Integumentary

The mother of a 3-year-old child arrives at a clinic and tells the nurse that the child has been scratching the skin continuously and has developed a rash. The nurse assesses the child and suspects the presence of scabies. The nurse bases this suspicion on which finding noted on assessment of the child's skin? A. Fine grayish-red lines B. Purple colored lesions C. Thick, honey colored crusts D. Clusters of fluid-filled vesicles

A

Which would be the priority intervention for a child suspected of having varicella (chickenpox)? A. Contact precautions B. Contact and droplet respiratory precautions C. Droplet respiratory precautions D. Universal precautions and standard precautions

B

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

C

In order to increase compliance with the acne treatment regimen for a teenager, the nurse should include what information in the education plan? A. Teenagers must be responsible for their own treatment and must be trusted to follow through and be compliant. B. It often takes up to 12 weeks to see an improvement and a response to treatment. C. Apply sunscreen every morning and anti-acne medication every night. D. Teach parents to praise the good habits of the teenager.

B

The nurse is monitoring a child with burns during treatment for burn shock. The nurse recognizes that which assessment provides the most accurate guide to determine the adequacy of fluid resuscitation? A. Skin turgor B. Neurological assessment C. Level of edema at the burn site D. Quality of peripheral pulses

B

Which would be a priority intervention for a child diagnosed with varicella (chickenpox) who was prescribed diphenhydramine (Benadryl) for itching? A. Give a warm bath with mild soap before lotion application. B. Avoid Caladryl lotion while taking diphenhydramine (Benadryl). C. Apply Caladryl lotion generously to decrease itching. D. Give a cool shower with mild soap to decrease itching.

B

Which assessment of an 18-month-old with burns on his feet would cause suspicion of child abuse? A. Splash marks on his right lower leg B. Burns noted on right arm C. Symmetrical burns on both feet D. Burns mainly noted on right foot

C

Which of the following explains physiologically the edema formation that occurs with burns? A. Vasoconstriction B. Decreased capillary permeability C. Increased capillary permeability D. Decreased hydrostatic pressure within capillaries

C

The clinic nurse is reviewing the health provider's prescription for a child who has been diagnosed with scabies. Lindane has been prescribed for the child. The nurse questions the prescription if which is noted in the child's record? A. The child is 18 months old. B. The child is being bottle fed. C. A sibling is using Lindane for the treatment of scabies. D. The child has a history of frequent respiratory infections.

A

When assessing the history of a child recently diagnosed with atopic dermatitis, which question is important to ask the parents? A. "Does your child have any allergies to foods or other substances?" B. "Has your child ever had these symptoms before?" C. "Has your child had any cystic lesions?" D. "Are your child's immunizations up to date?"

A

The school nurse has provided an instructional session about impetigo to parents of the children attending the school. Which statement, if made by a parent indicates a need for further instruction? A. "It is extremely contagious." B. "It is common in humid weather." C. "Lesions are located on the back, abdomen, and extensor surfaces." D. "It might start up in an area of broken skin, such as an insect bite."

C

The nurse is planning care for a 3-month-old infant with eczema. Which intervention would take the highest priority? A. Maintaining adequate hydration B. Keeping the baby content C. Preventing infection of the lesions D. Applying antibiotics to lesions

C

A toddler sustains a minor burn on the hand from hot coffee. What would be the first action in treating this burn? A. Apply ice to the burned area. B. Hold burned area under cool running water. C. Break any blisters with a sterile needle. D. Apply an antimicrobial ointment.

B

An adolescent girl is cooking on a gas stove when her bathrobe catches fire. Her father smothers the flames with a rug and calls an ambulance. She has sustained major burns over much of her body. Which of the following is also important in her immediate care? A. Wrap her in a blanket until help arrives. B. Encourage her to drink clear liquids. C. Place her in a tub of cool water. D. Remove her burned clothing and jewelry.

A

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

A

The nurse caring for a child who has sustained a burn injury plans care based on which pediatric considerations associated with this injury? Select all that apply. A. Scarring is less severe in a child than an adult. B. A delay in growth may occur after a burn injury. C. An immature immune system presents an increased risk of infection for infants and young children. D. The lower portion of body fluid to mass in a child increases the risk of cardiovascular problems. E. Fluid resuscitation is unnecessary unless the burned area is more than 25% of the total body surface area. F. Infants and young children are at increased risk for protein and calorie deficiency because they have smaller muscle mass and less body fat than adults.

B,C,F

A 6-year-old child is having burn care following premedication for pain. The child is not cooperative for dressing changes and begins screaming and kicking. What is the best action by the nurse? A. Inform the child that cooperation is necessary for proper healing and will shorten the hospital stay. B. Allow the parents to change the dressings with coaching from the nurse. C. Allow the child to participate in the dressing change process as much as possible. D. Inform the child that restraints will be used if there is no copperation.

C

A topical corticosteroid is prescribed by the health are provider of a child with atopic dermatitis (eczema). Which instruction should the nurse give the parent about applying the cream? A. Apply the cream over the entire body. B. Apply a thick layer of cream to the affected areas only. C. Avoid cleansing the area prior to application of the cream. D. Apply a thin layer of cream and rub it into the area thoroughly.

D

Permethrin (Elemite) is prescribed for a child with the diagnosis of scabies. The nurse should give which instruction to the parents regarding the use of this treatment? A. Apply the lotion to areas of the rash only. B. Apply the lotion to affected areas and leave it on for 6 hours. C. Avoid putting clothes on the child over the lotion. D. Apply the lotion to cool, dry skin at least 30 minutes after bathing.

D

The school nurse is conducting pediculosis capitis (head lice) assessments. Which finding indicates a child has a "positive" head check? A. Maculopapular lesions behind the ears B. Lesions in the scalp that extend to the hairline or neck. C. White, flaky particles throughout the entire scalp area. D. White sacs attached to the hair shafts in the occipital area.

D