Chapter 49 peds

Isotretinoin (Accutane) is indicated for the treatment of acne during adolescence when: A. Acne has not responded to other treatments. B. The adolescent is or may become pregnant. C. The adolescent is unable to give up foods causing acne. D. Frequent washing with antibacterial soap has been unsuccessful.

A. Acne has not responded to other treatments.

Lymphangitis ("streaking") is frequently seen in: A. Cellulitis. B. Folliculitis. C. Impetigo contagiosa. D. Staphylococcal scalded skin.

A. Cellulitis.

The nurse is teaching parents of a 3-year-old with impetigo that they can anticipate: A. No scarring. B. Pigmented spots. C. Slightly depressed scars. D. Atrophic white scars.

A. No scarring

The nurse is speaking with the parent of an infant with severe atopic dermatitis. What information should the nurse reinforce with the parent (Select all that apply)? A. "You can use warm wet compresses to relieve discomfort." * B. "You will need to keep your infant‟s skin well hydrated by using a mild soap in the bath." C. "You should bathe your baby in a bubble bath two times a day." * D. "You will need to prevent your baby from scratching the area by using a mild antihistamine." E. "You can try a fabric softener in the laundry to avoid rough cloth." * F. "You should apply an emollient to the skin immediately after a bath."

B. "You will need to keep your infant's skin well hydrated by using a mild soap in the bath." D. "You will need to prevent your baby from scratching the area by using a mild antihistamine." F. "You should apply an emollient to the skin immediately after a bath."

a child is admitted with extensive burns. The nurse notes that there are burns on the child‟s lips and singed nasal hairs. The nurse should suspect that the child has: A. A chemical burn. B. An inhalation injury. C. An electrical burn. D. A hot-water scald.

B. An inhalation injury

which primary treatment will the nurse implement for a child with warts? A. Vaccination B. Local destruction C. Corticosteroids D. Specific antibiotic therapy

B. Local destruction

To best assess the child with severe burns for adequate perfusion, the nurse monitors: A. Distal pulses. B. Skin turgor. C. Urine output. D. Mucous membranes.

C. Urine output.

Burn shock results from: a. hypovolemia. b. sepsis. c. toxins. d. metabolic acidosis.

a. hypovolemia

The depth of a burn that appears red to pale ivory, with a moist surface and fluid-filled blisters, is most likely: a. superficial. b. superficial partial thickness. c. deep partial thickness. d. full thickness

b. superficial partial thickness.

The depth of a burn injury may be classified as a. localized or systemic. b. superficial, superficial partial thickness, deep partial thickness, or full thickness. c. electrical, chemical, or thermal. d. minor, moderate, or major.

b. superficial, superficial partial thickness, deep partial thickness, or full thickness.

Assessment of a child with nits would reveal: a. very small black bugs jumping throughout the hair. b. white specks firmly attached to the hair shaft. c. small flakes, resembling dandruff, that are easily removed from the hair. d. clusters of nits at the crown of the head and front hairline

b. white specks firmly attached to the hair shaft.

A burned child is in the emergency department. The nurse calculates the fluid requirement for the next 24 hours to be 2700 mL. At what rate does the nurse set the pump for initially? a. 50 mL/hour b. 100 mL/hour c. 152.1 mL/hour d. 168.8 mL/hour

d. 168.8 mL/hour

The process of burn shock continues until what physiologic mechanism occurs? a. Heart rate returns to normal. b. Airway swelling decreases. c. Body temperature regulation returns to normal. d. Capillaries regain their seal.

d. Capillaries regain their seal.

The school nurse is educating a group of elementary school teachers about ringworm (tinea capitis). Which explanation of the condition by the nurse is best? a. It is a sign of uncleanliness. b. The patient should recover spontaneously without interventions c. It is self-limiting and not contagious. d. It is spread by direct and indirect contact.

d. It is spread by direct and indirect contact.

What should the nurse teach parents about skin care for the child with atopic dermatitis? a. After bathing, apply moisturizing cream when the skin has been thoroughly dried. b. Avoid clothing made of cotton and polyester because these materials are irritating. c. Dress the child warmly at bedtime to prevent itching due to coldness. d. Moisturizing creams can be applied whenever the skin looks dry

d. Moisturizing creams can be applied whenever the skin looks dry

When taking a history on a child with a possible diagnosis of cellulitis, what should bethe priority nursing assessment to help establish a diagnosis? a. Any pain the child is experiencing b. Enlarged, mobile, and nontender lymph nodes c. Child's urinalysis results d. Recent infections or signs of infection

d. Recent infections or signs of infection

What is the most common cause of burn injuries in children younger than 3 years? a. Flame. b. Electrical. c. Chemical. d. Scald

d. Scald

Assessment of the skin of a child with allergic derma-titis is likely to reveal: a. keratosis. b. ecchymoses. c. lichenification. d. pruritus.

d. pruritus.

true or false Impetigo is manifested as small red macules and vesicles that become pustules around the cheek and the mouth

true

true or false Poison Ivy is contact dermatitis as a result from exposure to the oil urushiol in the plant?

true

Where do the lesions of atopic dermatitis most commonly occur in the infant (Select all that apply)? A. Cheeks B. Buttocks C. Extensor surfaces of arms and legs D. Back E. Trunk F. Scalp

A. Cheeks C. Extensor surfaces of arms and legs E. Trunk F. Scalp

the management of a child who has just been stung by a bee or wasp should include the application of: A. Cool compresses. B. Warm compresses. C. Antibiotic cream. D. Corticosteroid cream.

A. Cool compresses.

Hydrotherapy is required to treat a child with extensive partial-thickness burn wounds. Which is the primary purpose of hydrotherapy? A. Debride the wounds. B. Increase peripheral blood flow. C. Provide pain relief. D. Destroy bacteria on the skin.

A. Debride the wounds.

The only symptom of pediculosis capitis (head lice) is usually: A. Itching. B. Vesicles. C. Scalp rash. D. Localized inflammatory response.

A. Itching.

the most immediate threat to life in children with thermal injuries is: A. Shock. B. Anemia. C. Local infection. D. Systemic sepsis.

A. Shock.

The nurse is examining 12-month-old Amy, who was brought to the clinic for persistent diaper rash. The nurse finds perianal inflammation with satellite lesions that cross the inguinal folds. This is most likely caused by: A. Impetigo. B. Candida albicans. C. Urine and feces. D. Infrequent diapering.

B. Candida albicans.

Ringworm, frequently found in schoolchildren, is caused by: A. Virus. B. Fungus. C. Allergic reaction. D. Bacterial infection.

B. Fungus.

A toddler sustains a minor burn on the hand from hot coffee. The first action in treating this burn is to: A. Apply ice to burned area. B. Hold the burned area under cool running water. C. Break any blisters with a sterile needle. D. Clean the wound with soap and warm water.

B. Hold the burned area under cool running water.

An important nursing consideration when caring for a child with impetigo contagiosa is to: A. Apply topical corticosteroids to decrease inflammation. B. Carefully remove dressings so as not to dislodge undermined skin, crusts, and debris. C. Carefully wash hands and maintain cleanliness when caring for an infected child. D. Examine child under a Wood's lamp for possible spread of lesions.

C. Carefully wash hands and maintain cleanliness when caring for an infected child.

Which of the following best describes a full-thickness (third-degree) burn? A. Erythema and pain B. Skin showing erythema followed by blister formation C. Destruction of all layers of skin evident with extension into subcutaneous tissue D. Destruction injury involving underlying structures such as muscle, fascia, and bone

C. Destruction of all layers of skin evident with extension into subcutaneous tissue

One of the first signs of overwhelming sepsis in a child with burn injuries is: A. Seizures. B. Bradycardia. C. Disorientation. D. Decreased blood pressure.

C. Disorientation

Tretinoin (Retin-A) is a topical agent commonly used to treat acne. Nursing considerations with this drug include: A. Avoiding use of sunscreen agents. B. Using cosmetics with lanolin and petrolatum. C. Explaining that medication should not be applied until at least 20 to 30 minutes after washing. D. Explaining that erythema and peeling are indications of toxicity.

C. Explaining that medication should not be applied until at least 20 to 30 minutes after washing.

which physiologic change causes the edema formation that occurs with burns? A. Vasoconstriction B. Decreased capillary permeability C. Increased capillary permeability D. Decreased hydrostatic pressure within capillaries

C. Increased capillary permeability

Nursing care of the infant with atopic dermatitis focuses on: A. Feeding a variety of foods. B. Keeping lesions dry. C. Preventing infection. D. Using fabric softener to avoid rough cloth.

C. Preventing infection.

The primary clinical manifestation of scabies is: A. Edema. B. Redness. C. Pruritus. D. Maceration.

C. Pruritus.

The nurse is talking to the parents of a child with pediculosis capitis. Which should the nurse include when explaining how to manage pediculosis capitis? A. "You will need to cut the hair shorter if infestation and nits are severe." B. "You can distinguish viable from nonviable nits, and remove all viable ones." C. "You can wash all nits out of hair with a regular shampoo." D. "You will need to remove nits with an extra-fine tooth comb or tweezers."

D. "You will need to remove nits with an extra-fine tooth comb or tweezers."

Which statement regarding atopic dermatitis (eczema) in the infant is most accurate? A. It is easily cured. B. It is worse in humid climates. C. It is associated with upper respiratory tract infections. D. It is associated with allergy with a hereditary tendency.

D. It is associated with allergy with a hereditary tendency.

Cellulitis is often caused by: A. Herpes zoster. B. Candida albicans. C. Human papillomavirus. D. Streptococcus or Staphylococcus organisms.

D. Streptococcus or Staphylococcus organisms.

Which prescribed treatment should the nurse plan to implement for a child with psoriasis? A. Antihistamines B. Oral antibiotics C. Topical application of calamine lotion D. Tar and exposure to sunlight and ultraviolet light

D. Tar and exposure to sunlight and ultraviolet light

The nurse should expect to assess which causative agent in a child who has warts? A. Bacteria B. Fungus C. Parasite D. Virus

D. Virus

When assessing the child with atopic dermatitis, the nurse should ask the parents about a history of which of the following? a. Asthma b. Nephrosis c. Lower respiratory tract infections d. Neurotoxicity

a. Asthma

A nurse working in a trauma center would facilitate referrals to a burn center for which of the following children? (Select all that apply.) a. Electrical burn b. Chemical burn c. Burn from child abuse d. Burn in the perineal area e. 5% second-degree burn

a. Electrical burn b. Chemical burn d. Burn in the perineal area

Which medication is appropriate for the treatment of tinea capitis? a. Griseofulvin orally for 6 to 8 weeks b. Lotrimin cream to affected areas thrice a day until lesions are healed c. Tinactin spray twice a day to the affected lesions d. Penicillin four times a day for 10 days

a. Griseofulvin orally for 6 to 8 weeks

A child has small red macules and vesicles that become pustules around the child's mouth and cheek. Older lesions are crusted and honey-colored. What should the nurse teach the parents about this condition? a. Keep the child home from school for 24 hours after starting antibiotics. b. Clean the rash vigorously with Betadine three times a day. c. Notify the physician for any itching. d. Keep the child home from school until the lesions are healed.

a. Keep the child home from school for 24 hours after starting antibiotics.

When changing an infant's diaper, the nurse notices small bright red papules with satellite lesions on the perineum, anterior thigh, and lower abdomen. This rash is characteristic of a. candidiasis. b. irritant contact dermatitis. c. intertrigo. d. seborrheic dermatitis.

a. candidiasis.

The nurse is caring for a 12-year-old boy who sustained major burns when putting charcoal lighter on a campfire. The nurse observes that boy is "very brave" and appears to accept pain with little or no response. Based on the nurse's knowledge of burns, pain, and age-specific development, what is the most appropriate nursing action? a. talk with the health care provider about the possibility of requesting a psychological consultation. b. Encourage continued bravery as a coping strategy. c. praise the child frequently for his ability to deal with the pain. d. Spend time with the child to better understand why he doesn't seem to respond to pain

a. talk with the health care provider about the possibility of requesting a psychological consultation.

The nurse is caring for an infant with recurrent atopic dermatitis (eczema). What information would the nurse expect to see in the infant's history? a. the infant has several allergies similar to her mother. b. the infant recently traveled to a humid climate. c. It last happened in the summer. d. The infant had an upper respiratory infection a week ago.

a. the infant has several allergies similar to her mother.

The nurse is reviewing the orders for a child with cellulitis. What would the nurse expect to see ordered for this patient? a. Incision and drainage of cellulitis lesions covering a wide area b. Administration of oral or parenteral antibiotics for several days c. Topical application of an antibiotic cream to the involved area d. Damp to dry compresses using Burow's solution

b. Administration of oral or parenteral antibiotics for several days

The pediatric office nurse is giving instructions to a parent whose child has scabies. What information should the school nurse include? a. Notify your health care practitioner so an antibiotic can be prescribed. b. Be prepared for symptoms to last 2 to 3 weeks. c. treat all of the family members if symptoms develop. d. carefully treat only those areas where there is a rash.

b. Be prepared for symptoms to last 2 to 3 weeks.

A group of teenage boys have just gotten on the basketball team and will be showering in the school's locker room after practice. What suggestions should the school nurse provide to these adolescents to decrease the chance of contracting athlete's foot (tinea pedis)? (Select all that apply.) a. Wear your practice shoes home. b. Bring your own soap and towel, and don't share them with others. c. change your socks every other day when not practicing. d. Dry your feet completely. e. Make sure your shoes are thoroughly dry before wearing them. f. Use talcum powder or antifungal powder to keep your feet dry.

b. Bring your own soap and towel, and don't share them with others. d. Dry your feet completely. e. Make sure your shoes are thoroughly dry before wearing them. f. Use talcum powder or antifungal powder to keep your feet dry.

The nurse is teaching adolescents about the management of acne. What should the nurse include in the discussion? a. Avoid foods with a high fat content, such as French fries and chocolate b. Clean the face gently with a mild soap twice each day. c. Express comedones by gentle squeezing; then cleanse with alcohol. d. Clean the face with an antibacterial soap twice each day

b. Clean the face gently with a mild soap twice each day.

Parents of a child with lice infestation should be instructed carefully in the use ofantilice products because of which potential side effect? a. Nephrotoxicity b. Neurotoxicity c. Ototoxicity d. Bone marrow depression

b. Neurotoxicity

Which action is appropriate for the prevention of diaper dermatitis? a. Apply medicated powder to the perineum after each diaper change. b. Wash the diaper area with a mild soap and water after each voiding or bowel movement. c. Keep the diaper area open to air during rest periods. d. Change diapers at least every 4 hours.

b. Wash the diaper area with a mild soap and water after each voiding or bowel movement.

A child cut his hand a few days ago. Now the area is swollen and painful, and a red streak extends from it up to the forearm. These are signs of: a. impetigo. b. cellulitis. c. contact dermatitis. d. eczema.

b. cellulitis.

What should an adolescent female with severe acne know about Accutane before treatment is initiated? a. She will need to use sunscreen to reduce photosensitivity. b. Accutane can cause menstrual irregularities. c. Accutane is teratogenic if taken during pregnancy. d. Exposure to sunlight should be avoided while taking Accutane

c. Accutane is teratogenic if taken during pregnancy.

What is the first priority when initiating treatment on a child with a major burn injury? a. Fluid resuscitation. b. Prevention of sepsis. c. Airway assessment. d. Correcting metabolic imbalances

c. Airway assessment.

The nurse is applying wet dressings on the skin. What procedure would be correct for the nurse to use? a. Apply the dressing so that the area is totally immobilized. b. Pour the desired solution on soft gauze and then squeeze the gauze to remove excess liquid prior to putting it on the skin. c. Apply the dressing when it is saturated and dripping. d. Pour new solution over a dressing that has become dry, or apply solution with a syringe.

c. Apply the dressing when it is saturated and dripping.

What best describes a full-thickness (third- degree)burn? a. Erythema and pain b. Skin showing erythema followed by blister formation c. Destruction of all layers of skin evident with extension into subcutaneous tissue d. Destruction injury involving underlying structures such as muscle, fascia, and bone

c. Destruction of all layers of skin evident with extension into subcutaneous tissue

A child has painful, fluid-filled vesicles on the upper lip. What medication does the nurse anticipate teaching parents about? a. Corticosteroids b. Oral griseofulvin c. Oral antiviral agent d. Topical antibiotic

c. Oral antiviral agent

The school nurse is seeing a child who brought poison ivy to school in his leaf collection. The child says, "It only touched my hands." What is the initial nursing action? a. Soak the child's hands in warm water. b. Scrub the child's hands thoroughly with antibacterial soap c. Rinse the child's hands in cold, running water. d. Apply compresses using Burow's solution.

c. Rinse the child's hands in cold, running water.

the stinger from a honeybee should be removed by a. squeezing it out of the skin b. using tweezers to lift it out c. scraping it out horizontally d. applying heat to draw out the stinger

c. scraping it out horizontally