Pediatrics: Infectious and communicable disease/ throat and respiratory

A child is scheduled to receive inactivated poliovirus vaccine (IPV), and the nurse who is preparing to administer the vaccine reviews the child's record. The nurse questions the administration of IPV if which is documented in the child's record?

A history of anaphylactic reaction to neomycin

The mother of a hospitalized 2-year-old child with viral laryngotracheobronchitis (croup) asks the nurse why the health care provider did not prescribe antibiotics. Which response should the nurse make?

"Antibiotics are not indicated unless a bacterial infection is present."

A child is scheduled for a tonsillectomy in a day surgical unit. On the day after surgery, the mother calls the surgical unit and expresses concern because the child has a bad mouth odor. Which response is most appropriate?

"Bad mouth odor is normal and may be relieved by drinking more liquids."

A child hospitalized with pertussis is in the convalescent stage, and the nurse is preparing the child for discharge. The nurse has provided instructions to the parents for home care of the child. Which statement by a parent indicates a need for further teaching?

"I need to make sure that the child is isolated from the other children for at least 2 weeks to prevent the spread of the virus to them."

A child is seen in the health care clinic, and the nurse suspects the presence of pinworm infection (enterobiasis). The nurse instructs the mother as to how to obtain a cellophane tape rectal specimen. Which statement by the mother indicates an understanding of the correct procedure to obtain the specimen?

"I need to place a piece of transparent cellophane tape lightly over the anal area as soon as my child awakens and bring it to the clinic for examination."

The nurse is providing instructions to the mother of a child with croup regarding treatment measures if an acute spasmodic episode occurs. Which statement made by the mother indicates a need for further teaching?

"I should place a steam vaporizer in my child's room."

An adolescent is seen in the health care clinic with complaints of chronic fatigue. On physical examination, the nurse notes swollen lymph nodes, and laboratory test results indicate the presence of Epstein-Barr virus (mononucleosis). The nurse provides instruction regarding care of the adolescent. Which statement made by the mother indicates an understanding of the care measures?

"I will call the doctor if my child has abdominal or left shoulder pain."

The home care nurse provides instructions regarding basic infection control to the parent of an infant with human immunodeficiency virus (HIV) infection. Which statement, if made by the parent, indicates the need for further instruction?

"I will clean up any spills from the diaper with diluted alcohol."

A mother calls the health care provider's office requesting an appointment for her 8-year-old child. She states he has asthma and is telling her he had trouble breathing last night and does not want to go to school. In triaging this child, which is the most important question to initially ask the mother?

"Is your child telling you at this time he is having trouble breathing?"

The nurse provides instructions to the mother of a child with mumps regarding respiratory precautions, and the mother asks the nurse about the length of time required for the respiratory precautions. The nurse should make which statement to the mother?

"Precautions are indicated during the period of communicability."

The nurse is providing anticipatory guidance to the mother of a 10-month-old child. The mother asks how soon her daughter will be able to receive the chickenpox (varicella) vaccine. What is the best nursing response?

"She can receive it when she is 12 months old."

The clinic nurse is providing instructions to a parent of a child with cystic fibrosis regarding the immunization schedule for the child. Which statement should the nurse make to the parent?

"The child will receive the recommended basic series of immunizations along with a yearly influenza vaccination."

The nurse has provided instructions to the mother of a child with cystic fibrosis about appropriate dietary measures. Which statement by the mother indicates an understanding of these dietary measures

"The diet needs to be high in calories."

Several children have contracted rubeola (measles) in a local school, and the school nurse conducts a teaching session for the parents of the schoolchildren. Which statement made by a parent indicates a need for further teaching regarding this communicable disease?

"The disease can be spread to others from 10 days before any sign of the disease appears to 15 days after the rash appears."

A child is seen in a health care clinic, and a diagnosis of chickenpox is confirmed. The mother expresses concern for two other children at home and asks the nurse if the child is infectious to the other children. Which response by the nurse is most appropriate?

"The infectious period begins 1 to 2 days before the onset of the rash and ends about 5 days after the onset of the lesions and crusting of the lesions."

The nurse provides home care instructions to the parents of a child hospitalized with pertussis who is in the convalescent stage and is being prepared for discharge. Which statement by a parent indicates a need for further instruction?

"We need to maintain droplet precautions and a quiet environment for at least 2 weeks."

An ambulatory care nurse is preparing a list of instructions for the parents of a child who is being discharged after a tonsillectomy. The nurse should place which instructions on the list? Select all that apply.

-Avoid hot fluids. -Avoid raw vegetables. -Rest in bed or on a couch for 24 hours.

Which home care instructions should the nurse provide to the parent of a child with acquired immunodeficiency syndrome (AIDS)? Select all that apply.

-Monitor the child's weight. -Frequent hand washing is important. -The child should avoid exposure to other illnesses. -Clean up body fluid spills with bleach solution (10:1 ratio of water to bleach).

A child diagnosed with scarlet fever is being cared for at home. The home health nurse performs an assessment on the child and checks for which clinical manifestations of this disease? Select all that apply.

-Pastia's sign -White strawberry tongue -Petechial red, pinpoint spots on the soft palate

The nurse is preparing for the admission of an infant with a diagnosis of bronchiolitis caused by respiratory syncytial virus (RSV). Which interventions should the nurse include in the plan of care? Select all that apply.

-Place the infant in a private room. -Ensure that nurses caring for the infant with RSV do not care for other high-risk children.

The clinic nurse is assessing a child who is scheduled to receive a live virus vaccine (immunization). What are the general contraindications associated with receiving a live virus vaccine? Select all that apply.

-The child had a previous anaphylactic reaction to the vaccine. -The child has a disorder that caused a severely deficient immune system.

A child who is 4 years old is seen for a well-child checkup. He has been regularly receiving immunizations. Which immunizations should the child receive at this visit? Select all that apply.

-Varicella vaccine -Inactivated polio vaccine -Measles, mumps, rubella (MMR) vaccine

A child is receiving a series of the hepatitis B vaccine and arrives at the clinic with his parent for the second dose. Before administering the vaccine, the nurse should ask the child and parent about a history of a severe allergy to which substance?

A previous dose of hepatitis B vaccine or component

The nurse should expect to administer the first dose of the measles, mumps, and rubella (MMR) vaccine at which age?

12 months

The nursing student is assigned to administer immunizations to children in a clinic. The student should question whether to administer immunizations to a child with which condition?

A severe febrile illness

The mother of a child with cystic fibrosis (CF) asks the clinic nurse about the disease. What should the nurse tell the mother about CF?

A chronic multisystem disorder affecting the exocrine glands

The clinic nurse reads the results of a tuberculin skin test (TST) on a 3-year-old child. The results indicate an area of induration measuring 10 mm. The nurse should interpret these results as which finding?

Positive

The mother of a 6-year-old child arrives at a clinic because the child has been experiencing itchy, red, and swollen eyes. The nurse notes a discharge from the eyes and sends a culture to the laboratory for analysis. Chlamydial conjunctivitis is diagnosed. On the basis of this diagnosis, the nurse determines that which requires further investigation?

Possible sexual abuse

A child is scheduled for a tonsillectomy. The nurse plans care, knowing that which condition would be a priority because it presents the highest risk of aspiration during surgery?

Presence of loose teeth

After a tonsillectomy, a child is brought to the pediatric unit. The nurse should appropriately place the child in which position?

Prone

An infant is brought to the clinic for his third diphtheria-tetanus toxoid-acellular pertussis vaccination (DTaP). The mother reports that the infant developed a 99.4°F (37.4°C) temperature after the last DTaP. Which action is most appropriate?

Administer the vaccination.

A child with rubeola (measles) is being admitted to the hospital. In preparing for the admission of the child, the nurse should plan to place the child on which precautions?

Airborne

The nurse employed in an emergency department is monitoring a child diagnosed with epiglottitis. The nurse notes that the child is leaning forward with the chin thrust out. How should the nurse interpret this finding?

An airway obstruction

An infant receives a diphtheria, tetanus, and acellular pertussis (DTaP) immunization at a well-baby clinic. The parent returns home and calls the clinic to report that the infant has developed swelling and redness at the site of injection. Which intervention should the nurse suggest to the parent?

Apply a cold pack to the injection site.

A school-age child is seen in the health care provider's office for complaints of intense itching mostly at night. The health care provider makes a diagnosis of scabies and prescribes permethrin for treatment of the skin condition. Which at-home instruction should the nurse provide to the mother?

Apply the lotion liberally to the body and head, avoiding the eyes and mouth.

A school nurse is teaching parents about emergency treatment for epistaxis. Which best action should the nurse take to assist the parents in understanding the emergency treatment?

Ask the parents to demonstrate, on a mannequin, where to apply continuous pressure if a nosebleed occurs.

The nurse is caring for a child with a diagnosis of roseola. The nurse provides instructions to the mother regarding prevention of the transmission to siblings and other household members. Which instruction should the nurse provide?

Avoid allowing the children to share drinking glasses or eating utensils because the disease is transmitted through saliva.

A new parent expresses concern to the nurse regarding sudden infant death syndrome (SIDS). She asks the nurse how to position her new infant for sleep. In which position should the nurse tell the parent to place the infant?

Back rather than on the stomach

A child with acquired immunodeficiency syndrome is hospitalized for the treatment of Pneumocystis jiroveci pneumonia. The child will be receiving nebulizer treatments at home when discharged. The nurse instructs the mother regarding the maintenance of the nebulizer equipment. What should the nurse tell the mother to do?

Clean the nebulizer pieces with warm water after each treatment and allow to air dry.

The nurse is reviewing the laboratory results for a child scheduled for a tonsillectomy. The nurse determines that which laboratory value is most significant to review?

Prothrombin time

A parent brings her 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant?

DTaP, Hib, IPV, pneumococcal vaccine (PCV), rotavirus vaccine (RV)

A 10-year-old child with asthma is treated for acute exacerbation in the emergency department. The nurse caring for the child should monitor for which sign, knowing that it indicates a worsening of the condition?

Decreased wheezing

A 12-month-old child with human immunodeficiency virus infection is currently immunocompromised. The nurse determines that the immunization needs of this child include which action?

Delaying the administration of the varicella virus vaccine until the child is not immunocompromised

The mother of an 8-year-old child being treated for right lower lobe pneumonia at home calls the clinic nurse. The mother tells the nurse that the child complains of discomfort on the right side and that ibuprofen is not effective. Which instruction should the nurse provide to the mother?

Encourage the child to lie on the right side.

A child is sent to the school nurse by the teacher. On assessment of the child the nurse notes the presence of a rash. The nurse suspects that the child has erythema infectiosum (fifth disease) based on which assessment finding?

Erythema on the face, giving a "slapped cheeks" appearance

The nurse is caring for a child after a tonsillectomy. The nurse monitors the child, knowing that which finding indicates the child is bleeding?

Frequent swallowing

A pediatric nurse in the ambulatory surgery unit is caring for a child following a tonsillectomy. The child is complaining of a dry throat. Which item should the nurse offer to the child?

Green gelatin

The nurse is caring for a hospitalized infant with a diagnosis of bronchiolitis. In which position should the nurse place the infant?

Head and chest at a 30-degree angle with the neck slightly extended

The mother of a preschooler who attends day care calls a clinic nurse and tells the nurse that the child is constantly scratching the perianal area and that the area is irritated. The nurse suspects the possibility of pinworm infection (enterobiasis) and instructs the mother to obtain a rectal specimen by a tape test. At what time should the nurse tell the mother to obtain the specimen?

In the morning, when the child awakens

A child seen in the clinic is found to have rubeola (measles), and the mother asks the nurse how to care for the child. The nurse should tell the mother to implement which action?

Keep the child in a room with dim lights.

A child with laryngotracheobronchitis (croup) is placed in a cool mist tent. The mother becomes concerned because the child is frightened, consistently crying and trying to climb out of the tent. Which is the most appropriate nursing action?

Let the mother hold the child and direct the cool mist over the child's face.

The student nurse is caring for an infant with a tracheostomy and is preparing to suction the infant. The nursing instructor should intervene if the nursing student stated she would take which action to perform this procedure?

Limit insertion and suctioning time to 15 seconds to prevent hypoxia.

A child is scheduled to receive immunizations. The child's mother reports to the nurse that the child has been receiving long-term immunosuppressive therapy. The nurse prepares the scheduled immunizations knowing that which vaccine is contraindicated?

MMR (measles-mumps-rubella)

The nurse is caring for a hospitalized child with a diagnosis of measles (rubeola). In preparing to care for the child, which supplies should the nurse bring to the child's room to prevent transmission of the virus?

Mask and gloves

The nurse is caring for an infant with bronchiolitis, and diagnostic tests have confirmed respiratory syncytial virus (RSV). On the basis of this finding, which is the most appropriate nursing action?

Move the infant to a room with another child with RSV.

The nurse reviews the health record of a 2-year-old child. The health care provider has documented that the results of a tuberculin skin test have indicated an area of induration measuring 5 mm. How should the nurse interpret these results?

Negative

The home health nurse visits a child with infectious mononucleosis and provides home care instructions to the parents. Which instruction should the nurse give to the parents?

Notify the HCP if the child develops abdominal pain or left shoulder pain.

A mother arrives at the hospital emergency department with her child, in whom a diagnosis of epiglottitis is documented. Which prescription, if written by the health care provider, should the nurse question?

Obtain a throat culture.

A nursing student is conducting a clinical conference about measures that assist in preventing sudden infant death syndrome. The student plans to write on a handout that it is best to place an infant in which position for sleep?

On the back, or supine

Breathing exercises and postural drainage are prescribed for a hospitalized child with cystic fibrosis. What instruction should the nurse include in the client's teaching plan?

Perform the postural drainage first and then the breathing exercises.

The nurse is preparing to care for a child after a tonsillectomy. The nurse documents on the plan of care to place the child in which position?

Side-lying

The clinic nurse prepares to administer a measles, mumps, and rubella (MMR) vaccine to a 5-year-old child. The nurse should administer this vaccine by which method?

Subcutaneously in the outer aspect of the upper arm

After a tonsillectomy, the nurse reviews the health care provider's (HCP's) postoperative prescriptions. Which prescription should the nurse question?

Suction every 2 hours

The nurse is reviewing the health care provider's prescriptions for a child following a tonsillectomy. Which prescription should the nurse question?

Suction the child frequently if coughing.

The nurse is caring for a child following a tonsillectomy. The nurse should reposition the child on return from the operating room if the child is in which position?

Supine

A mother arrives at the clinic with her 3-year-old child. The mother tells the nurse that the child has had a fever and a cough for the past 2 days and that this morning the child began to wheeze. Viral pneumonia is diagnosed. Based on the diagnosis, the nurse anticipates that which will be a component of the treatment plan?

Supportive treatment

The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse should monitor for which indication that the child may be experiencing airway obstruction?

The child is leaning forward, with the chin thrust out.

A mother brings her 6-year-old child to the clinic because the child has developed a rash on the trunk and scalp. The mother reports that the child has had a low-grade fever, has not felt like eating, and has been tired. The child is diagnosed with chickenpox. The mother inquires about the communicable period associated with chickenpox, and the nurse bases the response on which statement?

The communicable period is 1 to 2 days before the onset of the rash to 6 days, when crusts have formed.

During clinical conference, a nursing student is discussing care for a child with a diagnosis of cystic fibrosis (CF). Which comment by a student indicates the need for further review of information about CF?

This disease causes dilation of the passageways of many organs.

After a tonsillectomy, a child begins to vomit bright red blood. The nurse should take which initial action?

Turn the child to the side.

The nurse in the ambulatory care unit is caring for a child after a tonsillectomy. The child's mother tells the nurse that the child is complaining of a dry throat and would like something to relieve the dryness. Which item should the nurse provide for the mother to give to the child?

Yellow noncitrus Jell-O

A parent brings her 4-month-old infant to a well-baby clinic for immunizations. The child is up to date with the immunization schedule. The nurse should prepare to administer which immunizations to this infant?

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