The clinic nurse receives a call from a parent of a 10-year-old who reports that their child just returned from summer camp and has developed an expanding circular red rash on the arm. The parent asks the nurse which over-the-counter (OTC) product is safe to use. How should the nurse respond?

Encourage the parent to come to the clinic if the child develops a fever.

Instruct the parent to apply an antihistamine ointment for one week.

Offer reassurance that OTC corticosteroid creams are safe and effective.

Explain the need for the child to have an immediate medical evaluation.

Answer and Explanation

The Correct Answer is D

Choice A reason: Encouraging the parent to come to the clinic if the child develops a fever is not the best response that the nurse can give. This is because a fever may indicate a serious infection, such as Lyme disease, that requires prompt treatment. The nurse should not wait for the child to develop a fever before advising the parent to seek medical attention.

Choice B reason: Instructing the parent to apply an antihistamine ointment for one week is not the best response that the nurse can give. This is because an antihistamine ointment may not be effective for a fungal infection, such as ringworm, or a bacterial infection, such as Lyme disease, that may cause a circular rash. The nurse should not recommend any OTC product without knowing the exact cause of the rash.

Choice C reason: Offering reassurance that OTC corticosteroid creams are safe and effective is not the best response that the nurse can give. This is because corticosteroid creams may worsen a fungal infection, such as ringworm, or mask the symptoms of a bacterial infection, such as Lyme disease, that may cause a circular rash. The nurse should not recommend any OTC product without knowing the exact cause of the rash.

Choice D reason: Explaining the need for the child to have an immediate medical evaluation is the best response that the nurse can give. This is because a circular rash can be a sign of a serious condition, such as Lyme disease, that requires urgent diagnosis and treatment. The nurse should inform the parent that the rash may not be ringworm, as many people assume, and that it may be caused by a tick bite or another factor. The nurse should also advise the parent to avoid touching or scratching the rash and to keep it clean and dry until the child sees a doctor.

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Correct Answer is B

Explanation

Choice A reason: Assessing for presence of a supernumerary breast nipple is not a relevant technique to determine if the client has reached the age of menarche. A supernumerary breast nipple is an extra nipple that develops along the embryonic milk line, usually in the chest or abdomen. It is a congenital anomaly that affects about 1% to 5% of the population, and it has no relation to the onset of menstruation.

Choice B reason: Using the Tanner staging to determine sexual maturity is a valid technique to determine if the client has reached the age of menarche. The Tanner staging is a scale that assesses the development of secondary sexual characteristics, such as breast growth, pubic hair growth, and genital development, in relation to the chronological age of the child. The Tanner staging can help estimate the stage of puberty and the likelihood of menarche, which usually occurs around Tanner stage 3 or 4 in girls.

Choice C reason: Palpating for evidence of temporary gynecomastia is not an appropriate technique to determine if the client has reached the age of menarche. Gynecomastia is the enlargement of breast tissue in males, due to hormonal imbalance, medication side effects, or other causes. It is a common condition that affects up to 70% of adolescent boys, and it usually resolves spontaneously within a few months or years. Gynecomastia has no relevance to the onset of menstruation in girls.

Choice D reason: Calculating approximate age menstruation should occur is not a reliable technique to determine if the client has reached the age of menarche. The age of menarche varies widely among individuals, depending on genetic, environmental, nutritional, and psychosocial factors. The average age of menarche in the United States is about 12.5 years, but it can range from 8 to 16 years. Therefore, calculating the approximate age of menarche based on averages or norms may not reflect the actual situation of the client.

A. Ask the boy to describe a typical day at school. B. Conduct a complete neurological assessment. C. Counsel the parents to pay more attention to the child. D. Compare the child's vital signs over the past three weeks.

Correct Answer is A

Explanation

Choice A reason: Asking the boy to describe a typical day at school is the best intervention that the nurse can implement. This can help the nurse identify any possible sources of stress or anxiety that may be causing the boy's physical symptoms. The nurse can also provide emotional support and guidance to the boy and his parents on how to cope with the school-related challenges.

Choice B reason: Conducting a complete neurological assessment is not the best intervention that the nurse can implement. This is not necessary unless the boy has other signs of neurological problems, such as seizures, vision changes, or altered mental status. A neurological assessment may also be invasive and uncomfortable for the boy and may increase his anxiety.

Choice C reason: Counseling the parents to pay more attention to the child is not the best intervention that the nurse can implement. This may imply that the parents are neglectful or irresponsible, which may not be true. The nurse should avoid making assumptions or judgments about the parents' behavior and instead collaborate with them to find the best solutions for the child's well-being.

Choice D reason: Comparing the child's vital signs over the past three weeks is not the best intervention that the nurse can implement. This may not provide much useful information, as the child's vital signs may vary depending on the time of day, activity level, and emotional state. The nurse should focus more on the child's subjective complaints and psychosocial factors.

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The clinic nurse receives a call from a parent of a 10-year-old who reports that their child just returned from summer camp and has developed an expanding circular red rash on the arm. The parent asks the nurse which over-the-counter (OTC) product is safe to use. How should the nurse respond?

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Naxlex Comprehensive Predictor Exams

A mother brings her preteen daughter to the clinic for her first female examination. During the health assessment, the nurse should implement which technique to determine if the client has reached the age of menarche?

Correct Answer is B

Explanation

A 10-year-old boy has been seen frequently by the school nurse over the past three weeks after school begins in the fall. He reports headaches, stomach aches, and difficulty sleeping. Which intervention should the nurse implement?

Correct Answer is A

Explanation

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