What initial action should the nurse practitioner take when treating a child with suspected head lice who has nits further than 1⁄4 inch from the scalp?

When treating a child with suspected head lice and nits that are more than a quarter-inch from the scalp, using a nit comb after a vinegar treatment is the most appropriate initial action. This method effectively helps in the removal of nits, as the comb is designed to extract both lice and their eggs from the hair.

The vinegar treatment can soften the adhesive used by nits to attach themselves to the hair strands, making it easier for the nit comb to do its job. This process is crucial in managing an infestation, especially in cases where the nits are not close to the scalp and may not pose a significant risk of transmission.

While other options may be relevant in different contexts, the focus on physical removal through combing, combined with a preparatory treatment such as vinegar, makes this approach particularly effective and appropriate in this scenario. It emphasizes the importance of mechanical removal in conjunction with chemical treatments to address head lice effectively.