OB/PEDS (Pre-Quiz) 37 & 45

When developing the plan of care for a 5-year-old boy with Rocky Mountain spotted fever, the nurse knows the cause of the illness is:

the bite of a tick.

An adolescent is prescribed isotretinoin. Which statement indicates that the adolescent understands the necessary precautions associated with this drug?

"I have to make sure that I do not become pregnant while taking this drug."

The nurse is caring for a 13-year-old adolescent with acne vulgaris and is teaching the adolescent about skin care. Which response by the adolescent indicates a need for further teaching?

"I should avoid eating any kind of chocolate."

A topical corticosteroid is prescribed for a child with contact dermatitis. Which statement by the parent would indicate the teaching was successful?

"I should not cover the area with plastic wrap after applying the cream."

A child has been diagnosed with hookworm. The nurse is teaching the parent about the treatment for the condition. Which statement, made by the parent, confirms that further education is needed?

"My child can play outside bare footed when treatment is done."

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse?

"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."

The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which client statements indicate learning has occurred? (Select all that apply.)

"This is not a drug to be used for all forms of acne. My sister has minor acne so I told her this wasn't for her." "If I am sexually active I need to let my healthcare provider know." "It's important I get my CBC blood test when my healthcare provider orders it."

The nurse is providing home care instructions for the parents of an infant with cradle cap. Which response by the parents indicates a need for further teaching?

"We can scrape off the crusts on his scalp with a cotton swab."

The nurse is teaching the parents of a 6-year-old child who has sustained a large laceration about providing care to the wound at home. The nurse determines that the parents need additional teaching when they state:

"We need to keep the wound tightly bandaged for at least 3 days."

The nursing is caring for a hospitalized child diagnosed with varicella-zoster virus. The child's parents ask how to prevent the child's siblings from contracting the virus. Which response by the nurse is best?

"We will place your child on contact and airborne precautions. It is best for the other children not to visit."

A 6-year-old child is diagnosed with tinea capitis and treatment is initiated. The nurse instructs the parents to have the child return to school within which time frame?

1 week

A nursing instructor has presented a class on the stages of an infectious disease to a group of students and asks the students to place the stages in their proper sequence from beginning to end. Place the stages in their proper sequence.

1. Incubation 2. Prodrome 3. Illness 4. Convalescence

A nurse is working as part of a response team caring for children who have been involved in an elementary school fire. Which children would the nurse identify as needing a referral to a burn unit? (Select all that apply.)

6-year-old with burns involving the knees and hips 8-year-old with an inhalation injury 10-year-old with partial-thickness burns over 15% of the body 9-year-old with asthma and burns to the face

The physician has ordered ibuprofen 150 mg every 6 hours as needed for a 3-year-old child for a fever greater than 38 Celsius. The label of the ibuprofen bottle reads "ibuprofen oral suspension 100 mg/5 mL." How much ibuprofen liquid will the nurse administer if the child's temperature goes above 38 C? Record your answer using one decimal place

7.5

The nurse is caring for a 2-year-old child with a burn. What finding would warrant referral to a burn unit?

A chemical burn

A nurse is preparing a presentation for a local mothers' group about common viral infections associated with a rash during childhood. When describing rubella, what information would the nurse include? Select all that apply.

Any itching with the rash is usually mild. The infection is communicable for a week before to a week after the rash appears. Incubation period usually ranges from 16 to 18 days.

The nurse is caring for a child with urticaria. What is the priority action?

Assessing the child's airway and breathing and noting any wheezing or stridor

The nurse is performing a physical examination for a 7-year-old girl who was bitten by a tick. What would alert the nurse to the possibility of early localized Lyme disease?

Bull's-eye rash around the bite

An adolescent is to receive topical retinoid therapy for his moderately severe acne. The nurse would instruct the adolescent about which adverse effects? (Select all that apply.)

Burning Photosensitivity Dryness

The nurse is collecting data from a 14-year-old adolescent and parent who have come to the clinic for a check-up. The parent reports that the adolescent has had hives intermittently for the past 2 months. What is the priority action for this client?

Determine the underlying cause.

The nurse is caring for a child with a partial-thickness burn. What assessment findings would the nurse expect to observe?

Edema with wet blistering skin

The mother of a 10-year-old child diagnosed with rubella asks what can be done to help her child feel better during her illness. What information can be provided?

Encourage rest and relaxation.

What would the nurse include in the teaching plan for parents and their child with a pruritic rash? Select all that apply.

Encouraging pressure on the skin rather than scratching Making sure the child's hands are clean Using distraction to prevent scratching Keeping fingernails trimmed short

A group of nursing students are reviewing the functions of white blood cells. The students demonstrate an understanding of the information when they identify which white blood cell as responsible for combating allergic disorders?

Eosinophils

The nurse is taking a health history of a 6-year-old child with suspected Stevens--Johnson syndrome. During the physical examination, the nurse would expect to note which physical findings?

Erythema multiforme with inflammatory bullae of at least two types of mucosa

A child has been brought to the pediatric clinic. The assessment reveals the child has a temperature of 100.9°F (38.3°C), as well as a rash that is pink and has raised areas. When the area is palpated the skin blanches. Which disease is most associated with these findings?

Exanthem subitum

The nurse is caring for a 15-year-old adolescent with psoriasis. In addition to the plaques, what would the nurse expect to note?

Fissures and scaling on palms and soles

The nurse is teaching a group of parents about head lice. Which statement is essential to include during the presentation?

Head lice are becoming very resistant to treatment.

A nursing instructor is preparing a class discussion about pediatric skin variations, specifically related to differences in dark-skinned children. What information would the nurse most likely include? (Select all that apply.)

Hypopigmentation often occurs after a skin condition heals Hypertrophic scarring is a common occurrence in dark-skinned children Papules often appear more prominent on the skin

The nurse is preparing to provide education on the prevention of infection to parents of children. Which intervention(s) will the nurse include? Select all that apply.

Judicious antibiotic use Proper handling and preparation of foods Proper handwashing Vaccination administration Limiting exposure to sick persons

A child is brought to the clinic with fever, cough, and coryza. The nurse inspects the child's mouth and observes what look like tiny grains of white sand with red rings. How would the nurse document these findings?

Koplik spots

A child who developed parotid gland swelling on March 5 was diagnosed with mumps. The nurse determines that the child will no longer be contagious at which time?

March 14

The mother brings her neonate to the emergency department and states, "My baby just doesn't look right. I know something is wrong." Based on an assessment, the nurse suspects the neonate is experiencing sepsis. Which finding in the client's medical record will help to confirm this diagnosis?

Maternal membranes ruptured 20 hours before birth.

A child is brought to the emergency department by his parents. The parents report that he stepped on a rusty nail about a week and a half ago. The child is complaining of cramping in his jaw and some difficulty swallowing. The nurse suspects tetanus. When assessing the child, the nurse would be alert to which muscle groups being affected next?

Neck

After teaching a class to a group of nursing students about reporting infectious diseases to the Centers for Disease Control and Prevention, the instructor determines a need for additional discussion when the students identify which infection as being reportable:

Pinworm

The nurse is caring for a child with a suspected fungal infection. Which test would the nurse anticipate being ordered?

Potassium hydroxide (KOH) prep

An 8-year-old child requires wet dressings four times a day as treatment for a skin disorder. What would be most important for the nurse to do?

Premedicate the child before changing the dressing.

When assessing an adolescent for acne, what findings would lead the nurse to identify the acne as severe? (Select all that apply.)

Presence of nodules Widespread inflammatory lesions Evidence of cysts

A 6-year-old child is brought to the clinic by his parents. The parents state, "He had a sore throat for a couple of days and now his temperature is over 102°F (38.9°C). He has this rash on his face and chest that looks like sunburn but feels really rough." What would the nurse suspect?

Scarlet fever

A 14-year-old child is diagnosed with tinea versicolor. What would the nurse expect the nurse practitioner to order?

Selenium sulfide

The nurse is caring for a 7-year-old child with burns. Which finding would be highly suggestive that the burn is a result of child abuse?

Stocking--glove pattern on hands or feet

The nurse at the pediatrician's office receives a call from the mother of a child who has just been bitten by the neighbor's dog. What action would be the priority?

Tell the mother to seek medical help immediately.

A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder?

The child has had 8 ounces of formula in the past 24 hours.

A group of nursing students are reviewing information about atopic dermatitis. Which answers indicate that the students understand the information? (Select all that apply.)

The disorder is chronic with periods of remissions. The reaction occurs in response to specific allergens. Changes in temperature can contribute to flare-ups.

The nurse is caring for a 7-year-old child in droplet precautions due to the diagnosis of pertussis. While visiting the child, which actions by the parents require the nurse to intervene? Select all that apply.

The parents state, "We have been limiting our child's fluids to help decrease the amount of coughing." The parents state, "We should postpone immunizing our 5-year-old since there has been contact with the infection."

The nurse is caring for a child, weighing 100 lb (45.5 kg), on the burn unit who has partial-thickness burns on over 30% of the body. During the beginning shift assessment, which assessment finding is of most concern to the nurse?

Urine output of 15 mL per hour over the last 4 hours

The nurse is caring for a 10-year-old boy with diphtheria. What would the nurse institute as a tier 2 precaution?

Use of a protective mask

The nursing diagnosis of risk for infection related to a disruption in the protective skin barrier is noted on a child's plan of care. Which action would be of priority importance?

Using appropriate hand hygiene

The nurse is providing education to an adolescent who has tinea pedis. What information should be included in the discussion? (Select all that apply.)

Wear cotton socks. Keep feet clean and dry.

While assessing a child, the nurse notes a runny nose, temperature 100.4°F (38°C), and a whoop sound when the child coughs. On which diagnosis will the nurse anticipate providing education for this family?

pertussis