Integumentary disorders PREPU

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A child has been hospitalized with a diagnosis of severe impetigo. The nurse is interviewing the family. Which question will have the greatest impact on the child's care?

"Does your child have any allergies to medications?"

The parent of a child with deep partial-thickness (second-degree) burns on the legs asks the nurse, "One of the staff told me that the dressings being used have silver in them. Why is that?" Which response by the nurse would be most appropriate?

"Dressings containing silver help prevent infection."

When providing care for a child with herpes zoster (shingles), the parents ask the nurse how the child contracted this infectious disorder. Which response by the nurse is most appropriate?

"Herpes zoster is a reactivation of a previous varicella zoster infection."

A 4-year-old is brought to the urgent care center for evaluation of a burn on the forearm. On inspection, the burn is minor. After teaching the parents about how to care for this minor burn. the nurse determines that the teaching was successful based on which statement by the parents?

"If blisters form, we should leave them alone and not break them."

The nurse is assessing the skin of a 6-year-old child with urticaria. When interviewing the child and parents, which question would be most important for the nurse to ask?

"Is the child having any trouble breathing?"

The nurse is teaching the parents of a 7-year-old child who was exposed to an adolescent infected with measles about 2 weeks ago. The child has not been immunized. Which statement by the parents requires further follow up by the nurse?

"It has been 14 days since the exposure, so my child is not infected."

A new parent brings the 3-month-old infant to the clinic for a well-baby check up. During the visit, the parent asks the nurse, "I know the rays from the sun can be harmful, so what should I do to protect my infant?" Which suggestion by the nurse would be most appropriate?

"The best thing to do is keep any infant under the age of 6 months out of the sun."

The nurse is teaching the parents of a child diagnosed with erythema multiforme about the condition. The nurse determines that the teaching was successful based on which statement by the parents?

"The rash should go away in about 2 weeks."

The nurse is teaching the parents of a 5-year-old child diagnosed with head lice about using permethrin. The nurse determines that the teaching was successful based on which statement by the parents?

"We need to leave the medication on for about 10 minutes before rinsing it off."

A parent calls the pediatric clinic and tells the nurse that the child has developed a large rash. Which question is most important for the nurse to ask the parent?

"What more can you tell me about the rash?"

A school-aged child is recovering from varicella. The parent calls the school nurse and states, "my child is feeling much better" and asks when the child can return to school. What information does the nurse provide the parent?

"Your child may return to school when all of the lesions have crusted over."

A child weighing 66 lb (30 kg) with deep partial thickness burns is receiving fluid resuscitation. The nurse is monitoring the child's urine output via Foley catheter every hour and documenting the findings on the flowsheet above. The nurse would notify the health care provider about which urine output?

56 ml

A nurse is providing care to an infant who is admitted with burns over the face, neck and chest. The nurse identifies which goal as priority for planning the infant's care?

Airway remains patent.

The nurse is preparing to perform a dressing change for a 9-year-old child with a severe burn injury. What nonpharmacologic intervention(s) will the nurse perform to decrease pain and discomfort for the child? Select all that apply.

Allow the child to choose means of distraction. Provide positive feedback. Allow the child to choose where on the body to start procedure.

A nurse is providing care to a 3-year-old child hospitalized with second-degree (partial-thickness) and deep partial-thickness burns to the dorsal portion of both legs. The nurse is preparing to change the child's dressings. Which action(s) should the nurse take to elicit the child's cooperation in the dressing change? Select all that apply.

Allow the child to decide which leg's dressing to change first. Permit the child to choose a method of distraction. Encourage the parent to hold the child's hand during the dressing change.

The nurse is teaching the parents of a 7-year-old child on preventing integumentary disorders. What will the nurse include in the teaching? Select all that apply.

Apply sunscreen to your child. Teach your child to recognize and avoid poison oak. Teach your child to not approach strange pets without permission. Learn to identify infestations such as lice, scabies, and bed bugs.

The nurse is caring for an 11-year-old child with a primary open skin lesion. What action(s) will the nurse include in the plan of care to prevent infection in the child? Select all that apply.

Assess for increased warmth around the wound. Teach hand hygiene to the child and parents. Advise the child not to scratch the affected area.

A child is hospitalized with a diagnosis of severe cellulitis. The nurse is preparing the family for discharge. Which instruction is most important for the nurse to convey to the family?

Complete the prescribed antibiotics.

A parent is observing a nurse provide care for the parent's 2-year-old toddler who was burned in a house fire. When the nurse is finished, the parent tells the nurse "I cannot believe this has happened. I should have been able to prevent this from happening." What is the best action for the nurse to take?

Encourage the parent to talk more about feelings.

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?

Explain that children who have had a serious injury sometimes exhibit regressive behavior.

When describing measles to a local parent group, the nurse explains that which of the following is the hallmark clinical manifestation?

Koplik spots

An infant is seen in the emergency department with several raised red welts over the abdomen and lower extremities. The parent states that the symptoms developed suddenly over the past few hours. The infant is fussy and has a low grade temperature. What assessment is most important for the nurse to perform?

Observe the infant's respiratory effort.

An adolescent is brought to the urgent care clinic for evaluation of the hands. The adolescent had been out snowboarding for the past several hours in 20°F (-6.7°C) temperatures. The adolescent was wearing gloves but took them off because they were wet and causing problems with holding onto the snowboard. The nurse completes an assessment and documents the findings. Based on the assessment findings above, which action would be appropriate as part of the plan of care?

Place the hands in warm water for 30 minutes.

After teaching a group of nursing students about varicella zoster infection, the instructor determines that the teaching was successful when the students identify which of the following?

Secondary bacterial infections of the skin can occur as a complication.

The nurse is administering a chickenpox vaccination to a 12-month-old girl. Which concern is unique to varicella?

This disease can reactivate years later and cause shingles.

A nurse is assessing a child brought to the clinic because of swelling on one side of the face. The nurse assesses the swelling by placing a hand along the child's jawline. The nurse suspects that the child has parotitis because most of the swelling occurs at which location?

above the nurse's hand

A 7-year-old child is brought to the emergency department after suffering a burn injury. The nurse would expect the child to be transferred and admitted to the burn center based on which finding(s)? Select all that apply.

history of type 1 diabetes since age 3 burns affecting the child's face and hands evidence of smoke inhalation injury demonstration of full-thickness (third-degree) burns on trunk

A 5-year-old child is brought to the pediatric health clinic for evaluation. The nurse completes the assessment and documents the findings. Based on the assessment findings above, which condition would the nurse suspect?

measles

A nurse is preparing a presentation for a group of parents of toddlers at the local community center. The topic of the presentation is burn prevention. When describing burns in toddlers, which situation would the nurse likely identify as the most common cause of thermal burns?

scalding from pulling a hot pan off the stove

The parents of a child diagnosed with varicella are concerned about their other children getting it. The nurse instructs the parents that their child is contagious for how much longer now that the rash has appeared?

until there are no more new lesions and lesions have crusted over

The nurse is providing care to a 5-year-old child brought to the emergency department with a cat bite wound on the arm. While teaching the parents how to care for the wound, the child's mother asks the nurse, "Why isn't the bite being stitched closed?" Which response by the nurse would be appropriate?

"Bites from cats are likely to become infected, so it is better to leave the wound open and heal from the inside out."

A nurse is teaching a group of parents about burn safety. Which statement made by a parent requires intervention by the nurse?

"I had our plumber lower our water heater temperature to 130°F (53°C).

Head lice infestations have occurred in several of the elementary schools in the surrounding area. The local school district has asked the nurse to conduct a presentation for parents at the community center about this condition. When preparing this presentation, which information is appropriate for the nurse to include? Select all that apply.

Head lice is mainly spread through play. Head lice can happen in anyone. It is easier to remove nits from wet hair.

A 7-year-old child with an earache comes to the clinic. The child's parent reports that 1 day ago the child had a fever and headache and did not want to play. When the nurse asks where it hurts, the child points to the jawline in front of the earlobe. What does the nurse expect the diagnosis will be for this child?

Mumps


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