NCLEX- Pediatrics Infectious & communicable diseases

A mother of a child brings the child to a clinic and reports that the child has a fever and has developed a rash on the neck and trunk. Roseola is diagnosed, and the mother is concerned that her other children will contract the disease. Which instruction should the nurse reinforce to the mother to prevent the transmission of the disease? 1."Disease transmission is unknown." 2."The disease is transmitted through the urine and feces, so the other children should use a separate bathroom." 3."The disease is transmitted through the respiratory tract, so the child should be isolated from the other children as much as possible." 4."The disease is transmitted by contact with body fluids, so any items contaminated with body fluids need to discarded in a separate receptacle."

1."Disease transmission is unknown." The method of transmission of roseola is unknown. Options 2, 3, and 4 are not correct transmission routes of roseola.

The nurse of a well-baby clinic prepares to administer an immunization to a child. The mother of the child tells the nurse that the child has had a fever and is taking antibiotics. The nurse takes the child's temperature and notes that it is 101.5° F rectally. The nurse plans to take which action? 1.Delay the immunization. 2.Administer the immunization. 3.Administer one of the three scheduled immunizations. 4.Administer one half of the prescribed dose of each scheduled immunization.

1.Delay the immunization. High fevers and severe illnesses are reasons to delay immunization, but only until the child has recovered from the acute stage of the illness. Minor illnesses such as a cold, otitis media, or mild diarrhea without fever are not contraindications to immunization.

n planning care for a child with contact dermatitis, which concern is the highest priority for the child? 1.Pain 2.Infection 3.Skin breaks 4.Parental knowledge about care

1.Pain In any skin disorder, the goal with children is to offer comfort interventions so that the child can rest. Once pain has decreased, the skin can be assessed for integrity and infection. Although important, teaching is not the priority in this situation.

A child is diagnosed with scarlet fever. The nurse collects data regarding the child. Which is characteristic of scarlet fever? 1.Pastia's sign 2.Abdominal pain and flaccid paralysis 3.Dense pseudoformation membrane in the throat 4.Foul-smelling and mucopurulent nasal drainage

1.Pastia's sign Pastia's sign is a rash seen among children with scarlet fever that will blanch with pressure, except in areas of deep creases and in the folds of joints. The tongue is initially coated with a white furry covering with red projecting papillae (white strawberry tongue). By the fourth to fifth day, the white strawberry tongue sloughs off and leaves a red, swollen tongue (strawberry tongue). The pharynx is edematous and beefy red in color. Option 2 is associated with poliomyelitis. Options 3 and 4 are characteristics of diphtheria

The nurse reviews the home care instructions with a parent of a 3-year-old with pertussis. Which statement by the parent indicates a need for further teaching? 1."I know that my child will make a loud whooping sound." 2."I understand this whooping cough is viral and I have to let it run its course." 3."I understand that I need to watch for respiratory distress signs with pertussis." 4."I can reduce the environmental factors that can trigger coughing, like dust and smoke."

2."I understand this whooping cough is viral and I have to let it run its course." Pertussis is caused by the bacteria Bordetella pertussis and treatment requires antimicrobial therapy. Symptoms of pertussis consist of a respiratory infection followed by increased severity of cough with a loud whooping on inspiration. The child may experience respiratory distress, and the parents should be instructed on reducing environmental factors that cause coughing spasms, such as dust, smoke, and sudden changes in temperature.

The nurse obtains a health history from a mother of a 15-month-old child before administering a measles, mumps, and rubella (MMR) vaccine. Which is essential information to obtain before the administration of this vaccine? 1.A recent cold 2.Allergy to eggs 3.The presence of diarrhea 4.Any recent ear infections

2.Allergy to eggs Before the administration of a measles, mumps, and rubella vaccine, a thorough health history needs to be obtained. The MMR vaccine is used with caution in a child with a history of allergy to gelatin or eggs because the live measles vaccine is produced by chick embryo cell culture. The MMR vaccine also contains a small amount of the antibiotic neomycin. Options 1, 3, and 4 are not contraindications to administering this immunization.

A child with rubeola (measles) is being admitted to the hospital. When preparing for the admission of the child, which precautions should be implemented? Select all that apply. 1.Enteric 2.Contact 3.Airborne 4.Protective 5.Neutropenic

2.Contact 3.Airborne Rubeola is transmitted via airborne particles or direct contact with infectious droplets. Airborne precautions and contact precautions are required; a mask and gloves are worn by those who come in contact with the child. Gowns and gloves are not indicated. Articles that are contaminated should be bagged and labeled. Options 1, 4, and 5 are not indicated for rubeola

The nurse assigned to care for a child with mumps is monitoring the child for the signs and symptoms associated with the common complication of mumps. The nurse monitors for which sign/symptom that is indicative of this common complication? 1.Pain 2.Deafness 3.Nuchal rigidity 4.A red, swollen testicle

3. Nuchal rigidity The most common complication of mumps is aseptic meningitis, with the virus being identified in the cerebrospinal fluid. Common signs include nuchal rigidity, lethargy, and vomiting. A red, swollen testicle may be indicative of orchitis. Although this complication appears to cause most concern among parents, it is not the most common complication. Although mumps is one of the leading causes of unilateral nerve deafness, it does not occur frequently. Muscular pain, parotid pain, or testicular pain may occur, but pain does not indicate a sign of a common complication

The nurse is preparing to administer a measles, mumps, rubella (MMR) vaccine to a 15-month-old child. Before administering the vaccine, which question should the nurse ask the mother of the child? 1."Has the child had any sore throats?" 2."Has the child been eating properly?" 3."Is the child allergic to any antibiotics?" 4."Has the child been exposed to any infections?"

3."Is the child allergic to any antibiotics?" Before administration of the MMR vaccine, a thorough health history must be obtained. MMR is used with caution in a child with a history of an allergy to gelatin, eggs, or neomycin because the live measles vaccine is produced by chick embryo cell culture, and MMR also contains a small amount of the antibiotic neomycin. Options 1, 2, and 4 are not contraindications to administering immunizations.

The nurse reinforces home care instructions to the parents of a child hospitalized with pertussis. The child is in the convalescent stage and is being prepared for discharge. Which statement by the parents indicates a need for further teaching? 1."We need to encourage adequate fluid intake." 2."Coughing spells may be triggered by dust or smoke." 3."We need to maintain respiratory precautions and a quiet environment for at least 2 weeks." 4."Good hand-washing techniques need to be instituted to prevent spreading the disease to others."

3."We need to maintain respiratory precautions and a quiet environment for at least 2 weeks." Pertussis is transmitted by direct contact or respiratory droplets from coughing. The communicable period occurs primarily during the catarrhal stage. Respiratory precautions are not required during the convalescent phase. Options 1, 2, and 4 are components of home care instructions

A mother brings her 15-month-old child to the primary health care provider's office with complaints that the child has suddenly developed a bright red rash on her cheeks. She has no other symptoms and has been playing and eating as usual. Based on the appearance of the child, the nurse might suspect that the child has which communicable disease? 1.Rubella 2.Roseola 3.Fifth disease 4.Chickenpox

3.Fifth disease Fifth disease has the general appearance of "slapped cheeks." Many children do not have any symptoms before the appearance of the reddened cheeks. This characteristic is not associated with the communicable diseases identified in options 1, 2, or 4.

An adolescent is seen in the health care clinic with complaints of chronic fatigue. On physical examination, the nurse notes that the adolescent has swollen lymph nodes. A laboratory test is performed, and the results indicate the presence of Epstein-Barr virus (mononucleosis). The nurse calls the mother of the adolescent to inform the mother of the test results and reinforces instructions regarding the care of the adolescent. Which statement by the mother indicates an understanding of the care measures? 1."I need to keep my child on bed rest for 3 weeks." 2."I will call the primary health care provider if my child is still feeling tired in 1 week." 3."I need to isolate my child so that the respiratory infection is not spread to others." 4."I need to call the primary health care provider if my child complains of abdominal pain or left shoulder pain."

4."I need to call the primary health care provider if my child complains of abdominal pain or left shoulder pain." The mother needs to be instructed to notify the primary health care provider if abdominal pain, especially in the left upper quadrant, or left shoulder pain occurs because this may indicate splenic rupture. Children with enlarged spleens are also instructed to avoid contact sports until splenomegaly resolves. Bed rest is not necessary, and children usually self-limit their activity. No isolation precautions are required, although transmission can occur via saliva, close intimate contact, or contact with infected blood. The child may still feel tired in 1 week as a result of the virus.

The nurse is reviewing instructions to a parent of a 6-year-old on how to prevent influenza. Which statement by the parent indicates a need for further teaching? 1."I will get a flu shot and I will have my child get a flu shot too." 2."I will avoid having my child come into contact with sick children." 3."I will have my child wash her hands frequently during the flu season." 4."I will not let my child play with other children who have the flu unless they are taking acetaminophen.

4."I will not let my child play with other children who have the flu unless they are taking acetaminophen. Children who have influenza should be kept home and away from other children until they are fever-free without the use of antipyretics. Influenza may be prevented with the annual vaccine, by avoiding other children who are sick, and with frequent hand washing

A mother brings her 4-month-old infant to the well-baby clinic for immunizations. Which immunizations should be administered to this infant? 1.Diphtheria, tetanus, acellular pertussis (DTaP), Measles, mumps, rubella (MMR), inactivated poliovirus vaccine (IPV) 2.Varicella and hepatitis B vaccines 3.MMR, Hib, DTaP 4.DTaP, Hib, IPV, pneumococcal vaccine (PCV)

4.DTaP, Hib, IPV, pneumococcal vaccine (PCV) DTaP, Hib, IPV, and PCV are administered at 4 months of age. DTaP is administered at 2 months, 4 months, 6 months, between 12 and 18 months, and between 4 and 6 years of age. Hib is administered at 2 months, 4 months, 6 months, and between 12 and 15 months of age. IPV is administered at 2 months, 4 months, 6 months, and between 4 and 6 years of age. The first dose of MMR is administered between 12 and 15 months of age; the second dose is administered at 4 to 6 years of age (if the second dose was not given by 4 to 6 years of age, it should be given at the next visit). The first dose of hepatitis B vaccine is administered between birth and 2 months, the second dose is administered between 1 and 4 months, and the third dose is administered between 6 and 18 months of age. Varicella zoster vaccine is administered between 12 and 18 months of age. PCV is administered at 2, 4, and 6 months of age and between 12 and 15 months of age.

A child is diagnosed with infectious mononucleosis. The nurse reinforces homecare instructions to the parents about the care of the child. Which instruction should the nurse provide to the parents? 1.Maintain the child on bed rest for 2 weeks. 2.Maintain respiratory precautions for 1 week. 3.Notify the pediatrician if the child develops a fever. 4.Notify the pediatrician if the child develops abdominal or left shoulder pain.

4.Notify the pediatrician if the child develops abdominal or left shoulder pain. The parents need to be instructed to notify the pediatrician if abdominal pain (especially in the left upper quadrant) or left shoulder pain occurs, because this may indicate splenic rupture. Children with enlarged spleens are also instructed to avoid contact sports until the splenomegaly resolves. Bed rest is not necessary and children usually self-limit their activity. Respiratory precautions are not required, although transmission can occur via direct intimate contact or contact with infected blood. Fever is treated with acetaminophen

The mother of a toddler with mumps asks the nurse what she needs to watch for in her child with this disease. The nurse bases the response on the understanding that mumps is which type of communicable disease? 1.Skin rash caused by a virus 2.Skin rash caused by a bacteria 3.Respiratory disease caused by virus involving the lymph nodes 4.Respiratory disease caused by a virus involving the parotid gland

4.Respiratory disease caused by a virus involving the parotid gland Mumps is caused by a paramyxovirus that causes swelling from the parotid gland, causing jaw and ear pain. It is transmitted via direct contact or droplets spread from an infected person, salive from infected saliva, and possibly by contact with urine. Airborne and contact precautions are indicated during the period of communicability. Options 1, 2, and 3 are incorrect.

A child is brought to a clinic after developing a rash on the trunk and on the scalp. The parents report that the child has had a low-grade fever, has not felt like eating, and has been generally tired. The child is diagnosed with chickenpox. Which statement by the nurse is accurate regarding chickenpox? 1.The communicable period is unknown. 2.The communicable period ranges from 2 weeks or less up to several months. 3.The communicable period is 10 days before the onset of symptoms to 15 days after the rash appears. 4.The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions.

4.The communicable period is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions. The communicable period for chickenpox is 1 to 2 days before the onset of the rash to 6 days after the onset and crusting of lesions. In roseola the communicable period is unknown. Option 2 describes diphtheria. Option 3 describes rubella.

A child seen in the clinic is found to have rubeola (measles) and the mother asks the nurse how to care for the child. Which instruction should the nurse provide to the mother? 1.Keep the child in a room with dim lights. 2.Give the child warm baths to help prevent itching. 3.Allow the child to play outdoors because sunlight will help the rash. 4.Take the child's temperature every 4 hours and administer 1 baby aspirin for fever.

1.Keep the child in a room with dim lights. A nursing consideration in rubeola is eye care. The child usually has photophobia, so the nurse should suggest that the parent keep the child out of brightly lit areas. Children with viral infections are not to be given aspirin because of the risk of Reye's syndrome. Warm baths and the sun will aggravate itching. In addition, the child needs to rest

A child is diagnosed with chicken pox. The nurse collects data regarding the child. Which finding is characteristic of chicken pox? 1.Macular rash on the trunk and scalp 2.Pseudomembrane formation in the throat 3.Maculopapular or petechial rash on the extremities 4.Small, red spots with a bluish-white center and red base

1.Macular rash on the trunk and scalp A macular rash that first appears on the trunk and scalp and then moves to the face and the extremities is a characteristic of chicken pox. Pseudomembrane formation in the throat is characteristic of diphtheria. A maculopapular or petechial rash primarily on the extremities is characteristic of Rocky Mountain spotted fever. Small red spots with a bluish-white center and red base are known as Koplik spots and are characteristic of measles

Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the school children. Which statement, if made by a parent, indicates a need for further teaching regarding this communicable disease? 1."Small blue-white spots with a red base may appear in the mouth." 2."The rash usually begins centrally and spreads downward to the limbs." 3."Respiratory symptoms such as a very runny nose, cough, and fever occur before the development of a rash." 4."The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears."

4."The communicable period ranges from 10 days before the onset of symptoms to 15 days after the rash appears." The communicable period for rubeola ranges from 4 days before to 5 days after the rash appears, mainly during the prodromal (catarrhal) stage. Options 1, 2, and 3 are accurate descriptions of rubeola. The small blue-white spots found in this communicable disease are called Koplik spots. Option 3 describes the incubation period for rubella, not rubeola.

A mother brings her child to the clinic because the child has developed a rash on the trunk and scalp. The child is diagnosed with varicella. What will the nurse tell the mother about the infectious period? 1."The infectious period is unknown." 2."The infectious period ranges from 2 weeks or less up to several months." 3."The infectious period is 10 days before the onset of symptoms to 15 days after the rash appears." 4."The infectious period is 1 to 2 days before the onset of the rash to 5 days after the onset of lesions and the crusting of lesions."

4."The infectious period is 1 to 2 days before the onset of the rash to 5 days after the onset of lesions and the crusting of lesions." Varicella is known as chickenpox. The infectious period for varicella is 1 to 2 days before the onset of the rash to 5 days after the onset of lesions and the crusting of lesions. In roseola, the infectious period is unknown. Option 2 describes diphtheria. Option 3 describes rubella.

The nurse is caring for a hospitalized child with a diagnosis of rubella (German measles). The nurse reviews the primary health care provider's progress notes and reads that the child has developed Forchheimer sign. Based on this documentation, which should the nurse expect to note in the child? 1.Swelling of the parotid gland 2.Petechiae spots located on the palate 3.A fiery red edematous rash on the cheeks 4.Small blue-white spots noted on the buccal mucosa

2.Petechiae spots located on the palate Forchheimer sign refers to petechiae spots, which are reddish and pinpoint and located on the soft palate. Small blue-white spots noted on the buccal mucosa are known as Koplik's spots seen in rubeola. A fiery red edematous rash on the cheeks, also called "slapped cheeks" is seen in erythema infectiosum. Swelling of the parotid gland is seen in mumps.

Several children have contracted measles (rubeola) in a local school, and the nurse provides information to the mothers of the children about this communicable disease. Which statement by a mother indicates a need for further teaching? 1."The disease is caused by a virus." 2."We will watch for the complication of otitis media." 3."The symptoms increase in severity after the rash appears." 4."Small, irregular red spots with a minute, bluish white center are seen on buccal mucosa before the rash appears."

3."The symptoms increase in severity after the rash appears." Symptoms gradually increase in severity until second day after rash appears, when they begin to subside. Options 1, 2, and 4 are accurate descriptions of rubeola. Option 3 is not true for the rubeola disease.

A parent calls the clinic nurse to schedule an appointment for her child's diphtheria, tetanus, and pertussis vaccination. The parent tells the nurse that her child had a swelling at the injection site and low-grade fever after the last diphtheria, tetanus, and pertussis (DTaP) vaccination. Which instructions should the nurse give to the parent to lessen this type of reaction to the upcoming vaccination? 1.To give the child a sugary juice drink before coming to the clinic appointment 2.To request that the injection be given with a shorter needle than the one used before 3.To administer an appropriate dose of Tylenol 45 minutes before the appointment 4.To bring a dose of Tylenol to the appointment and administer it before leaving the clinic

3.To administer an appropriate dose of Tylenol 45 minutes before the appointment Nurses can involve the parent in minimizing the potential adverse effects of the vaccine by recommending administration of an appropriate dose of acetaminophen 45 minutes before the appointment time. A sugary drink will not be effective to lessen the pain of the injection. Needle length (appropriate to deliver into the muscle) is an important factor and fewer reactions to immunizations are observed when the vaccine is given deep into the muscle rather than into subcutaneous tissue. A shorter needle may place the vaccination into subcutaneous tissue. Giving the Tylenol after the injection can be advised, but the dose before the injection is more effective.

A preschool child who was admitted to the hospital for a minor surgery develops a rash on the second day after hospitalization and is diagnosed with chicken pox (varicella). The nurse should take which action to provide safety for all children on the unit? 1.Place only the infected child in isolation. 2.Keep siblings from visiting the infected child. 3.Place the child and any other children who were exposed in isolation. 4.Place the infected child and any immunocompromised children in isolation.

4.Place the infected child and any immunocompromised children in isolation. The period of communicability for chicken pox is 1 day before the eruption of vesicles to about 1 week when crusts are formed. The infected child should be isolated until vesicles have dried, and other high-risk children (immunocompromised) should be isolated from the infected client.