Peds Chapter 45 PrepU

The nurse is caring for a child admitted with second-degree (partial-thickness) burns. What is most characteristic of this type of burn? 1. Blisters appear. 2. Skin is red and edematous. 3. Muscle damage occurs. 4. Pain is minimal.

1. Blisters appear.

The nurse is caring for a child with suspected child abuse (child mistreatment)-induced burns. Which assessment findings would support this? 1. 911 called immediately after the burn occurred 2. consistent history given by all caregivers 3. splattered-looking, small burned areas to both legs 4. a burn to the entire right hand up to 2 cm above wrist with consistent edges

4

A 2-month-old infant has been diagnosed with seborrheic dermatitis (cradle cap). The nurse is educating the parent about care of the child. Which instructions would the nurse include? Select all that apply. 1. Use a fine-tooth baby comb after washing the hair. 2. Apply mineral oil to loosen the crusts. 3. Carefully but vigorously wash the area of the "soft spot." 4. Remove the crust all at one time to prevent recurrence. 5. Wash the child's hair every day.

1, 2, 3, 5

The nurse has completed client teaching with a 16-year-old female who has been prescribed isotretinoin for cystic acne. Which statements indicate learning has occurred? Select all that apply. 1. "It's important I get my CBC blood test when my doctor orders it." 2. "I am young so I won't need to have the liver tests the pamphlet suggests." 3. "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." 4. "As long as I use two forms of birth control I don't need to have monthly pregnancy testing." 5. "If I am sexually active I need to let my doctor know."

1, 3, 5

A 30-month-old child has been discharged from the hospital after receiving treatment for second-degree (partial-thickness) burns over 6% of the body. One week later, the parent calls the nurse to say that the child has been drinking from a cup for one year, but is now constantly pulling at the mother's breast trying to nurse and refuses to drink from a cup. What is the best way for the nurse respond? 1. Make an appointment for the parent to bring the child to the clinic for evaluation. 2. Explain that children who have had a serious injury sometimes exhibit regressive behavior. 3. Tell the parent to allow the child to nurse as much as the child wants. 4. Encourage the parent to explain to the child that he or she must drink from the cup.

2

The nurse admits a 10-year-old who has just eaten lobster and has hives over much of the body. In collecting data regarding this child, which question should the nurse ask the caregiver first? 1. "Has the child ever eaten shellfish before now?" 2. "Have you ever given your child antihistamines?" 3. "Does anyone in your family have any food allergies?" 4. "Is your child allergic to peanuts or other foods?"

1

A 4-month-old infant is experiencing dermatitis in the diaper area. What treatments will be beneficial to this condition? Select all that apply. 1. Apply petroleum jelly to the diaper area. 2. Apply ointment with vitamin A to the diaper area. 3. Apply powder to the diaper area. 4. Allow the diaper area to air dry. 5. Use ointments containing zinc on the diaper area.

1, 2, 4, 5

A pediatric client who has been seriously burned is being given IV fluid replacements. It has been determined that the client will initially need 24 ounces of replacement fluids. In following a normal burn replacement treatment for this child, if the treatment is started at 10:00 AM, which of the following would be correct? The child would have received: 1. 12 ounces of IV fluid replacement by 4:00 PM. 2. 12 ounces of IV fluid replacement by 6:00 PM. 3. 18 ounces of IV fluid replacement by 4:00 PM. 4. 18 ounces of IV fluid replacement by 6:00 PM.

2

The camp nurse is caring for a child who was bitten on the leg by a dangerous spider. The child is being taken to a health care provider. What is the most appropriate action for the nurse to do with this child? 1. Administer pain medication. 2. Apply ice to the affected area. 3. Splint the leg. 4. Briskly scrub the site.

2

The parents of a child diagnosed with atopic dermatitis ask the nurse, "My child has a skin disorder. I don't understand why a complete blood count (CBC) was ordered?" What is the appropriate response by the nurse? 1. "This is just another tool to help rule out any other disorders that can be causing this skin disorder. There will be other lab tests ordered as well." 2. "Eosinophils are a type of white blood cell that are often elevated with atopic dermatitis. These are part of the CBC and helps in making the diagnosis." 3. "The complete blood count is a routine test used anytime there is an abnormal condition in the body." 4. "This test will help in determining the type of bacteria that is causing this infection."

2

The nurse is caring for a child with urticaria. What is the priority action? 1. obtaining a detailed history of new foods, medications, stress, or changes in environment 2. Noting whether hives are pruritic, blanch when pressed, or are migrating 3. assessing the child's airway and breathing and noting any wheezing or stridor 4. inspecting the skin and noting evidence of raised, edematous hives anywhere on the body

3

A nurse is providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? 1. "We should use a mild soap for sensitive skin." 2. "We should use soap to clean only dirty areas." 3. "We need to avoid any skin product containing perfumes, dyes, or fragrances." 4. "We should bathe our child in hot water, twice a day."

4

A nurse is providing teaching on ways to promote skin hydration for the parents of an infant with atopic dermatitis. Which response indicates a need for further teaching? 1. "We need to avoid any skin product containing perfumes, dyes, or fragrances." 2. "We should use soap to clean only dirty areas." 3. "We should use a mild soap for sensitive skin." 4. "We should bathe our child in hot water, twice a day."

4. "We should bathe our child in hot water, twice a day."

The nurse is discussing dietary intake with the parents of a 4-year-old child who has been diagnosed with atopic dermatitis. Later, the nurse notes the menu selection made by the parents for the child. Which selection indicates the need for further instruction? 1. peanut butter and jelly sandwich 2. carrot and celery sticks 3. tomato soup 4. chicken nuggets

1

The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? 1. "I always tell my daughter to use her own hairbrush." 2. "That is an infection that you get under your fingernails." 3. "My son got that infection when he was at the swimming pool." 4. "My husband had that once and his groin itched so much."

1

The nurse is developing the plan of care for a child who has suffered a major burn and has just been admitted to the acute care facility. Which nursing diagnosis would be most appropriate? 1. Risk for fluid volume overload related to thermal injuries 2. Risk for aspiration related to effects of medication 3. Acute pain related to thermal injuries and procedures 4. Knowledge deficit related to daily care procedures in the acute care setting

3

A child has an order for an erythrocyte sedimentation rate (ESR). The child's mother asks what the purpose of the test is. What is the best response by the nurse? 1. "This is a test to determine if your child has a skin infection." 2. "This test will tell if your child has allergies." 3. "This test will tell if your child has a fungus somewhere in their body." 4. "This test will tell if your child has an infection or inflammation somewhere in their body."

4

An adolescent with tinea versicolor is admitted for treatment of the disorder. Which nursing diagnosis will the nurse identify as having the highest priority for this client? 1. Disturbed body image 2. Risk for fluid volume deficit 3. Altered nutrition 4. Pain

1

The parent of a 1-week-old infant is concerned with white scales that have begun to flake off the infant's scalp. The parent asks the nurse what to do to treat this. How should the nurse best respond? 1. "Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and scalp daily with baby shampoo and applying baby oil." 2. "Cradle cap (seborrhea) will resolve by itself. There is no intervention needed." 3. "Your child most likely has dandruff. You can treat it with daily with antiseborrheic shampoo." 4. "The infant should have a thorough shampooing every day to prevent things like this."

1

A 30-month-old child has been discharged from the hospital after receiving treatment for second-degree (partial-thickness) burns over 6% of the body. One week later, the parent calls the nurse to say that the child has been drinking from a cup for one year, but is now constantly pulling at the mother's breast trying to nurse and refuses to drink from a cup. What is the best way for the nurse respond? 1. Encourage the parent to explain to the child that he or she must drink from the cup. 2. Explain that children who have had a serious injury sometimes exhibit regressive behavior. 3. Tell the parent to allow the child to nurse as much as the child wants. 4. Make an appointment for the parent to bring the child to the clinic for evaluation.

2

A child is hospitalized with burns over 25% of the body. The nurse is preparing to perform a dressing change. What aspect of changing the child's dressings is most important for the nurse to consider? 1. pain management 2. infection prevention 3. activities for distraction 4. therapeutic communication

2

The nurse is caring for a child with a severe burn. The treatment for this child during the first 48 hours will be most likely be related to: 1. graft placement. 2. hypovolemic shock. 3. wound care. 4. curling ulcer.

2

The nurse is caring for a 13-year-old client who asks about acne prevention. Which would be most appropriate for the nurse to suggest? 1. Wash the face twice a day with a mild soap then pat dry. 2. Wash the face with abrasive soaps three times a day. 3. Avoid chocolate and greasy foods. 4. Pop the pimples to make them go away.

1

The nurse is caring for a child on the burn unit weighing 100 lb (45.5 kg) who has second-degree (partial-thickness) burns over 30% of the body. During the beginning shift assessment, which assessment finding is of most concern to the nurse? 1. Urine output of 15 ml per hour over the last 4 hours 2. Weight gain of 0.9 kg over the last 2 days 3. Refused dinner due to nausea 4. Pain at a 7 on a 0 to 10 scale

1

The nurse is caring for a child brought to a pediatric clinic for swelling in the lower extremities. The skin is reddened with undefined borders and pits slightly when pressed. Based on the assessment findings, which of the following would the nurse suspect? 1. staphylococcal scalded skin syndrome (SSSS) 2. cat scratch disease 3. cellulitis 4. impetigo

3. cellulitis

The nurse is assessing a child who has had an open wound for the last 2 weeks with no signs of healing. The parents report they have been using over-the-counter antibiotic ointment with no signs of improvement. The child is active in football in the fall and the swim team in the winter. What disorder does the nurse suspect? 1. impetigo 2. folliculitis 3. staphylococcal scalded skin syndrome 4. community acquired MRSA

4

The nurse is assessing a child who was brought into the clinic. The nurse notes honey-colored crusting on the toddler's face, as seen in the figure. The nurse recognizes this to be what type of infection? 1. scabies 2. folliculitis 3. atopic dermatitis 4. impetigo

4

The nurse is discussing skin disorders with a group of caregivers. Which caregiver statement indicates an understanding of tinea capitis? 1. "That is an infection that you get under your fingernails." 2. "My son got that infection when he was at the swimming pool." 3. "My husband had that once and his groin itched so much." 4. "I always tell my daughter to use her own hairbrush."

4. "I always tell my daughter to use her own hairbrush."

The nurse is caring for a 7-year-old with burns. Which finding would be highly suggestive of a burn induced by child abuse (child maltreatment)? 1. splash patterns 2. nonuniform pattern 3. spattering pattern 4. stocking-glove pattern on hands or feet

4

The parent of a 1-week-old infant is concerned with white scales that have begun to flake off the infant's scalp. The parent asks the nurse what to do to treat this. How should the nurse best respond? 1. "The infant should have a thorough shampooing every day to prevent things like this." 2. "Cradle cap (seborrhea) will resolve by itself. There is no intervention needed." 3. "Your child most likely has dandruff. You ca treat it with daily with antiseborrheic shampoo." 4. "Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and applying baby oil."

4. "Your child most likely has cradle cap (seborrhea). You can care for it by cleansing the hair and applying baby oil."

The nurse is providing teaching on ways to maintain skin integrity and prevent infection for the parents of a boy with atopic dermatitis. Which response indicates a need for further teaching? 1. "We should avoid using petroleum jelly." 2. "We should avoid tight clothing and heat." 3. "We should keep his fingernails short and clean." 4. "We need to develop ways to prevent him from scratching."

1

The nurse is caring for a 2-month-old in a pediatric clinic. The mom states she is going on vacation in Florida in a month and she is concerned about sunburn. She asks if it is okay to use a sunscreen lotion made for children. What is the correct nursing response? 1. "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun." 2. "It is okay to use a children's sunscreen as long as you avoid the face." 3. "Put plenty of children's sunscreen on the infant at least 15 minutes before going outdoors, then reapply every three to four hours." 4. "You should not take your infant to Florida."

1. "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun."

The nurse is caring for a child with a prescription for PO prednisone. Which statement by the child's mother would indicate a need for further education? 1. "Since my child has type 1 diabetes, I will need to monitor my child's blood sugar levels closely while on this medication. 2. "I will give it to my child at least 1 hour before all meals." 3. "I will have to watch my child closely for signs of infection." 4. "My child should take the entire prescription as prescribed by the health care provider."

2

The nurse is developing the plan of care for a child who has suffered a major burn and has just been admitted to the acute care facility. Which nursing diagnosis would be most appropriate? 1. Risk for aspiration related to effects of medication 2. Acute pain related to thermal injuries and procedures 3. Knowledge deficit related to daily care procedures in the acute care setting 4. Risk for fluid volume overload related to thermal injuries

2. Acute pain related to thermal injuries and procedures

The nurse is assessing a child who has had an open wound for the last 2 weeks with no signs of healing. The parents report they have been using over-the-counter antibiotic ointment with no signs of improvement. The child is active in football in the fall and the swim team in the winter. What disorder does the nurse suspect? 1. impetigo 2. folliculitis 3. community acquired MRSA 4. staphylococcal scalded skin syndrome

3

The nurse is caring for a 2-month-old infant. The parent asks if it is okay to use a sunscreen lotion made for children. Which response by the nurse would be most accurate? 1. "Put plenty of children's sunscreen on the infant at least 15 minutes before going outdoors, then reapply every 3 to 4 hours." 2. "It is okay to use a children's sunscreen as long as you avoid the face." 3. "Sunscreen is not recommended until 6 months of age. Use light clothing and a hat to completely cover the child when in the sun." 4. "You should not bring your infant into sunny locations."

3

The nurse is interviewing the mother of a 6-month-old being seen at a well-child visit. The mother reports she has used an over-the-counter topical ointment intended for adults on her child for a skin rash. What is the most appropriate response by the nurse? 1. "Why did you do that instead of contacting your doctor?" 2. "This is dangerous so please do not do this again." 3. "Children have thin skin and can absorb medications differently than adults." 4. "How often do you use this medication?"

3. "Children have thin skin and can absorb medications differently than adults."

The nurse is presenting an in-service to a group of nurses who will be working in a dermatology clinic. One participant asks the nurse about a bacterial skin infection that she has seen in children that involves honey-colored crusted lesions. The nurse most likely is referring to: 1. seborrheic dermatitis. 2. candidiasis. 3. miliaria rubra (heat rash). 4. impetigo.

4

The clinic nurse is assessing a 12-year-old client. The client reports having dandruff and asks the nurse what can be done for it. Which response by the nurse is best? 1. "Apply warm baby oil to your scalp once a day for a few days." 2. "Wash your hair vigorously twice a day for one week." 3. "I will let your primary health care provider know you need prescription shampoo." 4. "Wash your hair with a gentle shampoo daily."

4. "Wash your hair with a gentle shampoo daily."