keep stomach contents down, preventing them from flowing back up into the esophagus. Holding the infant upright on the caregiver's shoulder or in a baby carrier can be effective in minimizing reflux symptoms. Right side: Placing the infant on the right side after feeding is not typically recommended for managing gastroesophageal reflux. Similar to the left side, this position may not provide optimal support for digestion and may not effectively reduce reflux symptoms. Prone: Placing the infant in a prone (face-down) position after feeding is not recommended due to the risk of sudden infant death syndrome (SIDS). Prone positioning is associated with an increased risk of SIDS, and current guidelines advise against placing infants to sleep or rest on their stomachs. Additionally, a prone position may not effectively reduce gastroesophageal reflux and may pose other risks to the infant's health and safety.