Chapter 36: Skin Conditions

The nurse in a pediatric clinic setting is aware of multiple children presenting with skin breakdown issues. Which contributing factors would the nurse identify as being preventable? SATA 1. Immobility issue 2. Immunosuppression 3. Deficient dietary intake 4. Poor hygiene practices 5. Genetic predispositions 6. Severe developmental delays

1. Immobility issue 3. Deficient dietary intake 4. Poor hygiene practices

Which parental statement indicates to the nurse an accurate understanding regarding the care of a child with tinea capitis (ringworm of the scalp)? 1) "We will give the griseofulvin with milk or peanut butter." 2) "We're glad ringworm isn't transmitted from person to person." 3) "Once the lesion is gone, we can stop the griseofulvin." 4) "Well, at least we don't have to worry about the family cat getting ringworm."

1) "We will give the griseofulvin with milk or peanut butter."

Which nursing action is accurate when applying a 5% permethrin lotion to a toddler with scabies? 1) Applying the lotion to the scalp, the forehead, and everywhere below the chin 2) Applying the lotion only to areas with evidence of activity 3) Applying the lotion only to the hands 4) Applying the lotion only to the scalp

1) Applying the lotion to the scalp, the forehead, and everywhere below the chin

The pediatric nurse is assessing a wound on a preschool-aged child's leg and notes that the site is pink with the formation of new epithelial cells. Based on these data, which term does the nurse use to describe the current stage of healing? 1) Proliferation 2) Inflammation 3) Restoration 4) Remodeling

1) Proliferation

Which preventive strategies for tinea pedis, a fungal infection also known as athlete's foot, should the nurse include in a teaching session for an adolescent client? SATA 1) Wear white, 100%-cotton socks, changed twice a day. 2) Use talc on the feet daily. 3) Use an over-the-counter corticosteroid cream to treat the area. 4) Wear foot covers such as flip-flops in the locker room and shower. 5) Apply heat to the area twice a day

1) Wear white, 100%-cotton socks, changed twice a day. 2) Use talc on the feet daily. 4) Wear foot covers such as flip-flops in the locker room and shower.

The LPN/LVN assists the RN in the preparation of a presentation to pediatric staff nurses about recognizing burns that are most likely associated with child abuse. Which comment by an attending nurse would indicate an understanding of the information? SATA 1. "A sock or glove burn results from holding the foot or hand in hot liquid and is frequently associated with abuse." 2. "Any burn with a mark associated with a familiar item is likely abuse." 3. "When both palms are burned from a hot oven, the child is most likely being abused." 4. "If a child has splash marks from a hot liquid, the parent is most likely abusing the child." 5. "Deep, circular marks are almost always indicative of cigarette burns and abuse."

1. "A sock or glove burn results from holding the foot or hand in hot liquid and is frequently associated with abuse." 2. "Any burn with a mark associated with a familiar item is likely abuse."

A father brings his 3-month-old infant to the pediatric clinic because of contact dermatitis in the infant's perineal area. Which comment made by the father to the nurse would indicate a need for reinforcing teaching? 1. "I tried cornstarch as advised by my mother." 2. "I clean the diaper area with cool water and a soft cloth." 3. "I only use soft cotton diapers washed in gentle detergent." 4. "The baby only receives breast milk and no formula."

1. "I tried cornstarch as advised by my mother."

A nurse is providing teaching to the parents of a young child with a fungal diaper rash. The nurse knows that more instruction needs to be provided when the parents make which statement? 1. "We will bathe the child in warm water with added hydrogen peroxide to treat the rash." 2. "We will bathe the child's skin to remove all layers of medication, diaper cream, and urine at least once a day." 3. "We will provide some diaper-free time to allow the skin to be exposed to air every day." 4. "We will assess for extending satellite lesions and will report if they are not improving."

1. "We will bathe the child in warm water with added hydrogen peroxide to treat the rash."

The mother of a 13-year-old is upset because the child had a tattoo placed on the upper arm. What should the nurse instruct this mother? 1. Apply sunblock over the tattoo 2. Cleanse the area with rubbing alcohol 3. Wash the area with hot water and soap 4. Dab the area with hydrogen peroxide daily

1. Apply sunblock over the tattoo

The nurse is observing an infant who is 9 months of age. The infant has red, raised, and weeping vesicles on the face and scalp. The nurse suspects the infant has eczema. Which finding would best support the nurse's suspicion? 1. Both parents have the condition. 2. The child has a history of allergies. 3. Laboratory reports support atopy. 4. The child is allergic to milk.

1. Both parents have the condition.

The nurse receives a call from a parent during the summer months. The parent reports the presence of "prickly heat" in a child who was outside all day. Which recommendations would the nurse offer to manage the condition? SATA 1. Cold compresses to inflamed areas. 2. Provide a warm oatmeal bath. 3. Apply aloe vera to the affected areas. 4. Dress in cool, loose clothing. 5. Apply sandalwood oil to involved areas.

1. Cold compresses to inflamed areas. 3. Apply aloe vera to the affected areas. 4. Dress in cool, loose clothing.

A licensed vocational nurse (LVN) is assisting in a class for new parents about injury prevention. What details are correct to include in the nurse's discussion of second-degree burns? SATA 1. Extend through the epidermis into the dermis 2. Edematous with weeping of moisture 3. Very painful 4. Extend through the epidermis 5. Heal at various speeds depending on size and location 6. Possibly require grafting

1. Extend through the epidermis into the dermis 2. Edematous with weeping of moisture 3. Very painful 5. Heal at various speeds depending on size and location 6. Possibly require grafting

A parent brings an adolescent girl to the clinic because of an inflamed eyebrow piercing. The girl shares that she and her friends gave each other the same piercing at the beach. She admitted to swimming afterward. Which intervention would the nurse expect to be prescribed? 1. Obtaining a bacterial and fungal skin-culture swab 2. Removal of the piercing jewelry 3. Testing to determine a metal allergy 4. Administration of pain medications as needed

1. Obtaining a bacterial and fungal skin-culture swab

The nurse is visiting a school with a history of head lice and a high rate of reinfestation among the children. Which observation would the nurse recommend the school address in order to control the problem? 1. Small, crowded coatroom 2. Large number of students per class 3. Lack of hand-washing facilities 4. Students switch seats for activities

1. Small, crowded coatroom

The LPN/LVN is reinforcing teaching by the RN to parents of a 2-year-old child with a skin condition. Which special considerations would the LPN/LVN reinforce? SATA 1. The age and developmental level of the child 2. That medications prescribed are often toxic. 3. The importance of keeping fingernails short 4. The reasons for frequent hand washing 5. That skin conditions are highly contagious

1. The age and developmental level of the child 3. The importance of keeping fingernails short 4. The reasons for frequent hand washing

The LPN/LVN is assisting with the care of children on a pediatric wound unit. Which children would the LPN/LVN identify as being at greatest risk for wound complications? SATA 1. The child who is immobile and incontinent with a pressure injury on the coccyx 2. The child with multiple wounds who experienced hemorrhage after an accident 3. The child who was accidentally cut with a hunting knife while camping with family 4. The child who has been receiving insulin therapy for the past 5 years. 5. The child with a severe foot wound on an extremity that was crushed in an accident

1. The child who is immobile and incontinent with a pressure injury on the coccyx 2. The child with multiple wounds who experienced hemorrhage after an accident 4. The child who has been receiving insulin therapy for the past 5 years. 5. The child with a severe foot wound on an extremity that was crushed in an accident

A parent calls the pediatric clinic and tells the nurse, "My son was bike riding and was exposed to poison ivy. I am not sure what to do." Which directions would the nurse provide the parent? SATA 1. Wash the child's exposed skin carefully. 2. Prevent the child from touching other body parts. 3. Wash all clothing worn by the child when exposed. 4. Carefully clean the child's bicycle and equipment. 5. Initially keep the child away from others.

1. Wash the child's exposed skin carefully. 2. Prevent the child from touching other body parts. 3. Wash all clothing worn by the child when exposed. 4. Carefully clean the child's bicycle and equipment. 5. Initially keep the child away from others.

A child is brought to a pediatric emergency department with burns acquired in a house fire. In which order would the health care team provide care for the child? Place the options in the correct order. 1. assess for a fluid shift 2. check for airway patency 3. assess for renal function and urine output 4. check lips and mouth for soot and smoke 5. monitor burn site for signs of infection

2,4,1,3,5

The LPN/LVN is assisting the RN in teaching a class to parents about child safety and the prevention of burns. When gathering information about the possibility of an electrical burn, which information would the LPN/LVN expect the RN to include? 1. Most house electrical outlets are low in strength. 2. Burns occur when electrical current passes through the body. 3. Dry metal objects inserted into an electrical socket will not cause a burn. 4. Serious electrical burns occur only if the person is standing in water.

2. Burns occur when electrical current passes through the body.

The LPN/LVN assists the RN in preparing a class for parents regarding sun exposure. Which information would the LPN/LVN expect the RN to include in the class materials? 1. Do not allow children under the age of 2 years to be exposed to the sun. 2. Children should wear protective clothing and a wide-brimmed hat. 3. From birth, infants require sunscreen with a SPF of 30 when outdoors. 4. Children should not be exposed to the sun between noon and 5 p.m.

2. Children should wear protective clothing and a wide-brimmed hat.

The LPN/LVN is assisting with the care of a preschool child admitted with cellulitis. The LPN/LVN observes red streaks from a reddened area with a small indentation in the center. For which reason would the LPN/LVN understand the child being admitted for IV antibiotic therapy? 1. The source is a spider bite. 2. Oral antibiotics were not effective. 3. The condition can progress quickly. 4. Antivenin is given intravenously.

2. Oral antibiotics were not effective.

A father is preparing to bathe his toddler when his cell phone rings. Turning to grab the phone, the father is momentarily distracted. The toddler climbs into the tub of scalding water and screams. What is the priority intervention? 1. Run cold water over the child. 2. Remove the child from the scalding water. 3. Call 911. 4. Check the child's airway.

2. Remove the child from the scalding water.

A new preschool teacher calls the pediatric clinic for guidelines on how to care for a child who presents with a large impetigo lesion. What is the most important action to prevent the spread of the infection? 1. Keep the lesion covered with a large adhesive bandage. 2. Teach the child and family good hand-washing techniques. 3. Cover the wound with a thick layer of zinc oxide to prevent the spread. 4. Tell the family they will need to keep the child at home until the lesion is healed.

2. Teach the child and family good hand-washing techniques.

Why are parents and caregivers instructed not to give aspirin to a child who presents with a rash caused by a viral agent? 1. To prevent masking a fever 2. To prevent the potentially serious risk of Reye syndrome 3. To prevent the child from developing Kawasaki disease 4. To encourage the child's fever to provide a natural pyrogenic effect that kills viruses

2. To prevent the potentially serious risk of Reye syndrome

The nurse is providing care for an infant diagnosed with severe contact dermatitis in the perineal area. The rash is red with white spots and is identified as a yeast infection. Which medication would the nurse anticipate being prescribed? 1. Antibacterial ointment 2. Topical antifungal cream 3. Oral antiviral medication 4. Antipruritic medications

2. Topical antifungal cream

How should parents be taught to bathe their infant who has severe eczema? 1. Soap and cool water twice daily during an exacerbation 2. Warm water only once a day with gentle pat drying 3. Bath water as hot as the child can tolerate to soothe the skin 4. Cold water soaks at least three times a day with air drying

2. Warm water only once a day with gentle pat drying

The pediatric nurse is providing a preschool-aged child's mother with information regarding impetigo. The mother is concerned about the possibility of passing the infection on to her other toddler-aged child. Which response by the nurse is most appropriate in this situation? 1 "I know that you are concerned about the health of both of your children. Your child has been prescribed 7 days of antibiotic therapy. After 24 hours of antibiotic therapy, you will not need to worry about any transmission of bacteria to your other child." 2 "Caring for both of your children right now will take more time than usual. Do you have anyone who can come and help you with their care?" 3 "To decrease the chance of exposing your younger child, both children must have all of their linens, towels, and toys washed to prevent the spread of disease. In addition, it is best to wash everyone's hands well." 4 "You need to

3) "To decrease the chance of exposing your younger child, both children must have all of their linens, towels, and toys washed to prevent the spread of disease. In addition, it is best to wash everyone's hands well."

The parent rushes the child to the emergency department with severe distress and audible wheezing. The parent states, "We were outside burning leaves and suddenly my child was having difficulty breathing." Which question would the nurse ask first? 1. "What did the child eat before going outside?" 2. "Did you notice a high level of dust from the leaves?" 3. "Could you have been burning poisonous plants?" 4. "Had the leaves been wet and moldy before?"

3. "Could you have been burning poisonous plants?"

The nurse is observing an infant who is 6 months old and was brought to the clinic with a papular rash on the chest, back, and upper arms. The parent states, "I noticed it right after he wore a new shirt." Which question would the nurse ask the parent first? 1. "What kind of detergent do you use?" 2. "How long was the shirt worn 3. "Did you wash the shirt before putting it on your child?" 4. "What is the fabric content?"

3. "Did you wash the shirt before putting it on your child?"

he LPN/LVN is assisting the RN in preparing a class for parents about burns. The RN covers information about first aid for children experiencing burns. Which comment by a parent would indicate an understanding of the RN's teaching? 1. "All burns require a trip to the emergency room." 2. "Put petroleum jelly on the burn to prevent contamination." 3. "I must immediately remove the source of the burn." 4. "Burns are cooled immediately with the application of an ice pack."

3. "I must immediately remove the source of the burn."

A student is brought by ambulance from a high school automotive class. The attending teacher states, "We flushed his face with water until the paramedics came." Which type of injury would the nurse expect the student to have received? 1. An electrical burn 2. A thermal burn 3. A chemical burn 4. A radioactive burn

3. A chemical burn

The LPN/LVN is assisting in the care of an infant being treated for third-degree burns on the buttocks, posterior upper thighs, lower legs, and feet. The parent states, "It was only a second before I realized the bath water was too hot." The report from Child Protective Services states that the home water heater was set on 56.1°C (133°F). What period of time would the LPN/LVN suspect the infant was in the water? 1. 1 second 2. 2seconds 3. 5 seconds 4. 15 seconds

4. 15 seconds

What causes the extending bright-red streaks associated with scabies? 1. The scratching of the child's fingernails 2. The spreading of the infectious bacteria 3. The burrowing of egg-laying mites 4. The enzymes released by the immune system

3. The burrowing of egg-laying mites

The LPN/LVN observes the skin of a pediatric patient as pictured. Which terminology would the LPN/LVN use to describe the skin condition? 1. Macular rash 2. Papular rash 3. Vesicle rash 4. Contact rash

3. Vesicle rash

A mother brings an infant to the pediatric emergency department with thermal burns to one arm and the back and chest area closest to the burned arm. Which statement by the mother would indicate the probable cause of the burn? 1. "I should have turned down the water heater." 2. "I know better than to place the baby on a heating pad." 3. "I should have turned the pan handles toward the stove front." 4. "I should never drink hot coffee while breastfeeding."

4. "I should never drink hot coffee while breastfeeding."

The LPN/LVN is assisting the RN with presenting information to male students on the high school football team. The focus is the prevention of cutaneous fungal infections. Which comment by an attendee would indicate a lack of understanding? 1. "Showering after practice is important." 2. "There are effective ways to clean equipment." 3. "I will not lend or borrow equipment." 4. "If I buy new equipment each season, I won't have to worry."

4. "If I buy new equipment each season, I won't have to worry."

The mother of a toddler is upset because the child experiences rashes in the winter. What should the nurse suggest to help with this skin condition? 1. Apply rubbing alcohol over the rash 2. Use a poly vinyl snowsuit when out of doors 3. Wash with hot water and antimicrobial soap 4. Ensure clothing fits loosely and is made of cotton

4. Ensure clothing fits loosely and is made of cotton

The LPN/LVN is assisting the RN in caring for a family battling scabies. Which information would the LPN/LVN expect the RN to teach the family? 1. Unwashable objects must to be thrown away. 2. The infestation indicates a lack of personal and environmental cleanliness. 3. Linens and clothing are washed weekly in hot water. 4. Furniture, floors, carpets, and car interiors require careful vacuuming.

4. Furniture, floors, carpets, and car interiors require careful vacuuming.

An infant who is 10 months of age is diagnosed with ringworm lesions on the scalp, arms, and legs. The parent denies contact with infected persons but mentions a large pet dog who has access to both the indoors and outdoors of the home. Which recommendation would the nurse offer regarding the family pet? 1. Keep the pet outdoors. 2. Keep the infant away from the pet. 3. Bathe the pet on a regular basis. 4. Have the pet checked by a veterinarian.

4. Have the pet checked by a veterinarian.

A child is admitted to the pediatric care facility for malnourishment and other indications of neglect. The admitting nurse notices red lines with bright red patchy lesions between the fingers and on the wrists, knees, and elbows. Which nursing intervention would the nurse implement immediately? 1. Bathe the child with an antibacterial soap in waist-high water. 2. Contact the health care provider and report the findings. 3. Implement measures to determine if the family needs medical attention. 4. Inform all health care personnel to use personal protective equipment (PPE).

4. Inform all health care personnel to use personal protective equipment (PPE).

A mother of a 10-year-old boy asks about the warts located on several of the fingers on her son's right hand. What is the best response by the nurse? 1. Warts are precancerous lesions that need to be surgically removed by a physician. 2. Warts are benign, not contagious, and will not spread anywhere else on your son's body. 3. Warts are caused by a variety of infectious organisms including fungi, viruses, and bacteria. 4. Warts are caused by the papillomavirus, can spread to other body parts and other people, and are treated with acids or freezing nitrogen.

4. Warts are caused by the papillomavirus, can spread to other body parts and other people, and are treated with acids or freezing nitrogen.

A toddler with a severe pruritic rash has an order for diphenhydramine (Benadryl). The dose is 0.5 milligram per kilogram of weight by mouth every 6 hours as needed. The child weighs 22.5 pounds. How much Benadryl will the nurse administer in one dose? ____________________

5.1 mg

__________ is an autoimmune disorder that typically presents in red rash that is not communicable to others.

eczema