Peds Portion of Exam 2

(1) What are the s/s of Roseola? (SATA) A. Persistent cough B. High fever C. Rash starting at the trunk and spreading to the neck, face, and extremities D. Inflamed pharynx E. Cervical lyphadenopathy F. Inflammation of the upper respiratory tract (coryza)

A, B, C, D, E, F

(1) What therapeutic management is expected for the patient with mumps? (SATA) A. Analgesics B. Antipyretics C. IV fluids PRN D. Institute droplet and contact precautions E. Maintain isolation during time of communicability F. Encourage rest

A, B, C, D, E, F

(1, 2) What are the original signs and symptoms of measles (rubeola) before the emergence of a rash? (SATA) A. Fever B. Malaise C. Koplik spots D. Cough E. Coryza F. Conjunctivitis

A, B, C, D, E, F

(1) How is chickenpox (varicella) transmitted? (SATA) A. Direct contact B. Droplet (airborne) spread C. Hair follicles D. Contaminated objects

A, B, D Droplet is important for NCLEX

(1) What are the clinical manifestations of Erythema Infectiosum (Fifth disease)? A. Erythema on the face B. Slapped-face rash that disappears by 1-4 days C. Steven-Johnson's Syndrome D. Self-limited arthritis E. Itching

A, B, D, E

** (1) How can mumps be transmitted from one person to another? (SATA) A. Direct contact with infected persions B. Telephone calls C. Droplet spread with infected persons D. Visual observation

A, C

(1, 8) How can pertussis (whooping cough) be transmitted? (SATA) A. Direct contact B. Blood C. Droplet spread D. Indirect contact with contaminated items E. Telephone conversations F. I give up

A, C, D

(1) Childhood immunization is the preventative measure for diptheria. T/F? A. True B. False

A. True

(1) Fifth disease is transmitted by respiratory secretions, blood, and blood products. T/F? A. True B. False

A. True

(1) Nursing interventions for Exanthem Subitum (Roseola) is to use standard precautions, give antipyretics and fluids. T/F? A. True B. False

A. True

(1) The source of mumps is from the saliva of an infected person. T/F? A. True B. False

A. True

(1) The therapeutic management for diptheria includes Equine antitoxin, antibiotics, and complete bed rest. T/F? A. True B. False

A. True

(1, 2) The patient with measles (rubeola) should be on airborne precautions. T/F? A. True B. False

A. True

(1, 8) Immunization is the best preventative measure for pertussis (whooping cough). T/F? A. True B. False

A. True

(1) Erythema infectiosum is also known as fifth disease. T/F? A. True B. False

A. True "It takes 5 fingers to slap someone"

Number breakdown

1. Communicable diseases in childhood-airway precautions 2. Measles rubeola 3. Meningitis vaccine 4. Scarlet fever 5. Erikson psychosocial development 6. Tanner stages 7. Enuresis teaching 8. Pertussis 9. Dosage calc (1 question) 10. Meningitis risk factors 11. Tonsillectomy Nursing Interventions 12. Epiglottitis teaching 13. Epiglottitits nursing interventions 14. GABHS Teaching 15. GABHS nursing interventions 16. Asthma teaching 17. Asthma rescue medications

(1) The mode of transmission for diphtheria includes direct contact with infected persons, a carrier or contaminated article. T/F? A. True B. False

A

(1) To prevent chickenpox, the patient should be immunized against it. T/F? A. True B. False

A

** (2) A nurse is assessing a toddler who has measles (rubeola). Which of the following findings should the nurse expect? A. Koplik spots B. Parotitis C. Strawberry tongue D. Paroxysmal coughing

A A. (Correct) Koplik spots are small, irregular oral lesions with a bluish-white center. They are characteristic of measles (rubeola). Koplik spots appear about 2 days before the maculopapular rash and are accompanied by fevers, malaise, conjunctivitis, and other cold manifestations. B. Swollen parotid glands are an expected finding in a child who has mumps. C. Strawberry tongue is an expected finding in a child who has scarlet fever D. Paroxysmal coughing is an expected finding in a child who has pertussis

(1) The nurse is caring for a child diagnosed with erythema infectiosum (fifth disease). Which clinical manifestation would the nurse expect to note in the child? A. An intense fiery red edematous rash on the cheeks B. Pinkish-rose maculopapular rash on the face, neck, and scalp C. Reddish and pinpoint petechiae spots found on the soft palate D. Small bluish-white spots with a red base found on the buccal mucosa

A Fifth disease is characterized by the presence of an intense fiery red edematous rash on the cheeks, which gives an appearance that the child has been slapped. Options B and C are manifestations related to rubella (German measles). Koplik's spots (option D) are found in rubeola (measles)

(1) What are the symptoms of diphtheria? SATA A. Symptoms of the common cold B. Sore throat, low-grade fever C. Lymphadenitis (Bull's neck) D. Hoarseness E. Vesicular rash F. Butterfly rash

A, B, C, D

(1, 8) What is the treatment for pertussis (whooping cough)? (SATA) A. Macrolide antibiotics B. Fluids C. Humidified oxygen D. Suctioning as needed E. Maintaining standard and droplet precautions F. I give up

A, B, C, D, E

(1) What are nursing interventions for chickenpox? A. Maintain standard, airborne and contact precautions B. Keep the child home from school until vesicles have dried C. Administer skin care D. Keep the child cool E. Teach the patient to pat or rub, don't scratch F. Avoid the use of aspirin

A, B, C, D, E, F

(1, 2) Koplik spots are associated with which disease? A. Mumps B. Measles (rubeola) C. Pertussis (Whooping cough) D. Rubella (German measles)

B

** (5) A nurse is performing a well-child assessment on a 7 year old client who takes great pride in bringing school papers home. The nurse recognizes that this behavior demonstrates which of the following of Erikson's stages A. Initiative vs. guilt B. Industry vs. inferiority C. Identity vs. role confusion D. Autonomy vs. shame and doubt

B A. Initiative vs. guilt is the developmental task of early childhood (ages 3-6 years old) B. (Correct) The developmental task of industry vs. inferiority is reflected by a child's level of motivation in relation to personal achievements that build good character during the school-age years (ages 6-12) C. Identity vs. role confusion is the task of the adolescent (ages 13-19 years) D. Autonomy vs. shame and doubt is the developmental task of a toddler (ages 12 months to 3 years)

(12/13) The emergency department nurse is caring for a child diagnosed with epiglottitis. In assessing the child, the nurse would monitor for which indication that the child may be experiencing airway obstruction? A. The child exhibits nasal flaring and bradycardia B. The child is leaning forward, with the chin thrust out C. The child has a low-grade fever and complains of a sore throat D. The child is leaning backward, supporting self with the hands and arms.

B Epiglottitis is a bacterial form of croup. A primary concern is that it can progress to acute respiratory distress. Clinical manifestations suggestive of airway obstruction include tripod positioning (leaning forward while supported by arms, chin thrust out, mouth open), nasal flaring, the use of accessory muscles for breathing, and the presence of stridor. Epiglottitis causes tachycardia and a high fever.

(3) A nurse is caring for an 18 year old adolescent who is up to date on immunizations and is planning to attend college. The nurse should recommend which of the following immunizations pprior to moving into a campus dormitory? A. Pneumococcal polysaccharide B. Meningococcal polysaccharide C. Rotavirus D. Herpes zoster

B The miningococcal polysaccharide immunization is used to prevent infection by certain groups of meningococcal bacteria. Meningococcal infection can cause life-threatening illnesses, such as meningococcal meningitis (which affects the brain) and miningococcemia (which affects the blood). Both of these conditions can be fatal. College freshman, particularly those who live in dormitories, are at an increased risk of meningococcal disease relative to other persons their age. Therefore, the CDC issued a recommendation that all incoming college students receive the meningococcal immunization.

(1) Herpes virus 6 is the agent that causes which disease? A. Measles (Rubeola) B. Mumps C. Exanthem Subitum (Roseola) D. Pertussis (Whooping cough)

C

(1) The "slapped face" appearance is the classic symptom of which disease? A. Chickenpox B. Diptheria C. Erythema infectiosum D. Roseola

C

(1, 2) For how long does the patient with measles (rubeola) have to remain in isolation? A. Until the 3rd day of the rash B. Until the 4th day of the rash C. Until the 5th day of the rash D. Until the 6th day of the rash

C

(1, 2) What is the treatment for measles (Rubeola)? A. Antibiotics B. Antifungals C. Vitamin A D. Vitamin C

C

(1, 2) When does the descending rash in measles (rubeola) occur? A. 1-2 days after original symptoms B. 2-3 days after original symptoms C. 3-4 days after original symptoms D. 4-5 days after original symptoms

C

(10) (read the rationales!) A nurse is caring for an 18 month old infant who has chronic otitis media. The nurse should recognize that chronic otitis media will affect which of the following? A. Olfaction B. Visual acuity C. Speech patterns D. Hand-eye coordination

C A. Complications of otitis media include MENINGITIS, labyrinthitis, and various types of abscesses and thromboses. However, the condition does not generally affect olfaction.

** (5) A nurse is planning care for a preschooler who is scheduled for a surgical procedure. The nurse should identify that the preschooler is in which of the following of Erikson's psychosocial stages of development? A. Industry vs. inferiority B. Trust vs. Mistrust C. Initiative vs. guilt D. Identity vs. role confusion

C A. Industry vs. inferiority is for school-aged children. IN this stage, the child takes initiative for learning and doing things well. Support and positive reinforcement foster the child's sense of pride, while a lack of appreciation can lead to a feeling of inferiority B. Trust vs. mistrust is for infants. In this stage, a caregiver's response to the infant's needs builds trust and reassures the infant that his or her needs are being met. A caregiver who is inconsistent or rejecting can cause a feeling of mistrust C. (Correct) A preschooler is in the developmental stage of initiative vs. guilt. Preschoolers initiate play activities and experience a feeling of guilt if their efforts at independence receive a negative reaction from caregivers D. The nurse should identify that an adolescent is in the developmental stage of identity vs. role confusion. In this stage, the adolescent combines his or her various roles and experiences into a personal identity. Failure to integrate these various images can lead to role confusion or uncertainty of identity or goals

** (5) A nurse is assessing a 7 year old child's psychosocial development. Which of the following findings should the nurse recognize as an indicator for further evaluation? A. The child prefers playmates of the same sex B. The child is competitive when playing board games C. The child complains daily about going to school D. The child enjoys spending time alone

C A. Male and female children who are 7 years old prefer to play with peers who are the same gender B. School-age children enjoy engaging in various types of competitive games and are learning about the concept of winning C. (Correct) Complaining everyday about going to school is an unexpected finding for a 7 year old child. The child is in Erikson's psychosocial development stage of industry vs. inferiority. Children at this stage want to learn and master new concepts. If the child complains daily about going to school, further evaluation is warranted D. A 7 year old child does not require the same level of companionship as older school-age children. Therefore, the fact that this child enjoys spending time alone is an expected finding

(1) The parent of a child with mumps calls the health care clinic to tell the nurse that the child has been lethargic and vomiting. What instruction would the nurse give to the parent? A. To continue to monitor the child B. That lethargy and vomiting are normal with mumps C. To bring the child to the clinic to be seen by the pediatrician D. That there is nothing to be concerned about as long as there is no fever.

C Mumps generally affects the salivary glands, but it can also affect multiple organs. The most common complication is septic meningitis, with the virus being identified in the cerebrospinal fluid. Common signs include nuchal rigidity, lethargy, and vomiting. The child needs to be seen by the pediatrician.

(8) A nurse is caring for an infant who has pertussis. Which of the following actions should the nurse take? A. Assess for edema of the extremities B. Apply warm compresses to the neck area C. Initiate airborne precautions D. Maintain a cardiorespiratory monitor

D A. Pertussis causes paroxysms of coughing with frequent vomiting. Therefore, infants who have pertussis are at risk of fluid volume deficit B. The nurse should take this action when caring for a child who has a mumps infection, which causes enlarged, painful parotid glands. C. The nurse should initiate standard and droplet precautions when providing care for a client who has pertussis D. (Correct) Infants with pertussis typically present with apnea in response to coughing spasms and mucus plugs. Humidified oxygen and suction equipment should be used as needed

(1) What is the period of communicability for mumps? A. Immediately before and after earache B. Immediately before and after fever C. Immediately before and after headache D. Immediately before and after parotid gland swelling

D

** (1, 10) A nurse is planning care for a child who has miningococcal meningitis. Which of the following isolation precautions should the nurse plan to implement? A. Airborne precautions B. Contact precautions C. Protective environment D. Droplet precautions

D A. Airborne would be appropriate for diseases such as rubeola, in which transmission can occur via inhalation but there is no chance of transmission through infected body fluids B. Contact precautions would be appropriate for diseases such as varicella-zoster, smallpox, and TB, in which there is a potential for transmission by both inhalation and contact with infected body fluids C. Protective environment isolation would be appropriate for a client who underwent allogenic hematopoietic stem cell transplant D. (Correct) The nurse should maintain droplet precautions for a client who has meningococcal meningitis for 24-72 hours after the initiation of antibiotic therapy. Disease transmission can occur through large-droplet particles when the client is talking. There is no drainage of infected body fluids with meningitis, so contact precautions are not necessary

** (2) A nurse is creating a plan of care for a preschooler who was admitted for the treatment of measles. Which of the following activities should the nurse include in the client's care plan? A. Constructing a model airplane B. Playing a video game in the playroom C. Pulling a wagon with toys in the hallways D. Putting together a puzzle with large pieces

D A. Constructing a model airplane is advanced for a preschooler's fine motor skills. B. A preschooler who has the measles is on airborne precautions and should not be in the playroom, as this would expose other children to the disease. The particles can be dispersed widely throughout the air and could be inhaled by another child in the playroom C. A preschooler who has the measles is on airborne precautions and should not be outside of the hospital room. Pulling a wagon in the hallway would likely spread this disease by dispersing particles containing infectious agents to other children who are either in the hallway or have their room doors open D. (Correct) The nurse should recommend putting together a puzzle with large pieces for a hospitalized preschooler. Other recommended activities for preschoolers on airborne precautions include playing pretend and dress up, painting, and looking at illustrated books.

(1) A nurse is planning care for a child who has miningococcal meningitis. Which of the following isolation precautions should the nurse plan to implement? A. Airborne precautions B. Contact precautions C. Protective environment D. Droplet precautions

D A. this type of isolation would be appropriate for diseases such as rubeola, in which transmission can occur via inhalation but there is no chance of transmission through infected body fluids B. This type of isolation would be appropriate for diseases such as varicella-zoster, smallpox, and TB, in which there is a potential for transmission by both inhalation and contact with infected body fluids C. This type of isolation precaution would be appropriate for a client who underwent an allogenic hematopoietic stem cell transplant D. (Correct) The nurse should maintain droplet precautions for a client who has meningococcal meningitis for 24-72 hours after the initiation of antibiotic therapy. Disease transmission can occur through large-droplet particles when the client is talking. There is no drainage of infected body fluids with meningitis, so contact precautions are not necessary

** (1, 8) A nurse on a pediatric unit has just received reports for 4 newly admitted clients. For which of the following children should the nurse plan to initiate droplet precautions? A. A child who has Rocky Mountain spotted fever B. A child who has roseola C. A child who has Molluscum contagiosum D. A child who has pertussis

D B. Roseola is a viral infection classified within the herpes virus family. Primary manifestations are a rash and a high fever. Other manifestations include lymphadenopathy, a sore throat, and a severe cough. The nurse should plan to use standard precautions when caring for a client who has roseola D. (Correct) The nurse should initiate droplet precautions for a child who has pertussis to decrease the risk of transmitting the infection to others on the unit. Pertussis, or whooping cough, is a bacterial infections that is transmitted via exposure or direct contact with the respiratory secretions from an infected person. Manifestations of pertussis include a fever, sneezing, and a severe productive cough that generally becomes worse before getting better

(1) What is the treatment for chickenpox? A. Antibiotic B. Antitoxin C. High dose steroids D. Antiviral

D Chickenpox is of a viral nature.

(2) The nurse caring for a child diagnosed with rubeola (measles) notes that the pediatrician has documented the presence of Koplik's spots. On the bases of this documentation, which observation is expected? A. Pinpoint petechiae noted on both legs B. Whitish vesicles located across the chest C. Petechiae spots that are reddish and pinpoint on the soft palate D. Small blue-white spots with a red base found on the buccal mucosa

D In rubeola (measles), Koplik's spots appear approximately 2 days before the appearance of the rash. These are small blue-white spots with a red base that are found on the buccal mucosa. The spots last approximately 3 days, after which time they slough off. Based on this information, the remaining options are all incorrect.

(1, 8) 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? A. We need to encourage our child to drink fluids B. Coughing spells may be triggered by dust or smoke C. Vomiting may occur when our child has coughing episodes D. We need to maintain droplet precautions and a quiet environment for at least 2 weeks

D 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 A, B, and C are accurate components of home care instructions

(1) What is a classic symptom of mumps that is seen by the 3rd day of infection? A. Fever B. Headache C. Malaise D. Anorexia E. Earache F. Enlarged parotid gland(s)

F When you see "enlarged parotid gland(s)," you should immediately think of mumps... it doesn't show up really in any other disease